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Gur-Hartman T, Tarrasch R, Zerem A, Sokol-Novinsky R, Elyoseph Z, Lerman-Sagie T, Mintz M. Consequences of vestibular hypofunction in children with ADHD/DCD. Eur J Paediatr Neurol 2024; 52:1-9. [PMID: 38968910 DOI: 10.1016/j.ejpn.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/20/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Children with Attention Deficit Hyperactivity Disorder (ADHD) demonstrate a heterogeneous sensorimotor, emotional, and cognitive profile. Comorbid sensorimotor imbalance, anxiety, and spatial disorientation are particularly prevalent among their non-core symptoms. Studies in other populations presented these three comorbid dysfunctions in the context of vestibular hypofunction. OBJECTIVE To test whether there is a subgroup of children with ADHD who have vestibular hypofunction presenting with concomitant imbalance, anxiety, and spatial disorientation. METHODS Children with ADHD-only (n = 28), ADHD + Developmental Coordination Disorder (ADHD + DCD; n = 38), and Typical Development (TD; n = 19) were evaluated for vestibular function by the Dynamic Visual Acuity test (DVA-t), balance by the Bruininks-Oseretsky Test of motor proficiency (BOT-2), panic anxiety by the Screen for Child Anxiety Related Emotional Disorders questionnaire-Child version (SCARED-C), and spatial navigation by the Triangular Completion test (TC-t). RESULTS Children with ADHD vs. TD presented with a high rate of vestibular hypofunction (65 vs. 0 %), imbalance (42 vs. 0 %), panic anxiety (27 vs. 11 %), and spatial disorientation (30 vs. 5 %). Children with ADHD + DCD contributed more frequent and severe vestibular hypofunction and imbalance than children with ADHD-only (74 vs. 54 %; 58 vs. 21 %, respectively). A concomitant presence of imbalance, anxiety, and spatial disorientation was observed in 33 % of children with ADHD, all sharing vestibular hypofunction. CONCLUSIONS Vestibular hypofunction may be the common pathophysiology of imbalance, anxiety, and spatial disorientation in children. These comorbidities are preferentially present in children with ADHD + DCD rather than ADHD-only, thus likely related to DCD rather than to ADHD disorder. Children with this profile may benefit from a vestibular rehabilitation intervention.
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Affiliation(s)
- Tamar Gur-Hartman
- School of Psychological Sciences, Tel Aviv University, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.
| | - Ricardo Tarrasch
- Sagol School of Neuroscience, Tel Aviv University, Israel; School of Education, Tel Aviv University, Israel
| | - Ayelet Zerem
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Sourasky Medical Center, Tel Aviv, Israel
| | - Riki Sokol-Novinsky
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | | | - Tally Lerman-Sagie
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Matti Mintz
- School of Psychological Sciences, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel
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Goulardins JB, Nascimento RO, Casella EB, Silva MA, Piek J, Matos MA, de Oliveira JA. Do Children with Co-Occurring ADHD and DCD Differ in Motor Performance? J Mot Behav 2024:1-11. [PMID: 38811009 DOI: 10.1080/00222895.2024.2361103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.
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Affiliation(s)
| | - Roseane Oliveira Nascimento
- Instituto de Ciências Sociais, Educação e Zootecnia, da Universidade Federal do Amazonas, Parintins, Amazonas, Brazil
| | - Erasmo Barbante Casella
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jan Piek
- School of Psychology, Curtin University, Perth, Western Australia, Australia
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Buker N, Karagoz E, Sengul YS, Guney SA, Ozbek A. Neurocognitive training enhances the outcomes of children with attention deficit hyperactivity disorder: A preliminary study. Child Care Health Dev 2024; 50:e13268. [PMID: 38767513 DOI: 10.1111/cch.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by diverse clinical manifestations including inattention, hyperactivity and impulsivity. OBJECTIVE The present study aims to investigate the effects of neurocognitive training (NT), a personalized and specialized exercise programme on symptoms, attention and dynamic balance in treatment-naïve children diagnosed with ADHD. METHODS Fourteen treatment-naïve children aged 7-12 years diagnosed with ADHD were enrolled in the intervention group. The NT intervention was administered weekly for 10 consecutive weeks, supplemented by a structured home exercise programme for 6 days a week over the same 10-week period. ADHD-related symptoms, attention and dynamic balance were assessed in pre-treatment, post-treatment, 6 months, and 12 months. Fifteen typically developing (TD) children, matched for age, underwent evaluation only once to establish baseline normative values. RESULTS Following the NT (post-treatment), significant improvements were observed in hyperactivity-impulsivity scores, oppositional-defiant behaviours and dynamic balance when compared to the TD children (p < 0.05). In the ADHD group, a significant difference was found in the long term (12-month follow-up) in hyperactivity-impulsivity, oppositional-defiant behaviours and dynamic balance (p < 0.05). CONCLUSION The findings suggest that the NT yields favourable effects on hyperactivity-impulsivity, oppositional defiant behaviours and dynamic balance in children diagnosed with ADHD, with these improvements appearing to be sustained over the long term. CLINICAL TRIAL REGISTRATION NUMBER NCT04707040.
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Affiliation(s)
- Nurullah Buker
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Ezgi Karagoz
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aylin Ozbek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Isaac V, Lopez V, Escobar MJ. Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD). Front Psychiatry 2024; 14:1336040. [PMID: 38298926 PMCID: PMC10827919 DOI: 10.3389/fpsyt.2023.1336040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous neurodevelopmental condition, that continues to have an elusive etiological background. A number of extant models and theories have historically intended to explain the many factors contributing to ADHD behaviors. One of the most accepted hypotheses has been the executive dysfunction theory associating reduction in executive control to abnormalities in structure and operational dysfunction of dopaminergic signaling networks. Nevertheless, executive functions are not always impaired in ADHD, and the literature describes other symptoms commonly reported suggesting individuals with ADHD would appear to suffer from a more general deficit. Another existing line of research, that has gained much attention recently, establishes that ADHD would have dysregulated states of brain arousal that would account for its commonly observed cognitive deficits and behavioral symptoms, described as the state regulation theory, which has now included measures of autonomic function. This article describes some important aspects that compose and challenge these two most influential theoretical constructs, executive dysfunction and state-regulation, based on their empirical evidence, implying the need to reevaluate the norms used to classify individuals and establish ADHD diagnosis. Large number of controversial results continue to exist within the study of ADHD biological and/or performance markers, possibly due to such heterogeneity and variability within the same diagnosis. The need to resolve these issues and establish newly revised diagnostic criteria for ADHD is critical, as therapeutic success depends on having accurately identified underlying neurophysiological factors in order to appropriately address them in treatment.
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Affiliation(s)
- Valeria Isaac
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Vladimir Lopez
- School of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Josefina Escobar
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
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Caldani S, Acquaviva E, Moscoso A, Landman B, Michel A, Delorme R, Bucci MP. Motor Capabilities in Children with ADHD Are Improved after Brief Visuopostural Training. Neurol Int 2023; 15:792-803. [PMID: 37489356 PMCID: PMC10366723 DOI: 10.3390/neurolint15030050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
Children with ADHD show poor motor control. The aim of the present study was to test whether children with ADHD improved their motor performances (oculomotor as well as posture) after a short visuopostural training period. Two groups (G1 trained and G2 non-trained), each comprising 15 children with ADHD matched in IQ (intelligence quotient), sex, and age, participated in the study. Eye movements and postural sway were measured before (T1) and after (T2) 10 min of visuopostural training for the trained group and after 10 min of resting for the non-trained group. Training consisted of a visual search task performed while the child was standing on an unstable platform. At T1, oculomotor and postural abilities were statistically similar for both groups of children with ADHD (trained and non-trained). At T2, significant improvements in both oculomotor and postural capabilities were observed for the trained group but not for the non-trained group. These findings suggest that a short visuopostural training period could help children with ADHD to learn how to focus their visual attention in order to improve motor performance. Visuopostural training could allow a better integration of sensory inputs via central mechanisms, leading to improvement in both oculomotor and postural control. Further studies on a larger number of children with ADHD will be needed to confirm these findings and explore the eventual possible persistence of the training effect.
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Affiliation(s)
- Simona Caldani
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Ana Moscoso
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Alexandre Michel
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, 75019 Paris, France
- Paris University, 75005 Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, 75015 Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS Université Paris Nanterre, 92001 Nanterre, France
- Centre for the Functional Exploration of Balance in Children (EFEE), Robert Debré Hospital, 75019 Paris, France
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Cundari M, Vestberg S, Gustafsson P, Gorcenco S, Rasmussen A. Neurocognitive and cerebellar function in ADHD, autism and spinocerebellar ataxia. Front Syst Neurosci 2023; 17:1168666. [PMID: 37415926 PMCID: PMC10321758 DOI: 10.3389/fnsys.2023.1168666] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
The cerebellum plays a major role in balance, motor control and sensorimotor integration, but also in cognition, language, and emotional regulation. Several neuropsychiatric disorders such as attention deficit-hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as neurological diseases such as spinocerebellar ataxia type 3 (SCA3) are associated with differences in cerebellar function. Morphological abnormalities in different cerebellar subregions produce distinct behavioral symptoms related to the functional disruption of specific cerebro-cerebellar circuits. The specific contribution of the cerebellum to typical development may therefore involve the optimization of the structure and function of cerebro-cerebellar circuits underlying skill acquisition in multiple domains. Here, we review cerebellar structural and functional differences between healthy and patients with ADHD, ASD, and SCA3, and explore how disruption of cerebellar networks affects the neurocognitive functions in these conditions. We discuss how cerebellar computations contribute to performance on cognitive and motor tasks and how cerebellar signals are interfaced with signals from other brain regions during normal and dysfunctional behavior. We conclude that the cerebellum plays a role in many cognitive functions. Still, more clinical studies with the support of neuroimaging are needed to clarify the cerebellum's role in normal and dysfunctional behavior and cognitive functioning.
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Affiliation(s)
- Maurizio Cundari
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
- Unit of Neuropsychiatry, Hospital of Helsingborg, Helsingborg, Sweden
- Unit of Neurology, Hospital of Helsingborg, Helsingborg, Sweden
| | - Susanna Vestberg
- Department of Psychology, Faculty of Social Science, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden
| | - Sorina Gorcenco
- Department for Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Rasmussen
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
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Meachon EJ, Klupp S, Grob A. Gait in children with and without ADHD: A systematic literature review. Gait Posture 2023; 104:31-42. [PMID: 37307762 DOI: 10.1016/j.gaitpost.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/17/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is increasing speculation whether Attention-Deficit/Hyperactivity Disorder (ADHD) has phenotypic or secondary motor symptoms. Some evidence suggests even fundamental motor skills such as walking can differ in ADHD, however, the evidence is limited and has not been reviewed. Therefore, we conducted a systematic review to summarize the findings regarding gait in ADHD compared to typically developing children in (1) normal (i.e., self-paced), (2) paced or complex (i.e., walking backwards), and (3) dual-task contexts. METHOD Following a thorough literature search and application of stringent exclusion criteria, a total of 12 studies were included in this review. All studies examined normal walking with a variety of gait parameters in children (age range: 5-18), however, selected parameters and group differences were often inconsistent. RESULTS In self-paced walking, studies reporting gait with coefficients of variance (CVs) indicated several between-group differences, whereas averages of gait variables were the same for those with ADHD and typically developing children. Paced or complex walking contexts often differed between ADHD and typically developing groups, favoring the ADHD group in some cases, but primarily the typically developing participants. Finally, walking contexts with dual-tasks showed more frequent performance losses in the ADHD group. DISCUSSION Children with ADHD seem to have specific patterns of gait variability compared to typically developing children, particularly in complex walking contexts and at faster paces. The influence of age, medication, and method of gait normalization may have influenced the results of studies. Overall, this review highlights the potential for a unique gait profile in children with ADHD.
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Affiliation(s)
- Emily J Meachon
- Department of Psychology, University of Basel, Basel, Switzerland.
| | - Stephanie Klupp
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Alexander Grob
- Department of Psychology, University of Basel, Basel, Switzerland
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8
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Effect of psychostimulant medications on static balance performance in adults with attention deficit hyperactivity disorder: Within-subjects repeated-measure study. Hum Mov Sci 2023; 88:103067. [PMID: 36780727 DOI: 10.1016/j.humov.2023.103067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE This study examined the effect of psychostimulant medications nPS) on balance and functional motor performance in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS Participants completed two sessions (off-medication and on-medication) in a within-subjects repeated-measure study design. There was a minimum of seven days between the two sessions. During both sessions, participants stood for 30 s per condition on a force platform. The conditions were: feet-apart with 1) eyes-open and 2) eyes-closed; feet-together with 3) eyes-open and 4) eyes-closed. Participants performed three trials of timed up and go (TUG) and lateral step-up test (LSUT) during both sessions. Outcome measures were sway area (SA [cm2]), average sway velocity (SV [cm/s]), TUG average time (s), and average number of LSUT repetitions. Data were analyzed using multivariate repeated measures analysis of variance and paired t-tests for examining PS effects on balance (SA and SV) and functional motor performance (TUG and LSUT), respectively. RESULTS The sample included 45 adults (35 females; mean age = 28.4 ± 6.3 years). The repeated-measures MANOVA indicated that PS was associated with better SA [F(1,44) = 9.6; p = 0.003;ηp2 = 0.18] but not with SV [F(1,44) = 1.0; p = 0.319;ηp2 = 0.02]. PS was associated with significantly better SA with decreasing base-of-support [F(1,44) = 9.9; p = 0.003;ηp2 = 0.18]. Additionally, PS use was associated with better TUG [t(1,44) = 2.65; p = 0.014;Cohen's d = 0.39] but not LSUT performances [t(1,44) = -0.68; p = 0.499;Cohen's d = -0.10]. CONCLUSIONS PS was associated with better SA and TUG in adults with ADHD. Further studies are needed to investigate the effects of PS on balance performance using rigorous designs in this population. IMPACT Healthcare providers should screen for PS status and balance when treating adults with ADHD to enhance safe motor performance.
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Alotaibi MM, Stavrinos D, Motl RW, Bell M, Snyder SW, Hurt CP, Singh H, Lein DH. Effect of psychostimulant medications on functional balance performance in persons with Attention-Deficit/Hyperactivity Disorder: A systematic review. Gait Posture 2023; 102:146-158. [PMID: 37018889 DOI: 10.1016/j.gaitpost.2023.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
RATIONALE Balance impairments are highly prevalent and underscreened in individuals with Attention-deficit/hyperactivity disorder (ADHD). Psychostimulant medications, used to treat ADHD symptoms, may improve balance performance in this population as demonstrated by a growing literature; however, there has not been a systematic investigation to understand the effects of psychostimulant medications on balance performance in individuals with ADHD. This systematic review examined the existing evidence to determine if psychostimulant medications improve balance performance in this population. METHODS We searched PubMed, CINAHL, SPORTDiscus, Scopus, Embase and Cochrane in March 2021 and in January 2022 to locate articles relevant to the topic. Two reviewers evaluated the methodological quality of included articles using the Study Quality Assessment Tools and the PEDro scale. The reviewers rated articles for the level of evidence based on the American Academy of Neurology (AAN) criteria. The reviewers further offered recommendations for research and clinical practice based on the strength of the reviewed articles using the AAN criteria. Additionally, the reviewers gleaned important characteristics from each article, such as study design, balance domain and study results. RESULTS Nine articles addressed the role of psychostimulant medications on balance outcomes. These articles included two Class II studies, two Class III studies and five Class IV studies. Based on study quality, this systematic review indicated low confidence in the use of psychostimulant medications for improving balance performance based on AAN criteria. CONCLUSION Psychostimulant medications trends to enhance balance performance in individuals with ADHD. However, the lack of well-designed studies and heterogeneity of balance measures warrant additional research.
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Affiliation(s)
- Mansour M Alotaibi
- Department of Physical Therapy, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.
| | - Despina Stavrinos
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Robert W Motl
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, The University of Illinois Chicago. Chicago, IL, USA.
| | - Megan Bell
- UAB Libraries, Lister Hill Library of the Health Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Scott W Snyder
- Department of Human Studies, School of Education, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Christopher P Hurt
- Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Harshvardhan Singh
- Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Donald H Lein
- Department of Physical Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
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Primitive Reflex Factors Influence Walking Gait in Young Children: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074070. [PMID: 35409750 PMCID: PMC8998170 DOI: 10.3390/ijerph19074070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022]
Abstract
Background: Primitive reflexes (PRs) are observed as an automatic response to a specific stimulus. They are vivid from intrauterine life to 6 months postnatal. The reactions are inhibited with the growing maturation of the central nervous system (CNS). In some cases, when the natural process of development is incorrect, PRs manifest later. The analysis of differentiation in gait parameters in children with persistent PRs is important for better understanding their specific behaviour and movement. This study’s aim was to investigate the influence of active PRs on the gait parameters of preschool children. Methods: There were 50 children examined, 30 girls and 20 boys. They were 3.5−6 years old. The children had persistent PRs in the trace form. Each child was examined by S. Goddard’s Battery Test. The acquisition of the spatial-temporal gait parameters was performed using a BTS G-SENSOR measurement instrument. Participants walked barefoot, in the most natural way for them, at a self-selected speed on a 5 m walkway, then turned around and went back. They performed this twice. Results: The reflex activity influences gait cycle duration (p = 0.0099), the left step length (p = 0.0002), the left double support phase (p = 0.0024), the right double support phase (p = 0.0258) and the right single phase. Difficulties in recreating the crawling pattern and GRASP reflex influence gait cadence (p < 0.05). The left GRASP reflex corresponds to step length (p < 0.05). The activeness of the symmetrical tonic neck reflex correlates with the right single support (p < 0.05). Conclusion: The presence of PRs affect walking gait in preschool children.
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Abstract
Physical activities, according to the embodied cognition theory, are an important manifestation of cognitive functions. As a result, in this paper, the Activate Test of Embodied Cognition (ATEC) system is proposed to assess various cognitive measures. It consists of physical exercises with different variations and difficulty levels designed to provide assessment of executive and motor functions. This work focuses on obtaining human activity representation from recorded videos of ATEC tasks in order to automatically assess embodied cognition performance. A self-supervised approach is employed in this work that can exploit a small set of annotated data to obtain an effective human activity representation. The performance of different self-supervised approaches along with a supervised method are investigated for automated cognitive assessment of children performing ATEC tasks. The results show that the supervised learning approach performance decreases as the training set becomes smaller, whereas the self-supervised methods maintain their performance by taking advantage of unlabeled data.
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Takagi S, Hori H, Yamaguchi T, Ochi S, Nishida M, Maruo T, Takahashi H. Motor Functional Characteristics in Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorders: A Systematic Review. Neuropsychiatr Dis Treat 2022; 18:1679-1695. [PMID: 35971415 PMCID: PMC9375548 DOI: 10.2147/ndt.s369845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The development of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) has various influences on physical abilities. Identification of specific physical abilities of people with ADHD/ASDs as biomarkers for diagnosing these conditions is necessary. Therefore, in the present review, we aimed firstly to extract the difference in physical abilities of people with ADHD or ASDs compared to those of normal individuals. Secondly, we aimed to extract the specific physical ability characteristics for identifying potential diagnostic biomarkers in people with ADHD/ASDs. METHODS A systematic literature review was performed. The databases were searched for relevant articles on motor function deficits and characteristics of ADHD or ASD. RESULTS Forty-one cross-sectional studies and three randomized controlled trials were identified, comprising 33 studies of ADHD, 10 studies of ASDs, and 1 study of both ADHD and ASDs. The quality of studies varied. Three types of physical activities/exercises were identified, including coordinated movement, resistance-type sports, and aerobic-type sports. People with ADHD/ASDs generally exhibited poorer physical abilities for all types of activities, possibly because of low levels of physical activity. Specifically, we found temporal discoordination of movement in ADHD and integration or synchronization of separate movements in ASDs. CONCLUSION Specific deficits in physical ability may be attributed to ADHD/ASDs. However, there is not enough research on the physical abilities of people with ADHD and ASDs to clarify the specific deficits. Investigation of specific motor functions that characterize ADHD/ASDs should be facilitated.
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Affiliation(s)
- Shunsuke Takagi
- Department of Psychiatry and Behavioral Neurosciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
| | - Hikaru Hori
- Department of Psychiatry, School of Medicine, Fukuoka University, Fukuoka, 814-0180, Japan
| | - Tatsuya Yamaguchi
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinichiro Ochi
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Shitsukawa, Ehime, 791-0295, Japan
| | - Masaki Nishida
- Faculty of Sport Science, Waseda University Tokorozawa, Saitama, 359-1192, Japan
| | - Takashi Maruo
- Department of Psychiatry and Behavioral Neurosciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Neurosciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
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Kaya Mutlu E, Birinci T, Kaya Aytutuldu G, Mutlu C, Razak Ozdincler A. The investigation of foot structure within children who have attention-deficit hyperactivity disorder: a case-controlled study. J Pediatr Orthop B 2022; 31:e24-e30. [PMID: 34028377 DOI: 10.1097/bpb.0000000000000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The impairments in motor performance could be related to the foot structure in children with attention-deficit/hyperactivity disorder (ADHD) while considering the close relationship between foot structure and lower extremity alignment. This study aimed to investigate the foot structure and its relationships between disease severity, physical activity and psychiatric traits in children with ADHD. Children with ADHD (n = 50; mean age: 12.02 ± 1.83 years) and typically developing peers (n = 30; mean age: 12.86 ± 2.56 years) were included. The static footprint analysis was collected by using digital images. The ImageJ program was used to calculate Clarke's angle, Staheli arch index (SAI) and Chippaux-Smirak index (CSI). The Turgay DSM-IV disruptive behavior disorders rating scale (T-DSM-IV-S), physical activity questionnaire for older children (PQ-C), children's depression inventory and state-trait anxiety inventory for children were all used to assess symptoms of ADHD, physical activity, depression, stress and anxiety, respectively. Approximately 52-53% of children with ADHD had mild to severe flatfoot, while only 8-13% of typically developing peers had flatfoot based on SAI and CSI (P = 0.01). Significant correlation was found between Clarke's angle and PQ-C (r = 0.21, P = 0.04). Besides, T-DSM-IV-S was significantly correlated with SAI (r = 0.24, P = 0.01) and CSI (r = 0.25, P = 0.01) in children with ADHD. Children with ADHD had a significantly greater tendency of flatfoot compared to typically developing peers. Besides, the deterioration of the foot structure of children with ADHD was associated with disease severity.
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Affiliation(s)
- Ebru Kaya Mutlu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa
| | - Tansu Birinci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University
| | - Guzin Kaya Aytutuldu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Yeditepe University
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Başakşehir Çam and Sakura City Hospital
| | - Arzu Razak Ozdincler
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Biruni University, Istanbul, Turkey
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Gait Parameters in Healthy Preschool and School Children Assessed Using Wireless Inertial Sensor. SENSORS 2021; 21:s21196423. [PMID: 34640743 PMCID: PMC8512031 DOI: 10.3390/s21196423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
Background: The objective gait assessment in children has become more popular. Basis parameters for comparison during the examination are advisable. Objectives: The study aim was to investigate the typical gait parameters of healthy preschool and school children, using a wireless inertial sensor as the reference for atypical gait. The additional aim was to compare the specific gait parameters in the younger and older group of children. Methods: One hundred and sixty-one children’s gait parameters were evaluated by a G-Walk BTS G-SENSOR smart analyzer. The children were walking barefoot, at a self-selected speed, on a five-meter walkway, and they turned around and go back twice. Results: Age significantly influences most of the spatiotemporal parameters. The support phase becomes shorter with age. Accordingly, the swing phase becomes longer with age. The results also show that older children need shorter double support and have longer single support. Moreover, the pelvic tilt symmetry index is higher with increasing age. In each age division, the smallest variation in all gait parameters within the oldest group of examined children was observed. A comparison between the left and right side gait parameters shows the higher difference in boys than in girls. A significant difference was calculated in the pelvic obliquity symmetry index. Girls had significantly more symmetrical obliquity than boys. Conclusions: the research indicates the basic parameters of typical children’s gait, which may be a reference to atypical gait in the case of trauma or disability.
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Van Hecke R, Deconinck FJA, Wiersema JR, Clauws C, Danneels M, Dhooge I, Leyssens L, Van Waelvelde H, Maes L. Balanced Growth project: a protocol of a single-centre observational study on the involvement of the vestibular system in a child's motor and cognitive development. BMJ Open 2021; 11:e049165. [PMID: 34117049 PMCID: PMC8202106 DOI: 10.1136/bmjopen-2021-049165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/07/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The involvement of the vestibular system in the motor and higher (cognitive) performances of typically developing or vestibular-impaired children is currently unknown or has only scarcely been explored. Interestingly, arguments for an interaction between vestibular, motor and cognitive functions in children can also be supported by research on children known for their difficulties in motor and/or cognitive processing (eg, children with neurodevelopmental disorders (NDD)), as they often present with vestibular-like characteristics. Therefore, in order to elucidate this interaction, and to increase the understanding of the pathophysiology and symptomatology of vestibular disorders and NDD in children, the Balanced Growth project was developed. It includes the following objectives: (1) to understand the association between motor skills, cognitive performances and the vestibular function in typically developing school-aged children, with special focus on the added value of the vestibular system in higher cognitive skills and motor competence; (2) to investigate whether a vestibular dysfunction (with/without an additional auditory disease) has an impact on motor skills, cognitive performances and motor-cognitive interactions in children and (3) to assess if an underlying vestibular dysfunction can be identified in school-aged children with NDD, with documentation of the occurrence and characteristics of vestibular dysfunctions in this group of children using an extensive vestibular test battery. METHODS AND ANALYSIS In order to achieve the objectives of the observational cross-sectional Balanced Growth study, a single-task and dual-task test protocol was created, which will be performed in three groups of school-aged children (6-12 years old): (1) a typically developing group (n=140), (2) (audio) vestibular-impaired children (n=30) and (3) children with an NDD diagnosis (n=55) (ie, autism spectrum disorder, attention deficit/hyperactivity disorder and/or developmental coordination disorder). The test protocol consists of several custom-made tests and already existing validated test batteries and includes a vestibular assessment, an extensive motor assessment, eight neurocognitive tests, a cognitive-motor interaction assessment and includes also additional screenings to control for potential confounding factors (eg, hearing status, intelligence, physical activity, etc). ETHICS AND DISSEMINATION The current study was approved by the ethics committee of Ghent University Hospital on 4 June 2019 with registration number B670201940165 and is registered at Clinical Trials (clinicaltrials.gov) with identifier NCT04685746. All research findings will be disseminated in peer-reviewed journals and presented at vestibular as well as multidisciplinary international conferences and meetings. TRIAL REGISTRATION NUMBER NCT04685746.
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Affiliation(s)
- Ruth Van Hecke
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Frederik J A Deconinck
- Department of Movement and Sports Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University Faculty of Psychology and Educational Sciences, Ghent, Belgium
| | - Chloe Clauws
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
- Department of Head and Skin, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Laura Leyssens
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Hilde Van Waelvelde
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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16
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Karabulut M, Bas B, Müjdeci B. Evaluation of dual-task performance with Nintendo Wii-Fit plus in children with specific learning disabilities. HEARING, BALANCE AND COMMUNICATION 2021. [DOI: 10.1080/21695717.2020.1870822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Mustafa Karabulut
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Banu Bas
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Banu Müjdeci
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
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17
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Surgent OJ, Walczak M, Zarzycki O, Ausderau K, Travers BG. IQ and Sensory Symptom Severity Best Predict Motor Ability in Children With and Without Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:243-254. [PMID: 32410096 PMCID: PMC7665981 DOI: 10.1007/s10803-020-04536-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Motor challenges are commonly reported in autism spectrum disorder (ASD). Yet, there is substantial heterogeneity in motor ability within ASD, and it is unknown what behavioral characteristics best explain individual differences in motor ability in ASD and related conditions. This observational study examined motor ability as a function of sensory features, attention deficit/hyperactivity symptoms, ASD symptoms, and IQ in 110 children with ASD, typical development, or an intermediate behavioral profile. While motor challenges were more prevalent in the ASD group compared to other groups, sensory symptom severity and IQ across all individuals best predicted motor performance above-and-beyond group status. Therefore, motor challenges may be best characterized by individual variation in sensory features and cognitive abilities rather than diagnostic group.
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Affiliation(s)
- Olivia J Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Matthew Walczak
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA
| | - Oskar Zarzycki
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Karla Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI, 53706, USA.
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Room 435, Madison, WI, 53705, USA.
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18
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Bob P, Konicarova J, Raboch J. Disinhibition of Primitive Reflexes in Attention Deficit and Hyperactivity Disorder: Insight Into Specific Mechanisms in Girls and Boys. Front Psychiatry 2021; 12:430685. [PMID: 34819879 PMCID: PMC8606578 DOI: 10.3389/fpsyt.2021.430685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: Cognitive and motor disintegration and other functional disturbances in various neuropsychiatric disorders may be related to inhibitory deficits that may manifest as a persistence or re-expression of primitive reflexes and few recent data suggest that these deficits may occur in Attention Deficit and Hyperactivity Disorder (ADHD). Methods: We have tested a hypothesis to which extent ADHD symptoms and balance deficits are related to persisting primitive reflexes, such as Asymmetric Tonic Neck Reflex (ATNR) and Symmetric Tonic Neck Reflex (STNR) in 80 medication-naïve children with ADHD (40 boys and 40 girls) in the school age (8-11 years) and compared these data with a control group of 60 children (30 boys and 30 girls). Results: These data show new finding that ADHD symptoms and balance deficits are strongly and specifically associated with persistent ATNR in girls and STNR in boys. Conclusions: These results provide first evidence in medical literature that ADHD in girls and boys is specifically related to distinguished neurological developmental mechanisms related to disinhibition of primitive reflexes.
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Affiliation(s)
- Petr Bob
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
| | - Jana Konicarova
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia.,Stroder Therapy Center, Cham, Germany
| | - Jiri Raboch
- Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, First Faculty of Medicine and Department of Psychiatry, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia
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19
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Evans EA, Cook NE, Iverson GL, Townsend EL, Duhaime AC. Assessing Physical Function and Mobility following Pediatric Traumatic Brain Injury with the NIH Toolbox Motor Battery: A Feasibility Study. Phys Occup Ther Pediatr 2021; 41:56-73. [PMID: 32396483 PMCID: PMC7657981 DOI: 10.1080/01942638.2020.1758985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIMS Traumatic brain injury (TBI) can impair physical function in children. The NIH Toolbox Motor Battery (NIHTB-M) was designed to be a brief assessment of physical function, but no studies have examined its use in children with TBI. This study aims to describe the feasibility of using the NIHTB-M to assess children with TBI. METHODS The NIHTB-M was administered to children with TBI 2 weeks (n = 22) and/or 6 months (n = 23) following injury. This descriptive study summarizes participant performance, administration challenges, and the association between NIHTB-M scores, participant characteristics, and subjective report of physical function. RESULTS Of the NIHTB-M domains, deficits in endurance and balance were most prevalent. Children aged 5 to 16 years could complete the assessment per administration guidelines, except for a few cases (n = 3) where orthopedic injuries limited participation. Younger children (aged 3 to 4) had difficulty following the NIHTB-M directions. Technological issues impacted balance assessment in several cases (n = 6). CONCLUSION The NIHTB-M is brief to administer, generally well tolerated by school-aged children and, despite occasional technological challenges, is a feasible performance-based battery for assessment of children with TBI for clinical and research purposes. Additional investigation of psychometric properties and ceiling and floor effects is needed.
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Affiliation(s)
- Emily A Evans
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Center for Gerontology and Healthcare Research, Brown University, Rhode Island, USA
| | - Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.,MassGeneral Hospital for Children™ Sports Concussion Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA.,MassGeneral Hospital for Children™ Sports Concussion Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Spaulding Rehabilitation Hospital and Spaulding Research Institute, Boston, Massachusetts, USA.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, USA
| | - Elise L Townsend
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Ann-Christine Duhaime
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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- San Francisco General Hospital and Trauma Center, University of California, San Francisco, California, USA
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20
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Chen D, Yu J, Wang J, Bai Y, Zhang Y, Lu X, Che B, Chen S, Huang Y, Yang X. Screening of Sensitive Items on Gross Motor Development in Toddlers Aged 24~36 Months and Analysis of the Factors Influencing the Passing Rate. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E226. [PMID: 33202785 PMCID: PMC7698003 DOI: 10.3390/children7110226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND To save assessment time and improve the efficiency, it is necessary to find sensitive indicators from the test items of gross motor development in the C-LAP system for children aged 24~36 months and analyze the influencing factors of the passing rate of these indicators. METHODS This retrospective study was conducted among 1354 toddlers (3058 person-times) aged 24 to 36 months in Beijing, Shanghai, Guangdong between January 2013 and December 2019. A linear regression model and Cox regression model were performed to screen sensitive indicators and explore their influencing factors, respectively. RESULTS "Walk backwards", "Stand from supine position" and "Hop with one foot at least twice" are the three sensitive indicators for evaluating the development of gross motor function in 24~36 month old children. The child's physiological age at first measurement and region are the two common independent factors influencing the passing rate of the three items, while paternal age and education may influence one or two of them. CONCLUSIONS "Walk backwards", "Stand from supine position" and "Hop with one foot at least twice" are sensitive indicators for the effective evaluation of the development of gross motor function in 24~36 month old children, and their passing rates are influenced by some demographic variables.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Xiaoguang Yang
- Key Laboratory of Public Health Safety, Ministry of Education, National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), School of Public Health, Fudan University, Shanghai 200433, China; (D.C.); (J.Y.); (J.W.); (Y.B.); (Y.Z.); (X.L.); (B.C.); (S.C.); (Y.H.)
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21
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Sember V, Grošelj J, Pajek M. Balance Tests in Pre-Adolescent Children: Retest Reliability, Construct Validity, and Relative Ability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155474. [PMID: 32751279 PMCID: PMC7432309 DOI: 10.3390/ijerph17155474] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
Balance is an essential prerequisite for the normal physical development of a child. It consists of the ability to maintain the body’s centre of mass over its base of support, which is enabled by automatic postural adjustments, and maintain posture and stability in various conditions and activities. The present study aimed to determine the measurement characteristics (reliability and concurrent validity) and the relative ability of balance tests and different motor tests in healthy 11-year-olds. We also evaluated the impact of vision on balance ability. Our results showed high interrater reliability (from 0.810 to 0.910) and confirmed the construct validity of the included balance tests. Girls performed significantly better than boys in laboratory tandem stance in following balance components: total sway path with eyes open (BSEO) (t = 2.68, p = 0.01, effect size (ES) = 0.81), total body sway with eyes closed of centre of pressure (CoP) displacement in the a-p direction (BSEC) (t = 1.86, p = 0.07, ES = 0.57), mean velocity of CoP displacements (VEO) (t = 2.67, p = 0.01, ES = 0.83), mean amplitude of CoP displacements in the a-p direction (AapEO) (t = 3.38. p = 0.00, ES = 1.01) and in mean amplitude of CoP displacements in the m-l direction (AmlEO) (t = 3.68, p = 0.00, ES = 1.19). With eyes closed, girls performed significantly better (t = 2.28, p = 0.03, ES = 0.70) than boys did in the mean amplitude of COP displacements in the a-p direction (AapEO) and significantly better (t = 2.37, p = 0.03, ES = 0.71) in the mean amplitude of COP displacements in the m-l direction (AmlEC). Insignificant correlations between different balance tests, except for a correlation between the flamingo test and one-leg stance on a low beam (r = 0.558, p < 0.01), show that each test assesses different aspects of balance ability; therefore, balance cannot be assessed with a single test.
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Affiliation(s)
- Vedrana Sember
- Faculty of Sports, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Janja Grošelj
- Elementary School Spodnja Idrija, 5280 Idrija, Slovenia;
| | - Maja Pajek
- Faculty of Sports, University of Ljubljana, 1000 Ljubljana, Slovenia;
- Correspondence: ; Tel.: +386-41-794-658
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22
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Buker N, Salik Sengul Y, Ozbek A. Physical Fitness and Dynamic Balance in Medication Naïve Turkish Children with ADHD. Percept Mot Skills 2020; 127:858-873. [PMID: 32615910 DOI: 10.1177/0031512520938517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated physical fitness levels and dynamic balance in medication-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). Participants were 24 medication-naïve Turkish children with ADHD (4 girls, 20 boys) and 19 typically developing (TD) Turkish children (4 girls, 15 boys). We measured physical fitness levels with the Eurofit Test Battery, body composition with the Inbody 720 Body Composition Analyzer, cognitive attention with the Stroop Test, and dynamic balance with the Y-Balance Test. We found significantly poorer dynamic balance and both upper extremity and running fitness problems among the medication-naïve Turkish children with ADHD compared to the TD group (p = 0.002; p = 0.032; p = 0.002). It may be important to adress dynamic balance and physical fitness when treating children with ADHD.
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Affiliation(s)
- Nurullah Buker
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Aylin Ozbek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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23
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Simmons RW, Taggart TC, Thomas JD, Mattson SN, Riley EP. Gait control in children with attention-deficit/hyperactivity disorder. Hum Mov Sci 2020; 70:102584. [PMID: 32217203 DOI: 10.1016/j.humov.2020.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 10/25/2022]
Abstract
The current profile of gait control in children with ADHD is incomplete and predominately based on children walking forward at a self-selected pace. There are no studies of potential gait deficits in this clinical population when walking in different directions in combination with varying rates of stepping that are freely selected and entrained to an external stimulus. The purpose of the current study was to address this lack of information by assessing gait of children aged 7-17 years with (n = 17) and without (n = 26) ADHD. Participants walked forward and backward along an electronically instrumented carpet at a self-selected stepping rate and in synchrony to a metronome that dictated an increased and decreased stepping rate. Using repeated measures analysis of covariance (ANCOVA) to assess spatiotemporal gait parameters, results showed that children with ADHD exhibited a significantly exaggerated, toes 'turned out,' foot position for all walking conditions compared to typically developing children. When walking backward, children with ADHD produced an increased step width, higher stepping cadence, and increased velocity. Additionally, coefficient of variation ratios indicated that children with ADHD produced greater variability of velocity, cadence, and step time for all walking conditions, and greater variability for stride length when walking at an increased stepping rate. Results were interpreted in terms of clinical significance and practical ramifications that inform rehabilitation specialists in designing therapies that ameliorate the reported gait deficits.
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Affiliation(s)
- Roger W Simmons
- Motor Control Laboratory, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, United States of America.
| | - Tenille C Taggart
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, CA 92120, United States of America; Clinical Psychology Doctoral Program, Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - Jennifer D Thomas
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, CA 92120, United States of America
| | - Sarah N Mattson
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, CA 92120, United States of America
| | - Edward P Riley
- Center for Behavioral Teratology, Department of Psychology, San Diego State University, San Diego, CA 92120, United States of America
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24
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Surgent OJ, Dadalko OI, Pickett KA, Travers BG. Balance and the brain: A review of structural brain correlates of postural balance and balance training in humans. Gait Posture 2019; 71:245-252. [PMID: 31082657 PMCID: PMC6594858 DOI: 10.1016/j.gaitpost.2019.05.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance challenges are associated with not only the aging process but also a wide variety of psychiatric and neurological disorders. However, relatively little is known regarding the neural basis of balance and the effects of balance interventions on the brain. RESEARCH QUESTION This review synthesizes the existing literature to answer the question: What are the key brain structures associated with balance? METHODS This review examined 37 studies that assessed brain structures in relation to balance assessment or intervention. These studies provided 234 findings implicating 71 brain structures. The frequency of implication for each structure was examined based upon specific methodological parameters, including study design (assessment/intervention), type of balance measured (static/dynamic), population (clinical/non-clinical), and imaging analysis technique (region of interest [ROI]/voxel-based morphometry [VBM]). RESULTS Although a number of structures were associated with balance across the brain, the most frequently implicated structures included the cerebellum, basal ganglia, thalamus, hippocampus, inferior parietal cortex, and frontal lobe regions. Findings in the cerebellum and brainstem were most common in studies with clinical populations, studies that used an ROI approach, and studies that measured dynamic balance. Findings in the frontal, occipital, and parietal regions were also more common in studies that measured dynamic compared to static balance. SIGNIFICANCE While balance appears to be a whole-brain phenomenon, a subset of structures appear to play a key role in balance and are likely implicated in balance disorders. Some of these structures (i.e., the cerebellum, basal ganglia and thalamus) have a well-appreciated role in balance, whereas other regions (i.e., hippocampus and inferior parietal cortex) are not commonly thought to be associated with balance and therefore may provide alternative explanations for the neural basis of balance. Key avenues for future research include understanding the roles of all regions involved in balance across the lifespan and in different clinical populations.
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Affiliation(s)
- Olivia J. Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI 53705, USA.,Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
| | - Olga I. Dadalko
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA
| | - Kristen A. Pickett
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, USA.,Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, 2185 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA
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Van Hecke R, Danneels M, Dhooge I, Van Waelvelde H, Wiersema JR, Deconinck FJA, Maes L. Vestibular Function in Children with Neurodevelopmental Disorders: A Systematic Review. J Autism Dev Disord 2019; 49:3328-3350. [DOI: 10.1007/s10803-019-04059-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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26
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Wearable-based electronics to objectively support diagnosis of motor impairments in school-aged children. J Biomech 2019; 83:243-252. [PMID: 30554812 DOI: 10.1016/j.jbiomech.2018.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/12/2018] [Accepted: 12/01/2018] [Indexed: 11/22/2022]
Abstract
Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are neuro-developmental disorders, starting in childhood, which can affect the planning of movements and the coordination. We investigated how and in which measure a system based on wearable inertial measurement units (IMUs) can provide an objective support to the diagnosis of motor impairments in school-aged children. The IMUs measured linear and rotational movements of 37 schoolchildren, 7-10yo, 17 patients and 20 control subjects, during the execution of motor exercises, performed under medical and psychiatric supervision, to assess different aspects of the motor coordination. The measured motor parameters showed a high degree of significance in discriminating the ADHD/DCD patients from the healthy subjects, pointing out which motor tasks are worth focusing on. So, medical doctors have a novel key lecture to state a diagnosis, gaining in objectivity with respect to the standard procedures which mainly involve subjective human judgment. Differently to other works, we propose a novel approach in terms of number of used IMUs and of performed motor tasks. Moreover, we demonstrate the meaningful parameters to be considered as more discriminant in supporting the medical diagnosis.
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Caldani S, Razuk M, Septier M, Barela JA, Delorme R, Acquaviva E, Bucci MP. The Effect of Dual Task on Attentional Performance in Children With ADHD. Front Integr Neurosci 2019; 12:67. [PMID: 30705623 PMCID: PMC6344422 DOI: 10.3389/fnint.2018.00067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/31/2018] [Indexed: 11/13/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder without validated objective markers. Oculomotor behavior and executive motor control could potentially be used to investigate attention disorders. The aim of this study was to explore an oculomotor and postural dual task in children with ADHD. Forty-two children were included in the study, gathering children with ADHD (n = 21) (mean 8.15 age ± years 0.36) and sex-, age-, and IQ-matched typically developing children (TD). Children performed two distinct fixation tasks in three different postural conditions. Eye movements and postural body sway were recorded simultaneously, using an eye tracker and a force platform. Results showed that children with ADHD had poor fixation capability and poor postural stability when compared to TD children. Both groups showed less postural control on the unstable platform and displayed more saccades during the fixation task. Surprisingly, in the dual unstable platform/fixation with distractor task, the instability of children with ADHD was similar to that observed in TD children. “Top-down” dys-regulation mediated by frontal-striatal dysfunction could be at the origin of both poor inhibitory oculomotor deficits and impaired body stability reported in children with ADHD. Finally, we could assume that the fact both groups of children focused their attention on a secondary task led to poor postural control. In the future it could be interesting to explore further this issue by developing new dual tasks in a more ecological situation in order to gain more insight on attentional processes in children with ADHD. HIGHLIGHTS – Children with ADHD showed poor fixation capability when compared to TD children. – “Top-down” dys-regulation mediated by frontal-striatal dysfunction could be at the origin of both poor inhibitory oculomotor deficits and impaired body stability reported in children with ADHD. – Both groups of children focused their attention on the visual fixation task leading to poor postural control. – In the future it could be interesting to develop new dual tasks in an ecological situation in order to gain more insight on attentional processes in children with ADHD.
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Affiliation(s)
- Simona Caldani
- UMR 1141 INSERM, Université Paris Diderot, Hôpital Robert Debré, Paris, France.,EFEE-Centre d'Exploration Fonctionnelle de l'Équilibre chez l'Enfant, Robert Debré Hospital, Paris, France
| | - Milena Razuk
- UMR 1141 INSERM, Université Paris Diderot, Hôpital Robert Debré, Paris, France.,Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, Brazil
| | - Mathilde Septier
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - José Angelo Barela
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, Brazil.,Institute of Biosciences, São Paulo State University, Rio Claro, Brazil
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France.,Paris Diderot University, Paris 7, Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Maria Pia Bucci
- UMR 1141 INSERM, Université Paris Diderot, Hôpital Robert Debré, Paris, France.,EFEE-Centre d'Exploration Fonctionnelle de l'Équilibre chez l'Enfant, Robert Debré Hospital, Paris, France
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28
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Postural instability in adult ADHD - A pilot study. Gait Posture 2019; 67:284-289. [PMID: 30391751 DOI: 10.1016/j.gaitpost.2018.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/09/2018] [Accepted: 10/14/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Apart from inattention, hyperactivity and impulsivity, ADHD in childhood presents with an impairment of motor coordination and balance functions. Until now, literature is scarce about sensorimotor deficits in adult ADHD. This is a pilot study that identifies and quantifies the role of sensory, motor, and central adaptation mechanisms for adult ADHD patients' sensorimotor deficits in a systematic way, using postural control. METHODS We analyzed spontaneous and externally perturbed stance in ten adult patients suffering from ADHD. Findings were compared to data from ten matched healthy subjects. RESULTS Spontaneous sway amplitudes and velocities were larger in ADHD patients compared to healthy subjects. Furthermore, body excursions as a function of platform tilts were abnormally large in ADHD patients, specifically in the low frequency range. Based on simple feedback model simulations, we found that ADHD patients showed a larger time delay between platform tilts and body response, and a lower value of the integral part of the neural controller, which affects the long-term control of their posture. These postural abnormalities correlated well with the hyperactivity and impulsivity dimensions of the individual ADHD symptoms. CONCLUSION We conclude that adult ADHD patients' major postural deficit consists of an impairment of a stable, long-term sensorimotor behavior, which fits very well to the concept of impulsivity and hyperactivity.
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Inter-trial variability in brain activity as an indicator of synergistic effects of HIV-1 and drug abuse. Drug Alcohol Depend 2018; 191:300-308. [PMID: 30170301 PMCID: PMC10127228 DOI: 10.1016/j.drugalcdep.2018.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND The objective of this investigation was to detect evidence of the synergism in the effects of HIV-1 and drug abuse on brain function that has been hypothesized but rarely shown. The investigation incorporated several noteworthy improvements in the approach. It used urine toxicology tests to exclude participants complicated by recent methadone use and illicit drug use. Also, it defined drug abuse on a scale that considered symptom severity. Most importantly, it examined inter-trial variability in brain activity as a potentially more sensitive indicator of group differences and functional impairment than the across-trial average. METHODS 173 participants were assigned to groups defined by their HIV-1 serostatus and Drug Abuse Screening Test score (DAST < vs. > = 6). They completed a simple letter discrimination task including rare target and rare nontarget stimuli. Event-related electroencephalographic responses and key press responses were measured on each trial. During a separate assessment, posturographic measures were recorded. RESULTS The inter-trial standard deviation of P300-like activity was superior to the mean amplitude of this activity in differentiating the groups. Unlike the mean, it revealed synergistic statistical effects of HIV and drug abuse. It also correlated significantly with static ataxia. CONCLUSIONS Inter-trial variability in P300-like activity is a useful marker for detecting subtle and episodic disruptions in brain function. It demonstrates greater sensitivity than the mean amplitude for detecting differences across groups. Also, as a putative indicator of a disruption in the attentional monitoring of behavior, it predicts subtle impairments in gross motor function.
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Hirjak D, Meyer-Lindenberg A, Fritze S, Sambataro F, Kubera KM, Wolf RC. Motor dysfunction as research domain across bipolar, obsessive-compulsive and neurodevelopmental disorders. Neurosci Biobehav Rev 2018; 95:315-335. [PMID: 30236781 DOI: 10.1016/j.neubiorev.2018.09.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/08/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
Although genuine motor abnormalities (GMA) are frequently found in schizophrenia, they are also considered as an intrinsic feature of bipolar, obsessive-compulsive, and neurodevelopmental disorders with early onset such as autism, ADHD, and Tourette syndrome. Such transnosological observations strongly suggest a common neural pathophysiology. This systematic review highlights the evidence on GMA and their neuroanatomical substrates in bipolar, obsessive-compulsive, and neurodevelopmental disorders. The data lends support for a common pattern contributing to GMA expression in these diseases that seems to be related to cerebello-thalamo-cortical, fronto-parietal, and cortico-subcortical motor circuit dysfunction. The identified studies provide first evidence for a motor network dysfunction as a correlate of early neurodevelopmental deviance prior to clinical symptom expression. There are also first hints for a developmental risk factor model of these mental disorders. An in-depth analysis of motor networks and related patho-(physiological) mechanisms will not only help promoting Research Domain Criteria (RDoC) Motor System construct, but also facilitate the development of novel psychopharmacological models, as well as the identification of neurobiologically plausible target sites for non-invasive brain stimulation.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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Sarafpour M, Shirazi SY, Shirazi E, Ghazaei F, Parnianpour Z. Postural Balance Performance of Children with ADHD, with and without Medication: A Quantitative Approach . ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:2100-2103. [PMID: 30440817 DOI: 10.1109/embc.2018.8512636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
tAtention Deficit Hyperactivity Disorder (ADHD) significantly impairs the performance of students during their early school years. However, the extent of the difference in postural stability between children with ADHD and Typically Developed (TD) children, are still not fully understood. Also, it is clinically important to investigate possible effects of medication on their performances. We recruited 38 children between the ages 6 to 12 with ADHD (15 medically naïve, 23 with current treatment history) and 25 age-matched as TD. Postural stability performance was assessed in four conditions: 1-eyes open, 2-eyes closed, 3-eyes open on foam and 4-eyes closed on foam. A cost-effective mobile force platform was used to evaluate postural performance quantitatively. Results revealed a lower stability performance in the medically-naïve participants especially in trials with eyes open on foam. No significant difference in performance was seen between children with medical treatment history and the TD group. Results suggest that using medication can effectively enhance postural stability for children with ADHD. We found portable balance assessment tools helpful in identifying changes in motor performances among children with ADHD. Our results indicate that further research is needed to understand the exact implications of ADHD on postural stability under different sensory stimuli.
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Rotational and Collic Vestibular-Evoked Myogenic Potential Testing in Normal Developing Children and Children With Combined Attention Deficit/Hyperactivity Disorder. Ear Hear 2018; 38:e352-e358. [PMID: 28562425 DOI: 10.1097/aud.0000000000000451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. DESIGN We enrolled 30 typically developing children (15 boys and 15 girls; mean age, 9 years 6 months; range, 7 to 12 years) and 33 children (19 boys and 14 girls; mean age, 9 years 0 months; range, 7 to 12 years) with cADHD diagnosed by our research psychiatrist. Typically developing controls were used to obtain normative data on vestibular testing and to examine the impact of age on the vestibular response parameters, and these results were compared with those of the cADHD group. All children underwent the sinusoidal harmonic acceleration subtype of the rotary chair test (0.01, 0.02, 0.08, 0.16, and 0.32 Hz) and the cervical vestibular-evoked myogenic potential (cVEMP) test. RESULTS At all five frequencies in the sinusoidal harmonic acceleration test, there was no significant correlation between age and any of the following rotary chair response parameters in typically developing children: vestibulo-ocular reflex (VOR) gain, phase, asymmetry, and fixation index. Furthermore, there was no significant correlation between age and any of the following cVEMP parameters for the right and left ears of control group: p1 and n1 latency, amplitude, threshold, and amplitude ratio. Significantly higher VOR gains were observed for children with cADHD at frequencies of 0.01 (p = 0.001), 0.08 (p < 0.001), 0.16 (p = 0.001), and 0.32 (p = 0.003) Hz, when compared with the control group. Furthermore, fixation abilities were significantly lower in the cADHD group than in the control group at 0.16 (p < 0.001) and 0.32 (p < 0.001) Hz. cVEMP parameters showed no significant differences between the two groups. CONCLUSIONS Our results showed higher VOR gains and poorer fixation abilities in children with cADHD compared with typically developing children. Cerebellar dysfunction in patients with ADHD has been well documented in the literature, and our findings of cVEMP and rotary chair tests for these children showed impaired vestibular function in these children, based on increased VOR gain values and decreased fixation capabilities. Because VOR gain is mediated through the inferior olive and controlled by the cerebellum, our results suggest that central inhibition of vestibular function may be deficient in children with cADHD, resulting in higher VOR gains. Also, there is general agreement that failure of fixation suppression indicates a central lesion. The lesion can originate from the parietal-occipital cortex, the pons, or the cerebellum. However, failure of fixation suppression is most prominent in lesions involving the midline cerebellum that could be counted for children with cADHD. We believe that this contribution is theoretically and practically relevant as high VOR gains and decreased suppression capabilities may result in symptoms of reading and writing difficulties, learning disabilities, vertigo, and motion sickness in these children. Therefore, assessment of vestibular function in children with cADHD at a young age must be considered when developing rehabilitation protocols for these children.
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Bruchhage MMK, Bucci MP, Becker EBE. Cerebellar involvement in autism and ADHD. HANDBOOK OF CLINICAL NEUROLOGY 2018; 155:61-72. [PMID: 29891077 DOI: 10.1016/b978-0-444-64189-2.00004-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The cerebellum has long been known for its importance in motor learning and coordination. However, increasing evidence supports a role for the cerebellum in cognition and emotion. Consistent with a role in cognitive functions, the cerebellum has emerged as one of the key brain regions affected in nonmotor disorders, including autism spectrum disorder and attention deficit-hyperactivity disorder. Here, we discuss behavioral, postmortem, genetic, and neuroimaging studies in humans in order to understand the cerebellar contributions to the pathogenesis of both disorders. We also review relevant animal model findings.
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Affiliation(s)
- Muriel M K Bruchhage
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Maria-Pia Bucci
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Esther B E Becker
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom.
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Abstract
More than a century after the description of its cardinal components, the cerebellar motor syndrome (CMS) remains a cornerstone of daily clinical ataxiology, in both children and adults. Anatomically, motor cerebellum involves lobules I-V, VI, and VIII. CMS is typically associated with errors in the metrics of voluntary movements and a lack of coordination. Symptoms and motor signs consist of speech deficits, impairments of limb movements, and abnormalities of posture/gait. Ataxic dysarthria has a typical scanning (explosive with staccato) feature, voice has a nasal character, and speech is slurred. Cerebellar mutism is most common in children and occurs after resection of a large midline cerebellar tumor. Ataxia of limbs includes at various degrees dysmetria (hypermetria: overshoot, hypometria: undershoot), dysdiadochokinesia, cerebellar tremor (action tremor, postural tremor, kinetic tremor, some forms of orthostatic tremor), isometrataxia, disorders of muscle tone (both hypotonia and cerebellar fits), and impaired check and rebound. Handwriting is irregular and some patients exhibit megalographia. Cerebellar patients show an increased body sway with a broad-based stance (ataxia of stance). Gait is irregular and staggering. Delayed learning of complex motor skills may be a prominent feature in children. CMS is currently explained by the inability of the cerebellum to handle feedback signals during slow movements and to create, store, select, and update internal models during fast movements. The cerebellum is embedded in large-scale brain networks and is essential to perform accurate motor predictions related to body dynamics and environmental stimuli. Overall, the observations in children and adults exhibiting a CMS fit with the hypothesis that the cerebellum contains neural representations reproducing the dynamic properties of body, and generates and calibrates sensorimotor predictions. Therapies aiming at a reinforcement or restoration of internal models should be implemented to cancel CMS in cerebellar ataxias. The developmental trajectory of the cerebellum, the immature motor behavior in children, and the networks implicated in CMS need to be taken into account.
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Affiliation(s)
- Mario Manto
- Neurology Service, CHU-Charleroi, Charleroi, Belgium; Neuroscience Service, Université de Mons, Mons, Belgium.
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35
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Hotham E, Haberfield M, Hillier S, White JM, Todd G. Upper limb function in children with attention-deficit/hyperactivity disorder (ADHD). J Neural Transm (Vienna) 2017; 125:713-726. [PMID: 29234901 DOI: 10.1007/s00702-017-1822-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 12/04/2017] [Indexed: 01/20/2023]
Abstract
Upper limb function was investigated in children with ADHD using objective methods. We hypothesised that children with ADHD exhibit abnormal dexterity, force application during manipulation of a novel object, and movement rhythmicity. Two groups of age- and gender-matched children were investigated: 35 typically developing children (controls, 10.5 ± 0.4 years, 32M-3F) and 29 children (11.5 ± 0.5 years, 27M-2F) with formally diagnosed ADHD according to DSM-IV-TR criteria. Participants underwent a series of screening tests and tests of upper limb function while "off" medication. Objective quantification of upper limb function involved measurement of force during a grip and lift task, maximal finger tapping task, and maximal pinch grip. Acceleration at the index finger was also measured during rest, flexion and extension, and a postural task to quantify tremor. The Movement Assessment Battery for Children-2 (MABC-2) was also administered. Significant between-group differences were observed in movement rhythmicity, manipulation of a novel object, and performance of the MABC-2 dexterity and aiming and catching components. Children with ADHD lifted a novel object using a lower grip force (P = 0.036), and held the object with a more variable grip force (P = 0.003), than controls. Rhythmicity of finger tapping (P = 0.008) and performance on the dexterity (P = 0.007) and aiming and catching (P = 0.042) components of the MABC-2 were also significantly poorer in the ADHD group than controls. Movement speed, maximum pinch grip strength, and tremor were unaffected. The results of the study show for the first time that ADHD is associated with deficits in multiple, but not all domains of upper limb function.
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Affiliation(s)
- Elizabeth Hotham
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Miranda Haberfield
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Susan Hillier
- School of Health Sciences and Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Jason M White
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Gabrielle Todd
- School of Pharmacy and Medical Sciences and Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
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36
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Cazalets JR, Bestaven E, Doat E, Baudier MP, Gallot C, Amestoy A, Bouvard M, Guillaud E, Guillain I, Grech E, Van-gils J, Fergelot P, Fraisse S, Taupiac E, Arveiler B, Lacombe D. Evaluation of Motor Skills in Children with Rubinstein–Taybi Syndrome. J Autism Dev Disord 2017; 47:3321-3332. [DOI: 10.1007/s10803-017-3259-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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37
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Bucci MP, Goulème N, Stordeur C, Acquaviva E, Scheid I, Lefebvre A, Gerard C, Peyre H, Delorme R. Discriminant validity of spatial and temporal postural index in children with neurodevelopmental disorders. Int J Dev Neurosci 2017; 61:51-57. [DOI: 10.1016/j.ijdevneu.2017.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Maria Pia Bucci
- UMR 1141 Inserm – Paris Diderot University, Robert Debré HospitalParisFrance
| | - Nathalie Goulème
- UMR 1141 Inserm – Paris Diderot University, Robert Debré HospitalParisFrance
- Lyon Neuroscience Research Center (Inserm U1028 CNRS UMR5292), LyonFrance & Department of Audiology and Otoneurological EvaluationCivil Hospitals of LyonLyonFrance
| | - Coline Stordeur
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
| | - Eric Acquaviva
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
| | - Isabelle Scheid
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
- High Functioning Autism Expert Centre, Fondamental FoundationParisFrance
| | - Aline Lefebvre
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
| | | | - Hugo Peyre
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
- Paris Diderot UniversityParis 7France
- High Functioning Autism Expert Centre, Fondamental FoundationParisFrance
| | - Richard Delorme
- Child and Adolescent Psychiatry DepartmentRobert Debré HospitalParisFrance
- Paris Diderot UniversityParis 7France
- High Functioning Autism Expert Centre, Fondamental FoundationParisFrance
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Kim SM, Hyun GJ, Jung TW, Son YD, Cho IH, Kee BS, Han DH. Balance Deficit and Brain Connectivity in Children with Attention-Deficit/Hyperactivity Disorder. Psychiatry Investig 2017; 14:452-457. [PMID: 28845172 PMCID: PMC5561403 DOI: 10.4306/pi.2017.14.4.452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/29/2016] [Accepted: 06/30/2016] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE We aimed to assess disturbances in postural and gait balance and functional connectivity within the brain regions controlling balance in children with attention-deficit/hyperactivity disorder (ADHD). METHODS Thirteen children with ADHD and 13 age- and sex-matched controls were recruited. Gait balance was assessed by the difference in the center of pressure (COP) between the left and right foot, as well as the difference in plantar pressure between the left and right foot during gait. Neuroimaging data were acquired using a 3.0 Tesla MRI scanner. Functional connectivity between the vermis of the cerebellum and all other brain regionswas assessed. RESULTS The difference in plantar pressure between the left foot and right foot in the ADHD group was greater than that observed in the control group. The average COP jerk score of the right foot in the ADHD group was higher than that observed in the control group. A higher functional connectivity between the cerebellum and the right middle frontal gyrus (premotor cortex) and medial frontal gyrus (cingulate gyrus) was observed in the control group relative to the ADHD group. In the ADHD group, the difference in plantar pressure between the left and right foot was also negatively correlated with the beta-value within the middle frontal gyrus. CONCLUSION Children with ADHD had disturbance of balance as assessed by plantar pressure. Decreased brain connectivity from the cerebellum to the premotor cortex and anterior cingulate was associated with disturbances of posture and balance in children with ADHD.
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Affiliation(s)
- Sun Mi Kim
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Gi Jung Hyun
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Tae-Woon Jung
- Department of Therapeutic Riding, Jeonju Kijeon College, Jeonju, Republic of Korea
| | - Young Don Son
- Department of Biomedical Engineering, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - In-Hee Cho
- Dr. Cho's Child & Adolescent Psychiatric Clinic, Seongnam, Republic of Korea
| | - Baik Seok Kee
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
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Isaac V, Olmedo D, Aboitiz F, Delano PH. Altered Cervical Vestibular-Evoked Myogenic Potential in Children with Attention Deficit and Hyperactivity Disorder. Front Neurol 2017; 8:90. [PMID: 28348547 PMCID: PMC5346589 DOI: 10.3389/fneur.2017.00090] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Emerging evidence suggests that children with attention deficit and hyperactivity disorder (ADHD) present more difficulties in standing and walking balance than typically developing children. Most of previous studies have assessed these functions using postural and sensory organization tests showing differences in balance performance between control and ADHD children. However, to date, it is unknown whether these balance alterations are accompanied with vestibular dysfunction. The principal aim of this study is to evaluate vestibular otolith function in ADHD and matched control children. METHODS We assessed vestibular otolith function in children with ADHD and controls using the subjective visual vertical (SVV) bucket test and cervical vestibular-evoked myogenic potentials (cVEMPs). In addition, gait and balance were evaluated using the dynamic gait index (DGI) and computerized posturography. RESULTS Non-significant differences between groups were obtained in SVV evaluation. DGI results show lower scores for overall test performance in children with ADHD (p < 0.001), while computerized postural recordings showed significant differences for the limit of stability between groups (p = 0.02). cVEMPs in response to 500 Hz tone bursts presented at 100 dB were absent or reduced in children with ADHD, as revealed by differences in P1 and N1 peak-to-peak amplitudes between groups (p < 0.01). CONCLUSION These findings suggest that vestibular brainstem reflexes are altered in a subset of children with ADHD. We propose to include cVEMP reflexes in the clinical evaluation of ADHD patients.
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Affiliation(s)
- Valeria Isaac
- Otolaryngology Department, Clinical Hospital of the University of Chile, Santiago, Chile; Pediatric Diagnostic and Therapy Center, CERIL, Santiago, Chile
| | - Diego Olmedo
- Otolaryngology Department, Clinical Hospital of the University of Chile , Santiago , Chile
| | - Francisco Aboitiz
- Departamento de Psiquiatría and Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile , Santiago , Chile
| | - Paul H Delano
- Otolaryngology Department, Clinical Hospital of the University of Chile, Santiago, Chile; Physiology and Biophysics, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile
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Abstract
Abstract
According to current findings, in the history of neurology proposed by Hughlings Jackson, certain later developed functions during ontogenesis of the central nervous system (CNS) tend to replace the older ones. In this context, recent and historical findings suggest that certain later developed cognitive and motor functions during brain ontogenesis related to higher levels of coordination tend to replace the older ones and their persistence is linked to various neuropsychiatric disorders. Particularly important functional disturbances in ADHD developed early in life likely linked to dissolution process are balance deficits linked to dysfunctions of higher levels of coordination related to neurophysiological and mental functions that typically occur in ADHD. In this context, recent data suggest that one of the important aspects of normal development that may play a role in ADHD is suppression of the so-called primitive reflexes. Taken together these data suggest that ADHD symptoms may present a compensatory process related to interference of more primitive neural mechanism, as related to primitive reflexes, with higher levels of brain functions linked to coordination and balance due to insufficiently developed cognitive and motor integration.
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Goetz M, Schwabova J, Hlavka Z, Ptacek R, Zumrova A, Hort V, Doyle R. Cerebellar Symptoms Are Associated With Omission Errors and Variability of Response Time in Children With ADHD. J Atten Disord 2017; 21:190-199. [PMID: 24412970 DOI: 10.1177/1087054713517745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We examined the presence of cerebellar symptoms in ADHD and their association with behavioral markers of this disorder. METHOD Sixty-two children with ADHD and 62 typically developing (TD) children were examined for cerebellar symptoms using the ataxia rating scale and tested using Conners' Continuous Performance Test. RESULTS Children with ADHD had significantly more cerebellar symptoms compared with the TD children. Cerebellar symptom scores decreased with age in the ADHD group; in the TD group remained stable. In both groups, cerebellar symptoms were associated with parent-rated hyperactive/impulsive symptoms, variability of response time standard error (RT-SE) and increase of RT-SE as the test progresses. More variables were associated with cerebellar symptoms in the ADHD group including omission errors, overall RT-SE and its increase for prolonged interstimulus intervals. CONCLUSION Our results highlight the importance of research into motor functions in children with ADHD and indicate a role for cerebellar impairment in this disorder.
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Affiliation(s)
| | | | | | - Radek Ptacek
- 2 General University Hospital, Prague, Czech Republic
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Goulardins JB, Marques JCB, De Oliveira JA. Attention Deficit Hyperactivity Disorder and Motor Impairment. Percept Mot Skills 2017; 124:425-440. [DOI: 10.1177/0031512517690607] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder during childhood, affecting approximately 3–6% of school-aged children; its cardinal symptoms of high activity, impulsivity, and behavioral distractibility might be assumed to have close relationships to interferences with motor skills. A separate body of literature attests to ways that motor problems can severely impact children’s daily lives, as motor problems may occur in 30–50% of children with ADHD. This article critically reviews research on motor impairment in children with ADHD, notable differences in motor performance of individuals with ADHD compared with age-matched controls, and possible neural underpinnings of this impairment. We discuss the highly prevalent link between ADHD and developmental coordination disorder (DCD) and the lack of a clear research consensus about motor difficulties in ADHD. Despite increasing evidence and diagnostic classifications that define DCD by motor impairment, the role of ADHD symptoms in DCD has not been delineated. Similarly, while ADHD may predispose children to motor problems, it is unclear whether any such motor difficulties observed in this population are inherent to ADHD or are mediated by comorbid DCD. Future research should address the exact nature and long-term consequences of motor impairment in children with ADHD and elucidate effective treatment strategies for these disorders together and apart.
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Affiliation(s)
- Juliana B. Goulardins
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Juliana C. B. Marques
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Jorge A. De Oliveira
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Manicolo O, Grob A, Hagmann-von Arx P. Gait in Children with Attention-Deficit Hyperactivity Disorder in a Dual-Task Paradigm. Front Psychol 2017; 8:34. [PMID: 28154547 PMCID: PMC5243797 DOI: 10.3389/fpsyg.2017.00034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 01/05/2017] [Indexed: 11/13/2022] Open
Abstract
The aim was to examine gait in school-aged children with attention-deficit hyperactivity disorder (ADHD) and typically developing controls in a dual-task paradigm. Thirty children with ADHD (without or off medication) aged 7-13 years and 28 controls walked without an additional task (single-task walking) and while performing a concurrent cognitive or motor task (dual-task walking). Gait was assessed using GAITRite recordings of spatiotemporal and variability gait parameters. Compared to single-task walking, dual-tasking significantly altered walking performance of children with and without ADHD, whereby dual-task effects on gait were not different between the two groups. For both children with ADHD and controls the motor concurrent task had a stronger effect on gait than the cognitive concurrent task. Gait in children with and without ADHD is affected in a dual-task paradigm indicating that walking requires executive functions. Future investigations of children's dual-task walking should account for the type of concurrent tasks.
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Affiliation(s)
- Olivia Manicolo
- Department of Psychology, University of Basel Basel, Switzerland
| | - Alexander Grob
- Department of Psychology, University of Basel Basel, Switzerland
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Naruse H, Fujisawa TX, Yatsuga C, Kubota M, Matsuo H, Takiguchi S, Shimada S, Imai Y, Hiratani M, Kosaka H, Tomoda A. Increased Anterior Pelvic Angle Characterizes the Gait of Children with Attention Deficit/Hyperactivity Disorder (ADHD). PLoS One 2017; 12:e0170096. [PMID: 28099484 PMCID: PMC5242439 DOI: 10.1371/journal.pone.0170096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/28/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Children with attention deficit/hyperactivity disorder (ADHD) frequently have motor problems. Previous studies have reported that the characteristic gait in children with ADHD is immature and that subjects demonstrate higher levels of variability in gait characteristics for the lower extremities than healthy controls. However, little is known about body movement during gait in children with ADHD. The purpose of this study was to identify the characteristic body movements associated with ADHD symptoms in children with ADHD. METHODS Using a three-dimensional motion analysis system, we compared gait variables in boys with ADHD (n = 19; mean age, 9.58 years) and boys with typical development (TD) (n = 21; mean age, 10.71 years) to determine the specific gait characteristics related to ADHD symptoms. We assessed spatiotemporal gait variables (i.e. speed, stride length, and cadence), and kinematic gait variables (i.e. angle of pelvis, hip, knee, and ankle) to measure body movement when walking at a self-selected pace. RESULTS In comparison with the TD group, the ADHD group demonstrated significantly higher values in cadence (t = 3.33, p = 0.002) and anterior pelvic angle (t = 3.08, p = 0.004). In multiple regression analysis, anterior pelvic angle was associated with the ADHD rating scale hyperactive/impulsive scores (β = 0.62, t = 2.58, p = 0.025), but not other psychiatric symptoms in the ADHD group. CONCLUSIONS Our results suggest that anterior pelvic angle represents a specific gait variable related to ADHD symptoms. Our kinematic findings could have potential implications for evaluating the body movement in boys with ADHD.
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Affiliation(s)
- Hiroaki Naruse
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Takashi X. Fujisawa
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Chiho Yatsuga
- Research Center for Child Mental Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- National Hospital Organization Hizen Psychiatric Center, Kanzaki-gun, Saga, Japan
| | - Masafumi Kubota
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Hideaki Matsuo
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Shinichiro Takiguchi
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Seiichiro Shimada
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Yuto Imai
- Hiratani Clinic for Developmental Disorders of Children, Kitayotsui, Fukui City, Fukui, Japan
| | - Michio Hiratani
- Research Center for Child Mental Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Hiratani Clinic for Developmental Disorders of Children, Kitayotsui, Fukui City, Fukui, Japan
| | - Hirotaka Kosaka
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Akemi Tomoda
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Research Center for Child Mental Development, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan
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Anand D, Colpo GD, Zeni G, Zeni CP, Teixeira AL. Attention-Deficit/Hyperactivity Disorder And Inflammation: What Does Current Knowledge Tell Us? A Systematic Review. Front Psychiatry 2017; 8:228. [PMID: 29170646 PMCID: PMC5684106 DOI: 10.3389/fpsyt.2017.00228] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/25/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a complex condition that interferes with development and/or functioning. Our objective is to investigate the potential association between ADHD and inflammation. METHODS We conducted a systematic review of human studies measuring inflammatory markers in ADHD. The studies were identified by searching PUBMED, MEDLINE, EMBASE, PSYCHINFO, COCHRANE, and SCOPUS databases for peer-reviewed journals published until September 2016. We included cytokine gene expression and protein measured. Fourteen papers met the inclusion criteria. RESULTS Seven studies evaluated the association of cytokine gene polymorphisms in ADHD, and six studies measured cytokines levels in blood. One study analyzed the presence of cytokines in cerebrospinal fluid in patients with ADHD. Altogether, these studies indicate a possible role of inflammation in ADHD pathogenesis, despite the significant heterogeneity and contradictory results. CONCLUSION Evidence points to the association of ADHD with inflammatory processes, but more studies are warranted.
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Affiliation(s)
- Deepa Anand
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston - UT Health, Houston, TX, United States
| | - Gabriela D Colpo
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston - UT Health, Houston, TX, United States
| | - Gregory Zeni
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristian P Zeni
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston - UT Health, Houston, TX, United States
| | - Antonio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston - UT Health, Houston, TX, United States
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Goetz M, Schwabova JP, Hlavka Z, Ptacek R, Surman CB. Dynamic balance in children with attention-deficit hyperactivity disorder and its relationship with cognitive functions and cerebellum. Neuropsychiatr Dis Treat 2017; 13:873-880. [PMID: 28356743 PMCID: PMC5367596 DOI: 10.2147/ndt.s125169] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is linked to the presence of motor deficiencies, including balance deficits. The cerebellum serves as an integrative structure for balance control and is also involved in cognition, including timing and anticipatory regulation. Cerebellar development may be delayed in children and adolescents with ADHD, and inconsistent reaction time is commonly seen in ADHD. We hypothesized that dynamic balance deficits would be present in children with ADHD and they would correlate with attention and cerebellar functions. METHODS Sixty-two children with ADHD and no other neurological conditions and 62 typically developing (TD) children were examined with five trials of the Phyaction Balance Board, an electronic balancing platform. Cerebellar clinical symptoms were evaluated using an international ataxia rating scale. Conners' Continuous Performance Test was used to evaluate patterns of reaction. RESULTS Children with ADHD had poorer performance on balancing tasks, compared to TD children (P<0.001). They exhibited significantly greater sway amplitudes than TD children (P<0.001) in all of the five balancing trials. The effect size of the difference between the groups increased continuously from the first to the last trial. Balance score in both groups was related to the variation in the reaction time, including reaction time standard error (r =0.25; P=0.0409, respectively, r =0.31; P=0.0131) and Variability of Standard Error (r =0.28; P=0.0252, respectively, r =0.41; P<0.001). The burden of cerebellar symptoms was strongly related to balance performance in both groups (r =0.50, P<0.001; r =0.49, P=0.001). CONCLUSION This study showed that ADHD may be associated with poor dynamic balance control. Furthermore, we showed that maintaining balance correlates with neuropsychological measures of consistency of reaction time. Balance deficits and impaired cognitive functioning could reflect a common cerebellar dysfunction in ADHD children.
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Affiliation(s)
- Michal Goetz
- Department of Child Psychiatry, Second Faculty of Medicine, Motol University Hospital
| | | | | | - Radek Ptacek
- Department of Psychiatry, Charles University, Prague, Czech Republic
| | - Craig Bh Surman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Aydinli FE, Çak T, Kirazli MÇ, Çinar BÇ, Pektaş A, Çengel EK, Aksoy S. Effects of distractors on upright balance performance in school-aged children with attention deficit hyperactivity disorder, preliminary study. Braz J Otorhinolaryngol 2016; 84:280-289. [PMID: 27939853 PMCID: PMC9449181 DOI: 10.1016/j.bjorl.2016.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/03/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Attention deficit hyperactivity disorder is a common impairing neuropsychiatric disorder with onset in early childhood. Almost half of the children with attention deficit hyperactivity disorder also experience a variety of motor-related dysfunctions ranging from fine/gross motor control problems to difficulties in maintaining balance. OBJECTIVES The main purpose of this study was to investigate the effects of distractors two different auditory distractors namely, relaxing music and white noise on upright balance performance in children with attention deficit hyperactivity disorder. METHODS We compared upright balance performance and the involvement of different sensory systems in the presence of auditory distractors between school-aged children with attention deficit hyperactivity disorder (n=26) and typically developing controls (n=20). Neurocom SMART Balance Master Dynamic Posturography device was used for the sensory organization test. Sensory organization test was repeated three times for each participant in three different test environments. RESULTS The balance scores in the silence environment were lower in the attention deficit hyperactivity disorder group but the differences were not statistically significant. In addition to lower balance scores the visual and vestibular ratios were also lower. Auditory distractors affected the general balance performance positively for both groups. More challenging conditions, using an unstable platform with distorted somatosensory signals were more affected. Relaxing music was more effective in the control group, and white noise was more effective in the attention deficit hyperactivity disorder group and the positive effects of white noise became more apparent in challenging conditions. CONCLUSION To the best of our knowledge, this is the first study evaluating balance performance in children with attention deficit hyperactivity disorder under the effects of auditory distractors. Although more studies are needed, our results indicate that auditory distractors may have enhancing effects on upright balance performance in children with attention deficit hyperactivity disorder.
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Affiliation(s)
- Fatma Esen Aydinli
- Hacettepe University, Faculty of Health Sciences, Speech and Language Department, Ankara, Turkey.
| | - Tuna Çak
- Hacettepe University, Faculty of Medicine, Child and Adolescent Mental Health Department, Ankara, Turkey
| | - Meltem Çiğdem Kirazli
- Hacettepe University, Faculty of Health Sciences, Speech and Language Department, Ankara, Turkey
| | - Betül Çiçek Çinar
- Hacettepe University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey
| | - Alev Pektaş
- Hacettepe University Hospital, Ear Nose and Throat Department, Audiology and Speech Pathology Unit, Ankara, Turkey
| | - Ebru Kültür Çengel
- Hacettepe University, Faculty of Medicine, Child and Adolescent Mental Health Department, Ankara, Turkey
| | - Songül Aksoy
- Hacettepe University, Faculty of Health Sciences, Speech and Language Department, Ankara, Turkey
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Ayaz AB, Ayaz M, Yazgan Y, Akin E. The Relationship between Motor Coordination and Social Behavior Problems in Adolescents with Attention-Deficit/Hyperactivity Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20121130091058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ayse Burcu Ayaz
- Sakarya University Research and Trainig Hospital, Child and Adolescent Psychiatry Outpatient Clinic, Sakarya - Turkey
| | - Muhammed Ayaz
- Sakarya University Research and Trainig Hospital, Child and Adolescent Psychiatry Outpatient Clinic, Sakarya - Turkey
| | - Yanki Yazgan
- Guzel Gunler Children's Health Center, Istanbul - Turkey
| | - Elif Akin
- Elazig Mental Health Hospital Child and Adolescent Outpatient Clinic, Elazığ - Turkey
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49
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Affiliation(s)
- Vijay A. Mittal
- *To whom correspondence should be addressed; tel: 847-467-3880, fax: 847-491-7859, e-mail:
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50
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Pavione Rodrigues Pereira R, Nascimento Fagundes S, Surry Lebl A, Azevedo Soster L, Machado MG, Koch VH, Tanaka C. Children with nocturnal enuresis have posture and balance disorders. J Pediatr Urol 2016; 12:216.e1-6. [PMID: 27290613 DOI: 10.1016/j.jpurol.2016.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/04/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Integration of the neuromuscular system is required for maintaining balance and adequate voiding function. Children with enuresis have delayed maturation of the motor cortex, with changes in the sensory and motor systems. Along with various alterations, including the genetic, hormonal, behavioral, and sleep disturbances, and neuromotor and sensory deficits associated with nocturnal enuresis (NE) in children and adults, a consistent alteration in the posture of children with NE has been observed in the current practice. Because posture and the balance control system are strongly connected, this study aimed to investigate posture and balance in children and teenagers with NE. MATERIAL AND METHODS A total of 111 children with enuresis were recruited to the enuretic group (EG) and 60 asymptomatic children made up the control group (CG). The participants were divided into two age subgroups: (A) 7-11 years old, N = 77 for EG/A, N = 38 for CG/A; and (B) 12-16 years old, N = 34 for EG/B, N = 22 for CG/B. Balance was assessed using an electronic force plate (100 Hz) to calculate the area of the center of pressure (COP) displacement. The COP is the point that results from the action of vertical forces projected onto the force plate. Sensory integration was analyzed using a 60-s trial with the subject standing under four conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; (4) eyes closed, unstable surface. Posture was assessed by placing reflective anatomical landmarks on the anterior superior iliac spine, the posterior superior iliac spine, the greater trochanter, and lateral malleolus. A photograph was taken while the subject stood quietly. The angles were obtained from landmark connections using software to assess the following posture variables: pelvic ante/retroversion and pelvic ante/retropulsion. RESULTS The EG showed a greater area of COP displacement compared with the CG under all four sensory conditions and both subgroups, except for EG/B in condition 3. Regarding posture, EG showed higher pelvic anteversion angles than CG. CONCLUSIONS Enuretic children showed forward inclination of the pelvis and had worse balance compared with control children.
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Affiliation(s)
- R Pavione Rodrigues Pereira
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil.
| | - S Nascimento Fagundes
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - A Surry Lebl
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - L Azevedo Soster
- Pediatric Sleep Laboratory, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - M G Machado
- Pediatric Urology Unit, Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - V H Koch
- Pediatric Nephrology Unit, Instituto da Criança do Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
| | - C Tanaka
- Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil
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