Subclinical orthostatic pulse pressure confirms mothers' ratings of <scp>ADHD</scp> in preschoolers

Casavant, Vanessa; Chae, Christina; Sherwani, Afsheen; Perlmuter, Lawrence C.

doi:10.1111/j.1469-8986.2012.01351.x

Cited by 8 publications

(8 citation statements)

References 52 publications

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“…The significantly higher prevalence of orthostatic intolerance symptoms of neurodevelopmental patients compared to controls provides direct empirical evidence for this suggestion within the literature (Perlmuter et al, 2013, Goodman, 2016). Moreover, our larger study used quantitative data from patients with diagnosed neurodevelopmental conditions, extending an association between orthostatic symptoms and ADHD questionnaire score in fewer healthy individuals (Casavant et al, 2012) as opposed to confirmed diagnosis. We observed increased orthostatic intolerance across patients with autism, ADHD, and Tourette Syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a more direct association is proposed between orthostatic hypotension and specific behavioural and emotional disorders (Perlmuter et al (2013). Correspondingly, in healthy preschool children, poorer pulse pressure regulation during orthostatic challenge (a measure of orthostatic hypotension) predicts higher ADHD scores (Casavant et al (2012). Moreover, children with poorer responses to orthostatic stress were more likely to be viewed as oppositional or have attention difficulties (Casavant et al (2012).…”

Section: Introductionmentioning

confidence: 99%

“…Correspondingly, in healthy preschool children, poorer pulse pressure regulation during orthostatic challenge (a measure of orthostatic hypotension) predicts higher ADHD scores (Casavant et al (2012). Moreover, children with poorer responses to orthostatic stress were more likely to be viewed as oppositional or have attention difficulties (Casavant et al (2012). While this study did not test ADHD patients, it points towards a relationship between orthostatic intolerance and ADHD which warrants further scrutiny.…”

Section: Introductionmentioning

confidence: 99%

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Increased rate of joint hypermobility in autism and related neurodevelopmental conditions is linked to dysautonomia and pain

Jll

Iodice

Cl³

et al. 2020

Preprint

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Objective: Autism, attention deficit hyperactivity disorder (ADHD), and tic disorder (Tourette syndrome; TS) are neurodevelopmental conditions that frequently co-occur and impact psychological, social and emotional functioning. Vulnerability to chronic physical symptoms, including fatigue and pain, are also recognised. The expression of joint hypermobility, reflecting a constitutional variant in connective tissue, predicts vulnerability to psychological symptoms alongside recognised physical symptoms. Here, we tested for increased rates of joint hypermobility, autonomic dysfunction and pain in 109 adults with neurodevelopmental diagnoses. Method: Rates of generalized joint laxity in those individuals with neurodevelopmental conditions were compared to those in the general population in UK. Levels of orthostatic intolerance and musculoskeletal symptoms were compared to a neurotypical control group. Results: Adults with neurodevelopmental diagnoses manifest elevated rates of joint hypermobility (50%) compared to the general population rate of 20% and a matched control population of 10%. Odds ratio for hypermobility in individuals with neurodevelopmental diagnoses, compared to the general population was 4.51 (95%CI 2.17-9.37), with greater odds in females rather than males. Neurodevelopmental patients reported significantly more symptoms of orthostatic intolerance and musculoskeletal skeletal pain than controls Conclusions: In adults with neurodevelopmental conditions, there is a strong link between the expression of joint hypermobility, autonomic dysfunction and pain, more so than in healthy controls. Increased awareness and understanding of this association may enhance the management of core symptoms and allied difficulties including comorbid stress-sensitive physical symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased rate of joint hypermobility in autism and related neurodevelopmental conditions is linked to dysautonomia and pain

Jll

Iodice

Cl³

et al. 2020

Preprint

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“…Attention-deficit hyperactive disorder, presenting with impulsive behavior, lack of concentration, and extreme hyperactivity, was recently shown to be associated with a poorer SBP regulation in a nonclinical sample. 71 In another study with a nonclinical sample, increased hopelessness was related to subclinical levels of change in SBP in response to an orthostatic challenge. 72 In at least one study, birth weight was shown to predict subclinical OH.…”

Section: Oh and Affective Disordersmentioning

confidence: 97%

A Review of the Etiology, Asssociated Comorbidities, and Treatment of Orthostatic Hypotension

Perlmuter

Sarda²,

Casavant³

et al. 2013

American Journal of Therapeutics

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The magnitude of increase in systolic blood pressure in response to the shift from supine to upright posture is considered to reflect the adequacy of orthostatic regulation. Orthostatic integrity is largely maintained by the interaction between the skeletal muscle pump, neurovascular compensation, neurohumoral effects, and cerebral blood flow regulation. Various physiological states and disease conditions may disrupt these mechanisms as seen in vasovagal syncope, dysautonomic orthostatic intolerance, and postural orthostatic tachycardia syndrome. Orthostatic hypotension (OH) and decreased cerebral blood flow are strongly related. Even subclinical OH has been associated to different degrees with impaired cognitive function, decreased effort, reduced motivation, increased hopelessness, and signs of attention-deficit hyperactivity disorder and dementia, diabetes mellitus, and Parkinson disease. Furthermore, subclinical levels of inadequate blood pressure regulation in response to orthostasis have been linked to increased depression and anxiety and intergenerational behavioral sequelae between mother and child. Identifying causes of subclinical and clinical OH is critical in improving quality of life for both children and older adults. A better understanding of the underlying causes responsible for the etiology of OH could lead to a rational design of novel effective therapeutic regimens for the treatment of this condition and associated comorbidities.

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“…2, 159-166, http://dx.doi.org/10.1080/17450128.2013 relationships have been observed in children, where poor orthostatic BP regulation has been associated with depressive symptoms (Stress, Mayefsky, & Perlmuter, 2003). Furthermore, poorer orthostatic BP regulation has been linked to greater risk of poorer cognitive performance (Casavant, Spivak, Wiltse, Chilamkurti, & Perlmuter, 2010), as well as inattention and oppositional behaviors (Casavant, Chae, Sherwani, & Perlmuter, 2012).…”

mentioning

confidence: 96%

Impact of maternal anxiety on children’s orthostatic blood pressure regulation and anxiety

Leung

Bangieva

Sarda

et al. 2013

Vulnerable Children and Youth Studies

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When changing posture from supine to standing, an increase in systolic blood pressure (SBP) is necessary for optimal orthostatic blood pressure (BP) regulation. Poor orthostatic BP regulation has been correlated with negative mood and behavioral sequelae in adults and children. This may be explained by the common neurobiological mechanism associated with cardiovascular functioning and anxiety. This study examined orthostatic BP regulation -indicated by SBP change -in healthy Caucasian and African American children aged 7-10 years. A multiple regression analysis was used to assess pediatric SBP change and state and trait anxiety in children and their mothers. Results revealed that higher state anxiety levels in children were associated with less effective SBP change. More importantly, higher maternal trait anxiety was also associated with less effective SBP in children. Trait and state anxiety may each have distinct links to orthostatic BP regulation, warranting further investigation of these processes across the lifespan.

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Subclinical orthostatic pulse pressure confirms mothers' ratings of ADHD in preschoolers

Cited by 8 publications

References 52 publications

Increased rate of joint hypermobility in autism and related neurodevelopmental conditions is linked to dysautonomia and pain

Increased rate of joint hypermobility in autism and related neurodevelopmental conditions is linked to dysautonomia and pain

A Review of the Etiology, Asssociated Comorbidities, and Treatment of Orthostatic Hypotension

Impact of maternal anxiety on children’s orthostatic blood pressure regulation and anxiety

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