Vegetative regulation as a marker of systemic imbalance in children of younger age with social and emotional disorders

Authors:

Ivanova Violetta Andreevna, Head of the Department of Medical Rehabilitation of the Children’s Rehabilitation and Restoration Center of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, 50 Bestuzhevskaya Street, 195067 Saint-Petersburg, Russian Federation; tel.: 89811888202, e-mail: abstraction@yandex.ru

Kormushkina Elizaveta Aleksandrovna, psychiatrist, psychotherapist of the Children’s Rehabilitation and Restoration Center of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, 50 Bestuzhevskaya Street, 195067 Saint-Petersburg, Russian Federation

Annotation:

Introduction. In recent years, there has been a steady increase in the number of children with socio-emotional disorders throughout the world. Deficiency of emotional response and social and communicative skills can occur with various developmental disorders and have polymodal pathogenesis, however, these disorders are most clearly defined in the structure of autism spectrum disorders. Separate structures are identified in the brain, the damage of which serves as the neurobiological basis of socio-emotional disorders. Dysfunction or damage to these structures is manifested by combined mental, autonomic and somatic disorders.

Aim. The aim is to study the state of the autonomic nervous system in children with socio-emotional disorders in the structure of autism spectrum disorders by spectral analysis of heart rate variability, to compare changes in the autonomic status with clinical complaints and compare the data with two control groups. Determine the feasibility of assessing the state of the autonomic nervous system during the development of an individual rehabilitation program.

Materials and methods. The study was carried out on the basis of Federal Scientific Center for Rehabilitation of the Disabled named after G. A. Albrecht, Ministry of Labor, Russia, St. Petersburg. The study involved 62 children undergoing an inpatient rehabilitation course. The main group consisted of 27 children with socio-emotional disorders that meet the diagnostic criteria for autism spectrum disorders. The two control groups consisted of 18 children with mental retardation and speech development delay and 17 children with cerebral palsy. The average age of children in all groups was 3.5 years. Assessment of vegetative activity was carried out by the method of spectral analysis of heart rhythm using a computer analyzer of heart rate variability (by “Intoks”, St. Petersburg), in the structure of the computerized complex “Cardiorhythmograph”. In all groups, the analysis of the quantity and quality of vegetative and somatic complaints was conducted according to the developed questionnaire.

Results and discussion. In the study and control groups according to spectral analysis of heart rhythm, there was no significant difference in the ratio of the sympathetic and para-sympathetic parts of autonomic activity, which can serve as an indicator of the relative compensation of autonomic disorders in children of this age group who were admitted to the rehabilitation center for rehabilitation. In this case, a subsequent analysis of the data established a significant increase in the parameter characterizing the activation of the parasympathetic (HF) and sympathetic (LF) parts of autonomic nervous system in all groups, with the highest numbers of averaged parasympathetic and sympathetic activation observed in the group of children with autism spectrum disorders.
Also, in the group of children with autism spectrum disorders, the indicator reflecting the involvement of all functional reserves of the body under the influence of the central regulation of the hypothalamic-pituitary level (TP) and characterizing the activation of the underlying (autonomous) control levels was significantly higher in comparison with the other two groups. A significant increase in this indicator reflects the state of excessive response, hyperergy, requiring restoration of the balance of energy consumption. Also, in the group of children with autism spectrum disorders, the indicator of hormonal support for the activity of neurohumoral regulation, angiotensin, thermoregulatory, and chemoreceptive systems was significantly higher than in the other two groups, reflecting the attraction of the body’s essential resources (VLF) to maintain adequate life activity.

Summary. The experience of studying the state of the autonomic nervous system in children with socio-emotional disorders has shown the feasibility, as well as the simplicity and accessibility of using the method of spectral analysis of heart rhythm in the rapid assessment of the nature of the autonomic response, which can be used in developing the optimal complex of rehabilitation therapy and rehabilitation measures in children.

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