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Altinok DCA, Ohl K, Volkmer S, Brandt GA, Fritze S, Hirjak D. 3D-optical motion capturing examination of sensori- and psychomotor abnormalities in mental disorders: Progress and perspectives. Neurosci Biobehav Rev 2024; 167:105917. [PMID: 39389438 DOI: 10.1016/j.neubiorev.2024.105917] [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: 06/14/2024] [Revised: 09/19/2024] [Accepted: 10/03/2024] [Indexed: 10/12/2024]
Abstract
Sensori-/psychomotor abnormalities refer to a wide range of disturbances in individual motor, affective and behavioral functions that are often observed in mental disorders. However, many of these studies have mainly used clinical rating scales, which can be potentially confounded by observer bias and are not able to detect subtle sensori-/psychomotor abnormalities. Yet, an innovative three-dimensional (3D) optical motion capturing technology (MoCap) can provide more objective and quantifiable data about movements and posture in psychiatric patients. To draw attention to recent rapid progress in the field, we performed a systematic review using PubMed, Medline, Embase, and Web of Science until May 01st 2024. We included 55 studies in the qualitative analysis and gait was the most examined movement. The identified studies suggested that sensori-/psychomotor abnormalities in neurodevelopmental, mood, schizophrenia spectrum and neurocognitive disorders are associated with alterations in spatiotemporal parameters (speed, step width, length and height; stance time, swing time, double limb support time, phases duration, adjusting sway, acceleration, etc.) during various movements such as walking, running, upper body, hand and head movements. Some studies highlighted the advantages of 3D optical MoCap systems over traditional rating scales and measurements such as actigraphy and ultrasound gait analyses. 3D optical MoCap systems are susceptible to detecting differences not only between patients with mental disorders and healthy persons but also among at-risk individuals exhibiting subtle sensori-/psychomotor abnormalities. Overall, 3D optical MoCap systems hold promise for objectively examining sensori-/psychomotor abnormalities, making them valuable tools for use in future clinical trials.
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Affiliation(s)
- Dilsa Cemre Akkoc Altinok
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Kristin Ohl
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sebastian Volkmer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Centre for Mental Health (DZPG), Partner Site Mannheim, Germany.
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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; 56:568-578. [PMID: 38811009 DOI: 10.1080/00222895.2024.2361103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/08/2024] [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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Tascioglu EN, Karademir S, Kara K, Tonak HA, Kara OK. Effectiveness of Power Exercises Compared to Traditional Strength Exercises on Motor Skills, Muscle Performance and Functional Muscle Strength of Children with Attention Deficit Hyperactivity Disorder: A Single-Blind Randomized Controlled Trial. Dev Neurorehabil 2024; 27:17-26. [PMID: 38650431 DOI: 10.1080/17518423.2024.2345335] [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: 01/02/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
The aim of this study was to compare the impact of 8-weeks of power exercises compared to traditional strength exercises on motor abilities, muscle performance, and functional strength in children with ADHD. A total of 34 children with ADHD were randomized into two groups to receive functional power training (n = 17, M age: 121.2 ± 16.6 months) and traditional strength training (n = 17, M age: 116.1 ± 13.4 months). After the 8-week intervention, two-way ANOVA results with 95% confidence intervals showed no differences between the groups in motor skills, muscle power, or functional muscle strength. However, the functional power training group had larger effect sizes and greater increases in total motor composite score (10% vs 7%), body coordination (13.8% vs 4.9%) and bilateral coordination (38.8% vs 27.9%) than the traditional strength training group. The power training group also exhibited catch-up growth with typically developing peers. These findings suggest that power exercises may be more effective than strength exercises for rapid force generation in daily life, particularly for children with ADHD.
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Affiliation(s)
| | | | - Koray Kara
- University of Health Sciences, Antalya, Turkey
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Kleeren L, Hallemans A, Hoskens J, Klingels K, Smits-Engelsman B, Verbecque E. A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis. J Atten Disord 2023; 27:354-367. [PMID: 36635879 DOI: 10.1177/10870547221146244] [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] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To map the effect of motor-based interventions on motor skills in children with ADHD. METHOD A systematic literature search was performed in Pubmed, Web of Science, and the SCOPUS database (last search: October 30th 2022). Methodological quality was assessed using the PEDro-scale and the quality of evidence was determined with the GRADE-method. Meta-analysis was performed when at least five studies were available. RESULTS Thirteen studies (7 RCTs) satisfied the inclusion criteria, five of which were eligible for meta-analysis. Only one of the included studies reached the low risk of bias threshold. Comparing different motor-based interventions to any non-motor control intervention showed large motor skill improvements (SMD = 1.46; 95% CI = [1.00;1.93]; I² = 47.07%). The most effective type of motor-based intervention and the optimal treatment parameters could not be determined yet. CONCLUSION Motor-based interventions in general seem to improve motor skills in children with ADHD. Additional RCTs are needed to increase current low GRADE confidence.
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Adhvaryu KP, Karthikbabu S, Rao PT. Motor performance of children with attention deficit hyperactivity disorder: focus on the Bruininks-Oseretsky Test of Motor Proficiency. Clin Exp Pediatr 2022; 65:512-520. [PMID: 35176833 PMCID: PMC9650357 DOI: 10.3345/cep.2021.00962] [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: 07/15/2021] [Accepted: 01/22/2022] [Indexed: 11/27/2022] Open
Abstract
The literature review aimed to analyze studies assessing the motor abilities of children with attention deficit hyperactivity disorder (ADHD) using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). The PubMed, OVID, Cochrane, and PEDro databases were searched for relevant articles published between February 2003 and September 2021. Despite the retrieval of limited studies, most included in this review were of fair to good quality. The diagnostic criteria for ADHD adhered to Diagnostic and Statistical Manual of Mental Disorders standards. The BOTMP has been used diversely in various countries, has been translated into various languages, is administered by various qualified medical professionals on children with variants of ADHD, with the long form of the tool used more widely than its short form. The motor performance of children with ADHD was better than that of children with other developmental disorders, but children with ADHD underperformed compared to their age-matched typically developing peers. Although the BOTMP tool has been widely used to evaluate the motor performance of children with various disabilities, our understanding of the motor repertoire of children with ADHD is inadequate. Future research can aim to use the BOTMP to better understand the motor repertoire of children with ADHD to aid their overall rehabilitation.
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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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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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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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Mancini V, Rudaizky D, Howlett S, Elizabeth-Price J, Chen W. Movement difficulties in children with ADHD: Comparing the long- and short-form Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2). Aust Occup Ther J 2020; 67:153-161. [PMID: 31944320 DOI: 10.1111/1440-1630.12641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 01/17/2023]
Abstract
AIMS Up to 50% of children with attention deficit hyperactivity disorder (ADHD) also present with difficulties with motor proficiency. Several assessments of motor proficiency are available for occupational therapists, though the validity of these measures in an ADHD population requires further exploration. The aim of this paper was to evaluate the consistency of scores obtained using the long-form and short-form of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) in a school-age ADHD sample. METHOD The BOT-2 long-form was administered to 84 school-age children (78 males) with ADHD; short-form scores were extracted from the relevant long-form items. RESULTS Long-form and short-form total scores were highly correlated (r = .87), though the average short-form score was significantly higher. As a categorical measure, 52 children were classified as "at-risk" for movement difficulties by the long-form; but only 36 by the short-form, yielding a false-negative rate of 30.77%. The sensitivity of short-form could be improved by raising the cut-off thresholds of short-form scores as identified by receiver operating characteristic curve analysis but did not yield practical utility. INTERPRETATION As a continuous indicator (i.e. total scores), the short-form is comparable to the long-form. However, the short-form overestimates the child's motor proficiency relative to the long-form and yields an unacceptably high rate of false negatives as a categorical measure. The current revision of the short-form is therefore not recommended as a screening nor diagnostic instrument in an ADHD population. In the absence of ADHD-specific norms, use of the long-form provides greater opportunity for occupational therapists to identify those at-risk for movement difficulties. However, any assessment of motor proficiency should be accompanied by a broader comprehensive assessment to best understand a child's motor functioning.
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Affiliation(s)
- Vincent Mancini
- Complex Attention and Hyperactivity Disorders (CAHDS), Child and Adolescent Mental Health Service, Department of Health, Perth, WA, Australia.,Discipline of Psychological Sciences, Australian College of Applied Psychology, Sydney, NSW, Australia
| | - Daniel Rudaizky
- Complex Attention and Hyperactivity Disorders (CAHDS), Child and Adolescent Mental Health Service, Department of Health, Perth, WA, Australia.,School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Sarah Howlett
- Complex Attention and Hyperactivity Disorders (CAHDS), Child and Adolescent Mental Health Service, Department of Health, Perth, WA, Australia
| | - Jordan Elizabeth-Price
- Complex Attention and Hyperactivity Disorders (CAHDS), Child and Adolescent Mental Health Service, Department of Health, Perth, WA, Australia.,Discipline of Psychological Sciences, Australian College of Applied Psychology, Sydney, NSW, Australia
| | - Wai Chen
- Complex Attention and Hyperactivity Disorders (CAHDS), Child and Adolescent Mental Health Service, Department of Health, Perth, WA, Australia
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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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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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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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Yurtbaşi P, Aldemir S, Bakır MGT, Aktaş Ş, Ayvaz FB, Satılmış ŞP, Münir K. Comparison of Neurological and Cognitive Deficits in Children With ADHD and Anxiety Disorders. J Atten Disord 2018; 22:472-485. [PMID: 26078398 PMCID: PMC4818207 DOI: 10.1177/1087054715578003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the neuro-cognitive profiles among initial clinic referred medication naive sample of children with anxiety disorders (ANXs) and ADHD in a youth sample. METHOD Three groups of patients, ANX ( n = 40), ADHD ( n = 48), and ANX + ADHD ( n = 33), aged 7 to 12 years, were compared with respect to their Physical and Neurological Examination for Subtle Signs (PANESS) and cognitive measures (digit span, digit symbol, Trail Making Test [TMT]-A and TMT-B, Stroop test). RESULTS ADHD group performed worse than the other two groups with regard to soft signs and cognitive test performance; ANX + ADHD were impaired relative to ANX but better than ADHD. Significant differences were found for gait and station problems, overflows and timed movements, TMT error points, and Stroop interference scores. ADHD patients had more difficulty in warding off irrelevant responses and lower speed of time-limited movements. CONCLUSION This clinical evaluation study suggested that ANX and ADHD seem to have significantly different neuro-cognitive features: Poorest outcomes were observed among children with ADHD; rather than problems of attention, inhibitory control deficits were the most prominent differences between ANX and ADHD; and the presence of ANX appears to have mitigating effect on ADHD-related impairments.
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Affiliation(s)
- Pınar Yurtbaşi
- Department of Child Adolescent Psychiatry, Turgut Özal University School of Medicine, Ankara, Turkey,Fogarty International Center Mental Health and Developmental Disabilities Program, Children’s Hospital, Boston, MA, USA
| | - Seçil Aldemir
- Department of Psychiatry, Turgut Özal University School of Medicine, Ankara, Turkey
| | | | - Şule Aktaş
- Department of Psychiatry, Turgut Özal University School of Medicine, Ankara, Turkey
| | - Fatma Betül Ayvaz
- Department of Child Adolescent Psychiatry, Turgut Özal University School of Medicine, Ankara, Turkey
| | - Şeyma Piştav Satılmış
- Department of Child Adolescent Psychiatry, Turgut Özal University School of Medicine, Ankara, Turkey
| | - Kerim Münir
- Fogarty International Center Mental Health and Developmental Disabilities Program, Children’s Hospital, Boston, MA, USA
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14
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Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment. Auris Nasus Larynx 2017; 44:700-707. [DOI: 10.1016/j.anl.2017.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/17/2016] [Accepted: 01/27/2017] [Indexed: 11/19/2022]
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15
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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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16
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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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17
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Goulardins JB, Rigoli D, Piek JP, Kane R, Palácio SG, Casella EB, Nascimento RO, Hasue RH, Oliveira JA. The relationship between motor skills, ADHD symptoms, and childhood body weight. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:279-286. [PMID: 27214681 DOI: 10.1016/j.ridd.2016.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/03/2016] [Accepted: 05/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Research has suggested an important association between motor proficiency and overweight/obesity. Many children with motor difficulties experience ADHD symptoms which have also been linked with overweight/obesity. Previous research has not considered both ADHD and motor performance when investigating their relationship with overweight/obesity. AIMS To investigate the relationships between motor performance, ADHD symptoms, and overweight/obesity in children. METHODS AND PROCEDURES A cross-sectional study was conducted involving189 children aged six to 10 years. Symptoms of ADHD were identified using the SNAP-IV rating scale. Motor impairment (MI) was identified using the Movement Battery Assessment for Children-2. Body composition was estimated from the Body Mass Index (BMI) based on World Health Organization child growth standards. OUTCOMES AND RESULTS Balance was the only motor skill associated with BMI even after controlling for gender and ADHD. Group comparisons revealed that the proportion of overweight ADHD children was significantly less than the proportion of overweight control children and overweight MI children; the proportion of underweight ADHD children was significantly greater than the proportion of underweight MI children. CONCLUSIONS AND IMPLICATIONS The results highlight the importance of taking into consideration both ADHD symptoms and motor difficulties in the assessment and intervention of physical health outcomes in children with ADHD and/or movement problems.
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Affiliation(s)
- Juliana B Goulardins
- Laboratory of Motor Behaviour, School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Melo Morais, 65, Cidade Universitaria, 05508-030 Sao Paulo, SP, Brazil.
| | - Daniela Rigoli
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, WA 6845, Australia
| | - Jan P Piek
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, WA 6845, Australia
| | - Robert Kane
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, WA 6845, Australia
| | - Siméia G Palácio
- Child Institute, Faculty of Medicine, University of Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647, Jardim Paulista, 05403-000 Sao Paulo, Brazil
| | - Erasmo B Casella
- Child Institute, Faculty of Medicine, University of Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647, Jardim Paulista, 05403-000 Sao Paulo, Brazil
| | - Roseane O Nascimento
- Laboratory of Motor Behaviour, School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Melo Morais, 65, Cidade Universitaria, 05508-030 Sao Paulo, SP, Brazil
| | - Renata H Hasue
- Department of Physical Therapy, Communication Science & Disorders and Occupational Therapy, Faculty of Medicine, University of Sao Paulo, Rua Cipotânea, 51, Cidade Universitaria, 05360-000 Sao Paulo, Brazil
| | - Jorge A Oliveira
- Laboratory of Motor Behaviour, School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Melo Morais, 65, Cidade Universitaria, 05508-030 Sao Paulo, SP, Brazil
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18
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The Evaluation of Physical Stillness with Wearable Chest and Arm Accelerometer during Chan Ding Practice. SENSORS 2016; 16:s16071126. [PMID: 27447641 PMCID: PMC4970169 DOI: 10.3390/s16071126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/18/2016] [Accepted: 07/04/2016] [Indexed: 11/16/2022]
Abstract
Chan Ding training is beneficial to health and emotional wellbeing. More and more people have taken up this practice over the past few years. A major training method of Chan Ding is to focus on the ten Mailuns, i.e., energy points, and to maintain physical stillness. In this article, wireless wearable accelerometers were used to detect physical stillness, and the created physical stillness index (PSI) was also shown. Ninety college students participated in this study. Primarily, accelerometers used on the arms and chest were examined. The results showed that the PSI values on the arms were higher than that of the chest, when participants moved their bodies in three different ways, left-right, anterior-posterior, and hand, movements with natural breathing. Then, they were divided into three groups to practice Chan Ding for approximately thirty minutes. Participants without any Chan Ding experience were in Group I. Participants with one year of Chan Ding experience were in Group II, and participants with over three year of experience were in Group III. The Chinese Happiness Inventory (CHI) was also conducted. Results showed that the PSI of the three groups measured during 20-30 min were 0.123 ± 0.155, 0.012 ± 0.013, and 0.001 ± 0.0003, respectively (p < 0.001 ***). The averaged CHI scores of the three groups were 10.13, 17.17, and 25.53, respectively (p < 0.001 ***). Correlation coefficients between PSI and CHI of the three groups were -0.440, -0.369, and -0.537, respectively (p < 0.01 **). PSI value and the wearable accelerometer that are presently available on the market could be used to evaluate the quality of the physical stillness of the participants during Chan Ding practice.
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Postural seated balance in children can be assessed with good reliability. Gait Posture 2016; 47:68-73. [PMID: 27264406 DOI: 10.1016/j.gaitpost.2016.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/09/2016] [Accepted: 04/07/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Seated postural stability can be measured using Tekscan, CONFORMat. Standing postural stability has gained great clinical and, research value by use of different force platforms with mostly good reliability. No reliability testing or biologic variation assessment has been documented regarding seated balance. This study determines the reliability of the parameters of seated balance in healthy children using the Tekscan CONFORMat equipment. METHODS Sixty-six healthy children completed six measurements of seating position the first three with the child seated in a relaxed normal back position and the next three with the child seated in a complete up-right back position. The SAM software calculated five default parameters of balance (area, distance, variability, antero-posterior (AP) excursion and left-right excursion). RESULTS Reliability parameters were assessed by one-way analysis of variance intra-class correlation (ICC) proving excellent reliability for relaxed and up-right back position with respect to distance (0.75/0.84) and good reliability with respect to variability (0.61/0.62) and area (0.61/0.60). AP excursion (0.41/0.59) and left-right excursion (0.54/0.24) showed fair to poor reliability. CONCLUSION In conclusion, two of the five default parameters of balance used in the Tekscan CONFORMat system are direction-independent parameters and have been found reproducible for measuring seated balance in children. This study can be used as reference for comparisons of seated balance in children with affected seated postural control and for evaluating a clinical treatment effect.
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20
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Identification of neuromotor deficits common to autism spectrum disorder and attention deficit/hyperactivity disorder, and imitation deficits specific to autism spectrum disorder. Eur Child Adolesc Psychiatry 2015; 24:1497-507. [PMID: 26233230 DOI: 10.1007/s00787-015-0753-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
Abstract
Deficits in motor and imitation abilities are a core finding in autism spectrum disorders (ASD), but impaired motor functions are also found in attention deficit/hyperactivity disorder (ADHD). Given recent theorising about potential aetiological overlap between the two disorders, the present study aimed to assess difficulties in motor performance and imitation of facial movements and meaningless gestures in a sample of 24 ADHD patients, 22 patients with ASD, and 20 typically developing children, matched for age (6-13 years) and similar in IQ (>80). Furthermore, we explored the impact of comorbid ADHD symptoms on motor and imitation performance in the ASD sample and the interrelationships between the two groups of variables in the clinical groups separately. The results show motor dysfunction was common to both disorders, but imitation deficits were specific to ASD. Together with the pattern of interrelated motor and imitation abilities, which we found exclusively in the ASD group, our findings suggest complex phenotypic, and possibly aetiological, relationships between the two neurodevelopmental conditions.
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Goulardins JB, Rigoli D, Licari M, Piek JP, Hasue RH, Oosterlaan J, Oliveira JA. Attention deficit hyperactivity disorder and developmental coordination disorder: Two separate disorders or do they share a common etiology. Behav Brain Res 2015; 292:484-92. [DOI: 10.1016/j.bbr.2015.07.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/19/2015] [Accepted: 07/02/2015] [Indexed: 12/28/2022]
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