Autonomic functions in Attention-deficit/hyperactivity disorder (ADHD) before and after Methylphenidate
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
ADHD is associated with autonomic dysfunction which gets further modulated with drug therapy. There are few prospective studies to evaluate the changes of Autonomic Function Tests before and after methylphenidate treatment in drug-naive patients with ADHD. The present study was conceived with the objective to study autonomic functions in children with Attention-deficit/hyperactivity disorder (ADHD) before and after treatment with Methylphenidate. Autonomic function tests were conducted on 52 drug-naive patients with ADHD. The patients then received methylphenidate medication for 12 weeks. The above parameters were repeated at 12 weeks of study period. On the Sympathetic reactivity tests, the increase in Systolic blood pressure and diastolic blood pressure on exposure to cold (Cold Pressor test) and sustained handgrip (Handgrip test) was significantly higher after Methylphenidate treatment which can be attributed to an activation of the sympathetic nervous system. The parasympathetic reactivity tests showed that there was a significant decrease of E: I ratio (Deep Breathing Test) after methylphenidate treatment. Changes in heart rate during deep breathing reflect parasympathetic modulation. However, there was no significant changes in 30:15 ratio (Heart response to standing). Hence methylphenidate increases the sympathetic domination, and reduces the parasympathetic domination, and tilts the sympathovagal balance towards the sympathetic arm.
Authors and Affiliations
Pramesh Dogra, Rajiv Bandhu, Sunita Mondal, Dinesh Kataria, Om Sai Ramesh V
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