Abstract:
We carried out a systematic review and meta-analysis to investigate the effects of stimulant and non-stimulant medications on autonomic functioning in people with ADHD (PROSPERO: CRD42020212439). We searched (9th August 2021) PsycInfo, MEDLINE, EMBASE, Web of Science and The Cochrane Library, for randomised and non-randomised studies reporting indices of autonomic activity, (electrodermal, pupillometry and cardiac), pre- and post-medication exposure in people meeting DSM/ICD criteria for ADHD. In the narrative syntheses, we included 5 electrodermal studies, 1 pupillometry study and 57 studies investigating heart rate and blood pressure. In the meta-analyses, 29 studies were included on blood pressure and 32 on heart rate. Administration of stimulants, and to a lesser degree, non-stimulants increased heart rate and blood pressure in people with ADHD. Similarly, an upregulation of arousal, reflected in increased electrodermal activity and pupil diameter was observed following stimulant use. Yet, the methodological diversity of studies presented in this review reinforces the need for more standardised and rigorous research to fully understand the relationship between arousal, medication, and behaviour in ADHD.
摘要:
我们进行了系统评价和荟萃分析,以研究兴奋剂和非兴奋剂药物对ADHD患者自主神经功能的影响(PROSPERO:CRD42020212439)。我们搜索(2021年8月9日)PsycInfo,MEDLINE,EMBASE,WebofScience和Cochrane图书馆,对于报告自主活动指数的随机和非随机研究,(皮肤电,瞳孔测量和心脏),符合DSM/ICDADHD标准的患者用药前后暴露。在叙事综合中,我们纳入了5项皮肤电研究,1个瞳孔测量研究和57个研究心率和血压。在荟萃分析中,包括29项关于血压的研究和32项关于心率的研究。兴奋剂的管理,在较小的程度上,非兴奋剂会增加ADHD患者的心率和血压。同样,唤醒的上调,在使用兴奋剂后,观察到皮肤电活动和瞳孔直径增加。然而,本综述中提出的研究的方法多样性加强了对更标准化和严谨的研究的需要,以充分理解唤醒之间的关系,药物,和多动症的行为。