Systematic Review and Meta-Analysis: Altered Autonomic Functioning in Youths With Emotional Dysregulation - 29/01/24
, Gianluca Sesso, MD c, d, Annarita Milone, MD c, Gabriele Masi, MD c, Samuele Cortese, MD, PhD e, fAbstract |
Objective |
To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents.
Method |
Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis.
Results |
There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED.
Conclusion |
This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning.
Study preregistration information |
Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? prospero/; CRD42021239635.
Le texte complet de cet article est disponible en PDF.Key words : autonomic nervous system, EDA, emotional dysregulation, HRV, RSA
Plan
| This article was reviewed under and accepted by Ad Hoc Editor Daniel P. Dickstein, MD. |
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| Drs. Bellato and Sesso shared first authorship of this work. Drs. Masi and Cortese shared senior authorship of this work. |
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| The study was partially supported by the Italian Ministry of Health: Ricerca Corrente (Project 2.10: Bipolar spectrum in youth, from cyclothymia to bipolar disorder: clinical and pharmacological implications; GM), and the “5 per 1000” voluntary contributions. |
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| This article is a part of a special review series devoted to child and adolescent emotion dysregulation as part of the presidential initiative of AACAP President Gabrielle A. Carlson, MD (2019-2021). Articles were selected to cover a range of topics in the area, including reviews of genetics, neuroimaging, pharmacological and nonpharmacological treatment, screening tools, and prevention, among others. The series was edited by Guest Editor Daniel P. Dickstein, MD, Associate Editor Robert R. Althoff, MD, PhD, and Editor-in-Chief Douglas K. Novins, MD. |
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| This work has been prospectively registered: display_record.php?ID=CRD42021239635. |
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| Author Contributions Conceptualization: Bellato, Sesso, Milone, Masi, Cortese Data curation: Bellato, Sesso Formal analysis: Bellato, Sesso Investigation: Bellato, Sesso Methodology: Bellato, Sesso, Cortese Resources: Bellato Software: Sesso Supervision: Masi, Cortese Validation: Bellato, Sesso, Cortese Visualization: Sesso Writing – original draft: Bellato, Sesso Writing – review and editing: Bellato, Sesso, Milone, Masi, Cortese |
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| The authors thank Alessandro Tonacci, PhD, of Consiglio Nazionale delle Ricerche, Italy, for providing additional data not available in the original paper, which the authors used for the meta-analysis. |
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| Disclosure: Dr. Masi has received research grants from Lundbeck and Humana, has served on an advisory board for Angelini, and has been a speaker for Angelini, FB Health, Janssen, Lundbeck, and Otsuka. Prof. Cortese has declared honoraria and reimbursement for travel and accommodation expenses for lectures from the following nonprofit associations: Association for Child and Adolescent Mental Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association for Psychopharmacology (BAP), and Healthcare Convention for educational activity on ADHD. He has served on the advisory board of ACAMH and the BAP. Drs. Bellato, Sesso, and Milone have reported no biomedical financial interests or potential conflicts of interest. |
Vol 63 - N° 2
P. 216-230 - février 2024 Retour au numéro
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