Lourdes García Murillo1, Samuele Cortese2, David Anderson3, Adriana Di Martino1, Francisco Xavier Castellanos4. 1. The Child Study Center at NYU Langone Medical Center, New York, USA. 2. The Child Study Center at NYU Langone Medical Center, New York, USA; Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK; School of Medicine, University of Nottingham, UK; Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK. 3. The Child Study Center at NYU Langone Medical Center, New York, USA; Child Mind Institute, New York, NY, USA. 4. The Child Study Center at NYU Langone Medical Center, New York, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA. Electronic address: Francisco.Castellanos@nyumc.org.
Abstract
INTRODUCTION: Our aim was to assess differences in movement measures in attention-deficit/hyperactivity disorder (ADHD) vs. typically developing (TD) controls. METHODS: We performed meta-analyses of published studies on motion measures contrasting ADHD with controls. We also conducted a case-control study with children/adolescents (n = 61 TD, n = 62 ADHD) and adults (n = 30 TD, n = 19 ADHD) using the McLean motion activity test, semi-structured diagnostic interviews and the behavior rating inventory of executive function and Conners (parent, teacher; self) rating scales. RESULTS: Meta-analyses revealed medium-to-large effect sizes for actigraph (standardized mean difference [SMD]: 0.64, 95% confidence interval (CI): 0.43, 0.85) and motion tracking systems (SDM: 0.92, 95% CI: 0.65, 1.20) measures in differentiating individuals with ADHD from controls. Effects sizes were similar in studies of children/adolescents ([SMD]: 0.75, 95% CI: 0.50, 1.01) and of adults ([SMD]: 0.73, 95% CI: 0.46, 1.00). In our sample, ADHD groups differed significantly in number of head movements (p = 0.02 in children; p = 0.002 in adults), displacement (p = 0.009/p < 0.001), head area (p = 0.03/p < 0.001), spatial complexity (p = 0.06/p = 0.02) and temporal scaling (p = 0.05/p = 0.04). Mean effect sizes were non-significantly larger (d = 0.83, 95% CI: 0.20, 1.45) in adults vs. children/adolescents with ADHD (d = 0.45, 95% CI: 0.08, 0.82). In the concurrent go/no-go task, reaction time variability was significantly greater in ADHD (p < 0.05 in both age groups) than controls. CONCLUSIONS: Locomotor hyperactivity remains core to the construct of ADHD even in adults. Our results suggest that objective locomotion measures may be particularly useful in evaluating adults with possible ADHD.
INTRODUCTION: Our aim was to assess differences in movement measures in attention-deficit/hyperactivity disorder (ADHD) vs. typically developing (TD) controls. METHODS: We performed meta-analyses of published studies on motion measures contrasting ADHD with controls. We also conducted a case-control study with children/adolescents (n = 61 TD, n = 62 ADHD) and adults (n = 30 TD, n = 19 ADHD) using the McLean motion activity test, semi-structured diagnostic interviews and the behavior rating inventory of executive function and Conners (parent, teacher; self) rating scales. RESULTS: Meta-analyses revealed medium-to-large effect sizes for actigraph (standardized mean difference [SMD]: 0.64, 95% confidence interval (CI): 0.43, 0.85) and motion tracking systems (SDM: 0.92, 95% CI: 0.65, 1.20) measures in differentiating individuals with ADHD from controls. Effects sizes were similar in studies of children/adolescents ([SMD]: 0.75, 95% CI: 0.50, 1.01) and of adults ([SMD]: 0.73, 95% CI: 0.46, 1.00). In our sample, ADHD groups differed significantly in number of head movements (p = 0.02 in children; p = 0.002 in adults), displacement (p = 0.009/p < 0.001), head area (p = 0.03/p < 0.001), spatial complexity (p = 0.06/p = 0.02) and temporal scaling (p = 0.05/p = 0.04). Mean effect sizes were non-significantly larger (d = 0.83, 95% CI: 0.20, 1.45) in adults vs. children/adolescents with ADHD (d = 0.45, 95% CI: 0.08, 0.82). In the concurrent go/no-go task, reaction time variability was significantly greater in ADHD (p < 0.05 in both age groups) than controls. CONCLUSIONS:Locomotor hyperactivity remains core to the construct of ADHD even in adults. Our results suggest that objective locomotion measures may be particularly useful in evaluating adults with possible ADHD.
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