背景：成人注意力缺陷多动障碍（aADHD）的特征是注意力不集中，多动症,冲动,和情绪不稳定，所有这些都与自主神经系统调节的改变有关。这和拟交感神经药物的临床有效性提出了一个问题，即aADHD患者的自主神经调节是否改变。方法：我们系统地搜索了PubMed，科克伦图书馆,和WebOfScience的出版物研究aADHD和控制在静息状态和/或任务条件下的自主神经调节。结果：我们回顾了15项研究，涉及846名参与者（424名aADHD和422名对照）。包括4项关于静息交感神经的研究，13项关于任务过程中交感神经调制的研究，3篇静息状态副交感神经调制研究和3篇任务相关副交感神经调制论文。研究包括皮肤电活动的测量，心率变异性,血压变异性,血容量脉搏,喷射前阶段，和压力反射敏感性。2项研究报告aADHD患者交感神经张力降低；7篇论文描述了该队列中对任务需求的交感神经反应性降低。一项研究将aADHD与迷走神经张力受损联系起来，而没有迹象表明在aADHD患者中与任务相关的副交感神经反应性发生改变。结论：审查的数据显示aADHD患者的心血管自主神经调节受损，主要在交感神经调制和压力暴露期间。
Background: Adult Attention Deficit Hyperactivity Disorder (aADHD) is characterised by inattention, hyperactivity, impulsivity, and emotional instability, all of which were linked to altered modulation of the autonomic nervous system. This and the clinical effectiveness of sympathomimetic medication raised the question if autonomic modulation is altered in aADHD patients.Methods: We systematically searched PubMed, Cochrane Library, and Web Of Science for publications investigating autonomic modulation in aADHD and controls during resting-state and/or under task conditions.Results: We reviewed 15 studies involving 846 participants (424 aADHD and 422 controls), including 4 studies on sympathetic tone at rest, 13 studies on sympathetic modulation during tasks, 3 studies on resting state parasympathetic modulation and 3 papers on task-related parasympathetic modulation. Studies comprised measurements of electrodermal activity, heart rate variability, blood pressure variability, blood volume pulse, pre-ejection period, and baroreflex sensitivity. 2 studies reported reduced sympathetic tone in aADHD; 7 papers described lower sympathetic reactivity to task demands in this cohort. One study linked aADHD to impaired vagal tone, while no indications of altered tasks-related parasympathetic reactivity in aADHD patients were reported.Conclusion: The reviewed data revealed impaired cardiovascular autonomic modulation in aADHD patients, predominantly in sympathetic modulation and during stress exposure.
