Key result
Children with ADHD prior to methylphenidate had significantly lower rMSSD compared to healthy controls (26 vs 44 ms, P≤0.0001), which improved to 36 ms during methylphenidate treatment.
Why the study?
Does methylphenidate improve autonomic dysfunction measured by heart rate variability in children with ADHD?
Observational (n=50)
Does methylphenidate improve autonomic dysfunction measured by heart rate variability in children with ADHD?
Absolute Event Rate: 26% vs 44%
p-value: p=≤0.0001
In a pilot study, children with ADHD exhibited diminished vagal tone that improved with methylphenidate treatment, suggesting a potential protective autonomic effect rather than a proarrhythmic one.
May indicate methylphenidate-associated vagal improvement in ADHD; hypothesis-generating and should not yet change practice.
Background. Although stimulants have long been touted as treatments for attention deficit disorder with or without hyperactivity (ADHD), in recent years, increasing concerns have been raised about the cardiovascular safety of these medications. We aimed to prove if measurements of autonomic function with time domain analysis of heart rate variability (HRV) in 24-hour Holter ECG are useful to predict the risk of sudden cardiac death in ADHD children and adolescents. Methods. We analysed HRV obtained from children with the diagnosis of ADHD prior to (N = 12) or during medical therapy (N = 19) with methylphenidate (MPH), aged 10.8 ± 2.0 years (mean ± SD), who were referred to our outpatient Paediatric Cardiology Clinic to rule out heart defect. As a control group, we compared the HRV data of 19 age-matched healthy children without heart defect. Results. Average HRV parameters from 24-hour ECG in the ADHD children prior to MPH showed significant lower values compared to healthy children with respect to rMSSD (26 ± 4 ms versus 44 ± 10 ms, P ≤ 0.0001) and pNN50 (6.5 ± 2.7% versus 21.5 ± 9.0%, P ≤ 0.0001). These values improved in MPH-treated children with ADHD (RMSSD: 36 ± 8 ms; pNN50: 14.2 ± 6.9%). Conclusion. Children who suffer from ADHD show significant changes in HRV that predominantly reflects diminished vagal tone, a well-known risk factor of sudden cardiac death in adults. In our pilot study, MPH treatment improved HRV.
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Buchhorn et al. (2012) conducted an observational in Attention Deficit Disorder (ADHD) (n=50). Methylphenidate (MPH) vs. Prior to therapy and healthy controls was evaluated on rMSSD (ms) in ADHD children prior to MPH versus healthy children (p=≤0.0001). Children with ADHD prior to methylphenidate had significantly lower rMSSD compared to healthy controls (26 vs 44 ms, P≤0.0001), which improved to 36 ms during methylphenidate treatment.
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