Methylphenidate Improves Autonomic Functioning among Youth with Attention-Deficit/Hyperactivity Disorder

Abstract

Psychostimulants are commonly prescribed medications for youth with attention-deficit/hyperactivity disorder (ADHD). Limited studies have evaluated how psychostimulants (e.g., methylphenidate [MPH]) impact autonomic nervous system (ANS) indexes among youth with ADHD. Understanding the effects of MPH on autonomic functioning is essential, given that youth with ADHD have been shown to experience atypical autonomic functioning (i.e., reduced activity across both sympathetic and parasympathetic branches) compared to typically developing youth. The current study investigated how a specific psychostimulant, Osmotic Release Oral System [OROS] MPH, impacts parasympathetic (indexed by respiratory sinus arrhythmia [RSA]) and sympathetic (indexed by electrodermal activity [EDA]) functioning among youth with ADHD via a within-subjects, double-masked, cross-over design. Two hundred fifty-six participants (157 youth with ADHD), ages 5 to 13 years, completed a two-minute resting baseline task while electrocardiograph and electrodermal data were obtained. Youth with ADHD completed the resting baseline task twice, 3 weeks apart, once during active medication and once during placebo conditions (counterbalanced). Typically developing youth were assessed without medication or placebo. Youth with ADHD during the placebo condition exhibited reduced RSA and EDA compared to typically developing youth. In contrast, youth with ADHD during the medication condition did not differ significantly from typically developing youth with respect to either RSA nor EDA. As such, OROS MPH appears to normalize RSA and EDA levels among youth with ADHD to levels comparable to typically developing youth. Future studies including indexes of the ANS among youth with ADHD are urged to consider the impact of MPH.

Keywords: Attention-deficit/hyperactivity disorder; Electrodermal activity; Methylphenidate; Respiratory sinus arrhythmia.

Fig. 1

(A) Respiratory sinus arrhythmia (RSA) activity during rest for typically developing youth (TD), as well as youth with attention-deficit/hyperactivity disorder (ADHD) during placebo and medication conditions. Error bars represent standard deviation. Covariates not included in graphed analyses. (B) RSA activity during rest for TD and ADHD youth during placebo and medication conditions. Error bars represent standard error, while * indicates p < .05 for respective analyses. Covariates within analyses included youth’s sex, comorbidities (e.g., anxiety, conduct disorder [CD], and oppositional defiant disorder [ODD]), and session in which youth with ADHD were enrolled in the placebo condition. During analyses with youth with ADHD during the medication condition, dosage of Osmotic Release Oral System Methylphenidate (OROS MPH) was included as an additional covariate

Fig. 2

(A) Electrodermal activity (EDA) levels during rest for typically developing youth (TD), as well as youth with attention-deficit/hyper-activity disorder (ADHD) during placebo and medication conditions. Error bars represent standard deviation. Covariates not included in graphed analyses. (B) EDA activity during rest for TD and ADHD youth during placebo and medication conditions. Error bars represent standard error, while * indicates p < .05 for respective analyses. Covariates within analyses included youth’s sex, comorbidities (e.g., anxiety, conduct disorder [CD], and oppositional defiant disorder [ODD]), and session in which youth with ADHD were enrolled in the placebo condition. During analyses with youth with ADHD during the medication condition, dosage of Osmotic Release Oral System Methylphenidate (OROS MPH) was included as an additional covariate