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

Kushki, Azadeh; Drumm, Ellen; Mobarak, Michele Pla; Tanel, Nadia; Dupuis, Annie; Chau, Tom; Anagnostou, Evdokia

doi:10.1371/journal.pone.0059730

Cited by 160 publications

(158 citation statements)

References 44 publications

(52 reference statements)

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“…We had hoped to use heart rate as an index of anxiety, as nervous children may have higher heart rates. 26, 27 This association may have been obscured by the association between obesity or poor lifestyle habits with higher heart rates. 28, 29 …”

Section: Discussionmentioning

confidence: 99%

Clinical predictors and impact of ambulatory blood pressure monitoring in pediatric hypertension referrals

Davis

Ferguson

Zachariah

2014

Journal of the American Society of Hypertension

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Background Elevated blood pressure (BP) is rising in children. Significant proportions of children have reactive hypertension or masked hypertension, making ambulatory blood pressure monitoring (ABPM) a valuable tool, although with potential economic implications. In youth referred for elevated BP, we sought clinic BP combinations that obviated the need for ABPM and to specify the economic role of ABPM. Methods In a retrospective pediatric referral cohort (n=170), we examine clinic systolic BP (SBP) predictors of components of ABPM hypertension and their combination. In economic analyses, we compared effectiveness and charges of three diagnostic pathways: 1. Clinic BP alone; 2. Abnormal Clinic BP prompting ABPM; or 3. Universal ABPM. Results ABPM hypertension occurred in 55 (32.4%) and reactive hypertension in 37 (21.8%), Average automated (β=0.208 [95%CI 0.027, 0.389], P=0.03) and maximum auscultatory clinic SBP (β=0.160 [95%CI 0.022, 0.299], P=0.02) were associated with ABPM SBP mean, but none predicted SBP load. No clinic SBP combination was associated with ABPM hypertension. Universal ABPM accrued the lowest average charge per hypertensive youth identified ($10,948). Conclusions We did not identify a clinic SBP combination that predicted ABPM hypertension in youth referred for elevated BP. Universal ABPM in this context may be the most economically and clinically efficient diagnostic strategy.

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Section: Discussionmentioning

confidence: 99%

Clinical predictors and impact of ambulatory blood pressure monitoring in pediatric hypertension referrals

Davis

Ferguson

Zachariah

2014

Journal of the American Society of Hypertension

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“…Findings pertaining to autonomic system arousal also suggest heightened physiological activity. For example, Kushki et al [40▪] reported sympathetic overarousal and reduced parasympathetic tone in children with ASD who were completing a Stroop task.…”

Section: Risk Factors and Correlates Of Anxiety In Autism Spectrum DImentioning

confidence: 99%

An update on anxiety in youth with autism spectrum disorders

Vasa

Mazurek

2015

Current Opinion in Psychiatry

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Purpose of review Anxiety is one of the most common co-occurring psychiatric conditions in youth with autism spectrum disorders (ASDs). This article reviews recent evidence as well as earlier relevant studies regarding the characteristics, assessment, and treatment of anxiety in youth with ASD. Recent findings It is well established that the prevalence of anxiety in youth with an ASD is significantly greater than the prevalence of anxiety in the general population. Recent studies have highlighted the importance of informant, method, and instrument when measuring anxiety in this population. Despite the high prevalence, findings to date have been unable to identify any consistent risk factors for anxiety. New psychological treatments, including modified cognitive behavioral therapy for youth with high functioning ASD and co-occurring anxiety, are emerging. Pharmacological data, however, are scant. Existing studies show that youth with ASD are at increased risk for behavioral activation when taking SSRIs. Summary Clinicians working with youth with ASD are encouraged to routinely screen for anxiety. Until further data are available, clinical judgment is needed when prescribing treatments, particularly selective serotonin reuptake inhibitors, which require close monitoring of side-effects. Research on risk factors, pathophysiology, and treatment of this condition is needed.

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“…EDRs can be interpreted as measures of physiological and psychological arousal, but they can be indicative of both negative and positive stimuli [89]. In clinical rehabilitation, electrodermal measurements may serve as a complementary access pathway to a motor-based switch [91] or brain-computer interface [92], an indicator of autonomic nervous system response to anxiety in children with autism spectrum disorders [93], and a quantitative measure of motor imagery abilities in individuals with spinal cord injuries [94], among other possibilities.…”

Section: Current Practicementioning

confidence: 99%

E-textiles in Clinical Rehabilitation: A Scoping Review

2015

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Electronic textiles have potential for many practical uses in clinical rehabilitation. This scoping review appraises recent and emerging developments of textile-based sensors with applications to rehabilitation. Contributions published from 2009 to 2013 are appraised with a specific focus on the measured physiological or biomechanical phenomenon, current measurement practices, textile innovations, and their merits and limitations. While fabric-based signal quality and sensor integration have advanced considerably, overall system integration (including circuitry and power) has not been fully realized. Validation against clinical gold standards is inconsistent at best, and feasibility with clinical populations remains to be demonstrated. The overwhelming focus of research and development has been on remote sensing but the opportunity for textile-mediated feedback to the wearer remains unexplored. Recommendations for future research are provided.

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

Cited by 160 publications

References 44 publications

Clinical predictors and impact of ambulatory blood pressure monitoring in pediatric hypertension referrals

Clinical predictors and impact of ambulatory blood pressure monitoring in pediatric hypertension referrals

An update on anxiety in youth with autism spectrum disorders

E-textiles in Clinical Rehabilitation: A Scoping Review

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