Investigating the Autonomic Nervous System Response to Anxiety in Children with Autism Spectrum Disorders

Assessment of anxiety symptoms in autism spectrum disorders (ASD) is a challenging task due to the symptom overlap between the two conditions as well as the difficulties in communication and awareness of emotions in ASD. This motivates the development of a physiological marker of anxiety in ASD that is independent of language and does not require observation of overt behaviour. In this study, we investigated the feasibility of using indicators of autonomic nervous system (ANS) activity for this purpose. Specially, the objectives of the study were to 1) examine whether or not anxiety causes significant measurable changes in indicators of ANS in an ASD population, and 2) characterize the pattern of these changes in ASD. We measured three physiological indicators of the autonomic nervous system response (heart rate, electrodermal activity, and skin temperature) during a baseline (movie watching) and anxiety condition (Stroop task) in a sample of typically developing children (n = 17) and children with ASD (n = 12). The anxiety condition caused significant changes in heart rate and electrodermal activity in both groups, however, a differential pattern of response was found between the two groups. In particular, the ASD group showed elevated heart rate during both baseline and anxiety conditions. Elevated and blunted phasic electrodermal activity were found in the ASD group during baseline and anxiety conditions, respectively. Finally, the ASD group did not show the typical decrease in skin temperature in response to anxiety. These results suggest that 1) signals of the autonomic nervous system may be used as indicators of anxiety in children with ASD, and 2) ASD may be associated with an atypical autonomic response to anxiety that is most consistent with sympathetic over-arousal and parasympathetic under-arousal.     

Functional characteristics of the cardiovascular system in adolescents with high normal blood pressure

Sanogenetic monitoring of schoolchildren’s health has demonstrated that, among high school students, the proportion of adolescents with elevated blood pressure (hypertension + hypernormotension) has risen from 15–20% in 8th-year students to 30–50% in 9th- to 11th-year students, while the proportion of adolescents with hypertension was 3.7% in all age groups. The level of blood pressure (BP) was compared with parameters of the autonomic control of the cardiovascular system. A high normal BP in adolescents 13–14 and 17–18 years of age was correlated with the higher proportion of low frequencies in the spectrum of heart rate variability (HRV) and with the lower sensitivity of the arterial baroreflex. At the age of 15–16 years, a high normal BP was accompanied by a reduced heart rate and a higher sensitivity of the arterial baroreflex; BP correlated also with a decrease in power of the high-frequency region of the HRV spectrum. Unlike normotensive age-matched subjects, hypernormotensive adolescents 15–16 years of age have a lower finger blood pressure and reduced relative power of the low-frequency range in the HRV spectrum during the functional test (an increase in the dead space). This may be a result of a functional inadaptability of sympathetic autonomic regulation.     

Restoration of Vagal Tone: A Possible Mechanism for Functional Abdominal Pain

Functional abdominal pain (FAP) causes disruption of daily activities/missed school days, over utilization of healthcare, unnecessary surgeries, and anxiety in 10–15% of children. Its etiology is not clearly understood, however the success of several clinical protocols suggests that autonomic dysregulation is a factor. In this study autonomic activity, including heart rate variability (HRV), was compared between children with FAP and a comparison group. Twenty children with FAP and 10 children without FAP between the ages of 5 and 17 years old were compared on autonomic regulation using an ambulatory system at baseline and 8 weeks later. Children with FAP participated in 6 sessions of HRV biofeedback aimed at normalizing autonomic balance. At baseline, children with FAP appear to have more autonomic dysregulation than children without FAP. After completing HRV biofeedback, the FAP group was able to significantly reduce their symptoms in relation to significantly increasing their autonomic balance. In a sample of children with FAP, it appears that HRV biofeedback treatment improved their symptoms and that a change in vagal tone was a potential mediator for this improvement. The present study appears to point to excessive vagal withdrawal as an underlying mechanism of FAP.     

Prenatal Adversities and Latino Children’s Autonomic Nervous System Reactivity Trajectories from 6 Months to 5 Years of Age

The purpose of the study was to determine whether mothers’ adversities experienced during early pregnancy are associated with offspring’s autonomic nervous system (ANS) reactivity trajectories from 6 months to 5 years of age. This cohort study of primarily Latino families included maternal interviews at 13–14 weeks gestation about their experience of a range of adversities: father’s absence, general social support, poverty level, and household density. ANS measures of heart rate, respiratory sinus arrhythmia (parasympathetic nervous system) and preejection period (sympathetic nervous system) were collected during resting and challenging conditions on children at 6 months and 1, 3.5 and 5 years of age. Reactivity measures were calculated as the mean of the responses to challenging conditions minus a resting condition. Fixed effects models were conducted for the 212 children with two or more timepoints of ANS measures. Interactions between maternal prenatal adversity levels and child age at time of ANS protocol were included in the models, allowing the calculation of separate trajectories or slopes for each level of adversity. Results showed no significant relations between mothers’ prenatal socioeconomic or social support adversity and offspring’s parasympathetic nervous system trajectories, but there was a statistically significant relationship between social support adversity and offspring’s heart rate trajectories (p<.05) and a borderline significant relationship between socioeconomic adversity and offspring’s sympathetic nervous system trajectories (p = .05). Children whose mothers experienced one, not two, social support adversity had the smallest increases in heart rate reactivity compared to children whose mothers experienced no adversity. The children whose mothers experienced no social support and no socioeconomic adversity had the largest increases in heart rate and preejection period respectively from 6 months to 5 years showing the most plasticity. Mothers’ prenatal adverse experiences may program their children’s physiologic trajectory to dampen their heart rate or sympathetic responsivity to challenging conditions.     

Functional state of the cardiovascular system in 13-year-old adolescents with different types of autonomic nervous regulation

The features of the functional state of cardiovascular system in 13-year-old children with different types of autonomic nervous regulation were studied. Children with normotonic and parasympathetic types of autonomic regulation were found to have the highest adaptation capacities. The autonomic nervous system influences the bioelectrical processes in myocardium, the duration of cardiac cycle phases, and cerebral blood flow. Schoolchildren aged 13 years with higher sympathetic activity have shorter duration of the cardiac cycle, the phase of isometric contraction, and diastole. They have a lower pulse blood flow rate and a higher tone of large and medium cerebral vessels. No relationship was revealed between the initial autonomic nervous regulation of heart rate and the type of adaptation of myocardium to physical dynamic loads, as well as the type of adaptation of cerebral circulation to mental stress.     

Pregnant Mothers with Resolved Anxiety Disorders and Their Offspring Have Reduced Heart Rate Variability: Implications for the Health of Children

Objective

Active anxiety disorders have lasting detrimental effects on pregnant mothers and their offspring but it is unknown if historical, non-active, maternal anxiety disorders have similar effects. Anxiety-related conditions, such as reduced autonomic cardiac control, indicated by reduced heart rate variability (HRV) could persist despite disorder resolution, with long-term health implications for mothers and children. The objective in this study is to test the hypotheses that pregnant mothers with a history of, but not current anxiety and their children have low HRV, predicting anxiety-like offspring temperaments.

Methods

The participants in this case-control study consist of 56 women during their first trimester and their offspring (15 male, 29 female). Women had a history of an anxiety disorder (n=22) or no psychopathology (n=34) determined using the Mini-International Neuropsychiatric Interview. The main outcome measures were indices of autonomic cardiac control including root mean square of successive differences (RMSSD) and high frequency (HF) variability. Children’s fearfulness was also assessed using the Laboratory Temperament Assessment Battery (Lab-TAB)-Locomotor Version.

Results

HRV was lower in women and children in the past anxiety group compared to controls. HRV measures for mothers and children were positively correlated in the anxiety group only. In all children, low HRV measures at 2-4 months were associated with a higher chance of fearful behavior at 9-10 months.

Conclusions

Pregnant women with previous but not current anxiety and their children have low HRV. Children with low HRV tend to show more fearfulness. These findings have implications for identifying children at risk of anxiety disorders and point to possible underlying mechanisms of child psychopathology.     

Relationship Between Respiratory Sinus Arrhythmia, Heart Period, and Caregiver-Reported Language and Cognitive Delays in Children with Autism Spectrum Disorders

The present study examines the relationship between autonomic activity and cognitive/language delays in children with autism spectrum disorder (ASD). Baseline levels of respiratory sinus arrhythmia (RSA) and heart period (HP) were assessed in 23 4–7-year old children diagnosed with ASD. The relationship between RSA, HP, and ASD behavioral symptoms was examined. Similar to prior studies on typically developing children, lower basal RSA was related to more caregiver-reported language and cognitive delays, and to the lack of language.     

Cardiovascular regulation profile predicts developmental trajectory of BMI and pediatric obesity

The present study examined the role of cardiovascular regulation in predicting pediatric obesity. Participants for this study included 268 children (141 girls) obtained from a larger ongoing longitudinal study. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (vagal withdrawal) to three cognitively challenging tasks were derived when children were 5.5 years of age. Heart period (HP) and HP change (heart rate (HR) acceleration) were also examined. Height and weight measures were collected when children were 5.5, 7.5, and 10.5 years of age. Results indicated that physiological regulation at age 5.5 was predictive of both normal variations in BMI development and pediatric obesity at age 10.5. Specifically, children with a cardiovascular regulation profile characterized by lower levels of RSA suppression and HP change experienced significantly greater levels of BMI growth and were more likely to be classified as overweight/at-risk for overweight at age 10.5 compared to children with a cardiovascular regulation profile characterized by high levels of RSA suppression and HP change. However, a significant interaction with racial status was found suggesting that the association between cardiovascular regulation profile and BMI growth and pediatric obesity was only significant for African-American children. An autonomic cardiovascular regulation profile consisting of low parasympathetic activity represents a significant individual risk factor for the development of pediatric obesity, but only for African-American children. Mechanisms by which early physiological regulation difficulties may contribute to the development of pediatric obesity are discussed.     

Age-dependent heart rate variability in preschool children living under the conditions of the European Arctic region

The results of analysis of specific characteristics of the heart rate variability (HRV) regulation in preschool children living under the Arctic high-latitude conditions are presented. The principal ageand gender-specific differences in the HRV regulation have been inferred from the intergroup evaluations of the HRV indicators in boys and girls. A functional developmental delay has been shown in 2.5-year-old girls compared with boys of the same age group. The applied orthostatic test has shown lower reserve capacities in children of the senior group compared with the junior group. It has been shown that the mechanisms of the regulation of cardiac rhythm in girls experience higher strain during orthostasis as compared with boys. The division of children into age groups with an age difference of one year has allowed the detection of the tendency towards basically different responses to functional loads during orthostasis. The mean HRV values characteristic of four- to six-year-old children living in the Arctic are presented. It has been shown that the children living at middle latitudes have a higher adaptive potential compared with the children living in high-latitude Arctic areas.     

Reduced Heart Rate Variability in Social Anxiety Disorder: Associations with Gender and Symptom Severity

Background

Polyvagal theory emphasizes that autonomic nervous system functioning plays a key role in social behavior and emotion. The theory predicts that psychiatric disorders of social dysfunction are associated with reduced heart rate variability, an index of autonomic control, as well as social inhibition and avoidance. The purpose of this study was to examine whether heart rate variability was reduced in treatment-seeking patients diagnosed with social anxiety disorder, a disorder characterized by social fear and avoidance.

Methods

Social anxiety patients (n = 53) were recruited prior to receiving psychological therapy. Healthy volunteers were recruited through the University of Sydney and the general community and were matched by gender and age (n = 53). Heart rate variability was assessed during a five-minute recording at rest, with participants completing a range of self-report clinical symptom measures.

Results

Compared to controls, participants with social anxiety exhibited significant reductions across a number of heart rate variability measures. Reductions in heart rate variability were observed in females with social anxiety, compared to female controls, and in patients taking psychotropic medication compared to non-medicated patients. Finally, within the clinical group, we observed significant associations between reduced heart rate variability and increased social interaction anxiety, psychological distress, and harmful alcohol use.

Conclusions

The results of this study confirm that social anxiety disorder is associated with reduced heart rate variability. Resting state heart rate variability may therefore be considered a marker for social approach-related motivation and capacity for social engagement. Additionally, heart rate variability may provide a useful biomarker to explain underlying difficulties with social approach, impaired stress regulation, and behavioral inhibition, especially in disorders associated with significant impairments in these domains.     

Attention-deficit hyperactivity disorder and cardiac vagal control: a systematic review

Attention-deficit hyperactivity disorder (ADHD) is characterized by behavioural disinhibition, deficient emotional self-regulation, inattention, and hyperactivity. The constellation of deficits found in children with ADHD implicates autonomic dysregulation characterized by deficient control of the heart by parasympathetic influences. While it is generally assumed that autonomic regulation of the heart is impaired during ADHD, the information pertaining to this dysregulation is limited. A systematic review of three databases was conducted between January and March 2012 for peer reviewed publications examining the relationship between cardiac vagal control (CVC) and ADHD without comorbid psychopathology. 19 articles were reviewed with only 6 meeting inclusion criteria. Findings were not unanimous but suggested that children with unmedicated ADHD experienced lower levels of CVC than did healthy controls. It was difficult to evaluate whether children with ADHD exhibited a different pattern of withdrawal and application of CVC than did normal controls. Findings suggested CVC reactivity depended on the task employed but children with ADHD experienced dampened CVC reactivity during tasks that involved self-regulation and emotion regulation. Finally, medication acted to correct the autonomic imbalance experienced by children with ADHD but did not bring this imbalance into normal levels. Given that so few studies were identified, no firm conclusions can be made, and there is a clear need for additional research in this area. Recommendations for future research are discussed.     

Inverse Correlation Between Serum Calcium and Copper Levels in Male Urban Colombian Preschool Children: Relationships with Anthropometry and Age

Copper and calcium are essential for human growth and development. The present study was conducted to evaluate the relationship between calcium and copper levels, as well as their relationship to age and anthropometry in 180 preschool children ages 2-5?years old. Serum copper levels were inversely correlated with age (r?=?-0.184, P?=?0.032) and height (r?=?-0.175, P?=?0.043) in the whole group and with height for age Z score only in male children (r?=?-0.291, P?=?0.016). The correlation with age is not maintained when it is analyzed for gender. Serum calcium values in the total group were inversely correlated with weight (r?=?-0.153, P?=?0.044) and weight for height Z score (r?=?-0.246, P?=?0.001). No differences were found for gender in the levels of both metals. A negative relationship between serum calcium and copper was found only in male children (r?=?-0.339, P?=?0.005). Studies are required in other populations and experimental designs that can explain an inverse relationship between serum calcium and copper levels.     

The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli

Stress and anxiety are commonly thought to be detrimental to sexual function. Several studies in both the human and animal literature, however, have found that inducing anxiety can enhance sexual function in women. The mechanisms that explain a negative relationship between physical and psychological stress and sexual functioning are well documented, but little is known about how stress or anxiety might have a facilitatory effect on sexual arousal. As an initial step in exploring the relationship between anxiety and sexual arousal, the present study examined the role of the autonomic nervous system, and the adrenal hormones cortisol and dehydroepiandrosterone-sulfate (DHEA-S) in response to a sexual film, an anxiety-inducing film, and a humorous film. Nineteen premenopausal women (mean age 24.4 years) who were free from sexual difficulties came into the lab on three separate days. At each session they were shown an anxiety-inducing, sexually arousing, or humorous (control) film while their physiological arousal was measured. They also provided saliva samples before and after each film. Cortisol significantly decreased, while DHEA-S increased in the sexual and humorous conditions. Neither hormone changed significantly in the anxiety-inducing condition. Autonomic nervous system activity measured by heart rate and heart rate variability did not change in response to the sexual or anxiety-inducing films, but heart rate variability increased significantly in response to the humorous film. The cortisol/DHEA-S ratio at the post-sexual film time point was significantly negatively correlated with genital arousal (measured by vaginal pulse amplitude). Anxiety-inducing films did not result in a physiological stress response, which can explain why they do not impair sexual function.     

Influence of cognitive load on the body functional state in children aged 9 to 12 years during early stages of puberty

This article analyzes heart rate variability (HRV), the glucocorticoid function of adrenal glands, and brain electrical activity (EA) in children aged 9 to 12 years to study their functional state during early stages of puberty. The cognitive load (mental arithmetic) caused low-frequency waves in the heart rate spectrum in all subjects, regardless of the puberty stage and gender. With respect to the age range under study, the hormonal response to the arithmetic test, expressed in a decrease in the level of cortisol, was observed in boys only at the third stage of puberty. The visual analysis of the background electrical encephalogram showed frequent generalized bilateral and synchronous changes in the electrical activity (EA) in the form of diencephalic signs in children. The features of the relationship between the autonomic nervous system and the hypothalamic pituitary-adrenal system have been revealed in children aged 9 to 12 years during cognitive load. The closest correlations between HRV indices and cortisol levels have been found in girls at the first stage and boys at the third stage of puberty.     

Autonomic Regulation of Heart Rate and Distinctive Features of Oculomotor Activity in Eight- to Nine-Year-Old Boys and Girls during the Reading of Texts of Different Complexities

Distinctive features of autonomic regulation of the heart rate and spatiotemporal parameters of eye movements during the reading of texts of different complexities levels from a computer screen have been analyzed in girls and boys eight to nine years of age. Sex-related differences in heart rate variability (HRV) pattern were already observed in the resting state, since parasympathetic effects were stronger in boys than in girls. Parasympathetic activity decreased in boys who were reading texts of different complexities. The most pronounced decrease was observed during the reading of the first (simple) text. The changes in girls were mostly due to an increase in sympathetic activity and were less pronounced than in boys. Oculomotor activity analysis revealed differences in reading process strategy: reading was more fragmented (discrete) in the girls and more integrated in the boys. However, reading skills were not fully developed in children of eight to nine years of age, since “syllabized” reading was observed in girls and boys alike.     

Preschool Anxiety Disorders Predict Different Patterns of Amygdala-Prefrontal Connectivity at School-Age

Objective

In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an exploratory analysis, we investigated whether distinct anxiety disorders differ in the patterns of this amygdala-prefrontal dysregulation.

Methods

Participants were children taking part in a 5-year study of early childhood brain development and anxiety disorders. Preschool symptoms of generalized anxiety, separation anxiety, and social phobia were assessed with the Preschool Age Psychiatric Assessment (PAPA) in the first wave of the study when the children were between 2 and 5 years old. The PAPA was repeated at age 6. We conducted functional MRIs when the children were 5.5 to 9.5 year old to assess neural responses to viewing of angry and fearful faces.

Results

A history of preschool social phobia predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces. Preschool generalized anxiety predicted less functional connectivity between the amygdala and dorsal prefrontal cortices in response to fearful faces. Finally, a history of preschool separation anxiety predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces and greater school-age functional connectivity between the amygdala and dorsal prefrontal cortices to angry faces.

Conclusions

Our results suggest that there are enduring neurobiological effects associated with a history of preschool anxiety, which occur over-and-above the effect of subsequent emotional symptoms. Our results also provide preliminary evidence for the neurobiological differentiation of specific preschool anxiety disorders.     

Characteristics of the myocardium functional state and cerebral circulation of seven- to ten-year-old children with different variants of autonomic nervous regulation of the heart rate

A complex study of the functional state of the cardiovascular system of seven- to ten-year-old children with different types of autonomic nervous regulation of the heart rate was performed. It was found that the autonomic nervous system strongly affects the adaptive capacity of the body, bioelectrical processes in the myocardium, the duration of cardiac-cycle phases, the pulse volume, and the tone of large and small cerebral vessels.     

Effects of spatial-imagery task performance on the heart rate variability

Effects of the efficiency of spatial task performance on the autonomic heart control were studied. Dynamic changes in autonomic balance diagnosed on the heart rate variability during maze-model task performance (the type of spatial-imagery activity) showed that the type of heart rate regulation depended on the performance efficiency. The results suggest that in subjects with low performance efficiency, problems in performance are associated with negative emotions that produce the emotional psychogenic stress. In subjects with high efficiency, the autonomic contour of the heart rate regulation prevailed. This was presumable associated with the adequacy of the maze-model task.     

Heart Rate and Stroke Volume Responses in Children of Early School Age to Change in Their Physical Activity Regimen

A study was made of the adaptation of the cardiac pump function in children of early school age to change in their physical activity associated with the transition from preschool to elementary school. Children of the experimental group, who engaged in physical exercise daily over the first school year, developed so-called bradycardia of training, which enhanced the tendency of the heart rate to decrease with age. The level of bradycardia attained in the first school year was retained over the two subsequent years, despite a considerable decrease in the amount of physical activity in this period. Daily exercising significantly increased the stroke volume, which remained at a high level even after the daily exercising program was stopped. Children of the control group participated only in physical activities of the regular physical education program. Their heart rate remained unchanged over the first two school years. At the beginning of the third year, a decrease in the heart rate and a rise in the stroke volume were observed, as expected of their age.     

Psychophysiological indices in six-to eight-year-old children under information load depending on anxiety as a stable individual characteristic

The study of psychophysiological indices in children aged six to eight years under information loads of various complexity showed that anxious subjects were characterized by a high level of nonspecific activation at rest and a shift of the autonomic balance towards a relative domination of the tone of the sympathetic division of the autonomic nervous system (ANS). The information load in the “auto-rate” mode caused in children aged six to eight years an increase in the level of nonspecific activation and the activity of sympathetic regulation and an inhibition of parasympathetic regulation. An information load in the “maximum rate of work” mode caused a decrease in the quantitative and qualitative indices of mental activity in comparison with that under comfortable conditions and a subsequent increase in autonomic shifts and the level of situational anxiety. The decrease in the efficiency of intellectual work performed at a maximum rate against the background of a high level of nonspecific activation and an increase in situational anxiety in both groups apparently reflected an increase in the activity of the modulating cerebral system due to the domination of the nonproductive activation system related to defensive behavior. At the same time, in children with a high personal anxiety, autonomic manifestations of activation and situational anxiety in both modes of work were more distinct and the efficiency of work lower than in subjects with a low anxiety. This indicates that, in anxious children, due to the excess activation of the sympathetic division of the ANS, the information load has a higher physiological cost. Thus, children with a high level of personal anxiety under intense information loads are characterized by a larger increase in the activity of the sympathetic division of the ANS and the attenuation of the effect of the parasympathetic division; a considerable increase in situational anxiety; low efficiency of activity; and, hence, its high physiological cost.