Subtle Motor Signs as a Biomarker for Mindful Movement Intervention in Children with ADHD.


Author: Clark D1, Seymour KE1,2,3, Findling RL2, Mostofsky SH1,2,4

Affiliation: <sup>1</sup>Kennedy Krieger Institute, Center for Neurodevelopmental and Imaging Research, Baltimore, MD. Dr. Clark is now working at Gigantum, Washington, DC.

<sup>2</sup>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.

<sup>3</sup>Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD.

<sup>4</sup>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
Conference/Journal: J Dev Behav Pediatr.
Date published: 2020 Apr 14
Other:
  Special Notes: doi: 10.1097/DBP.0000000000000795. [Epub ahead of print]   ,  Word Count: 279  
    OBJECTIVE: Previous studies of Tai Chi or mindfulness-based interventions in attention-deficit/hyperactivity disorder (ADHD) have relied on self- or parent-reported outcome measures; however, there is a critical need for the validation of objective biomarkers of treatment. Therefore, we implemented a mindful movement intervention for children with ADHD, hypothesizing that an ADHD-relevant motor control measure could serve as a predictive biomarker of treatment-related improvement.



METHODS: Thirty-four participants were included, 8 to 12 year olds diagnosed with DSM-5 ADHD. Participants engaged in the mindful movement treatment, an 8-week program with 2 classes a week for 60 minutes. At pre- and post-treatment, ADHD symptoms and associated impairment and motor control via the Physical and Neurological Examination for Subtle Signs (PANESS) were assessed.



RESULTS: The results showed a significant reduction for PANESS Gaits and Station (p ≤ 0.001), total overflow (p = 0.009), and total score (p = 0.001) after treatment, with the largest effect for Gaits and Stations. The results also showed a significant reduction in symptoms of inattention (p ≤ 0.001), hyperactivity/impulsivity (p ≤ 0.001), oppositional defiant disorder (p = 0.001), and executive dysfunction (p ≤ 0.001). There were significant positive correlations between change in PANESS Gaits and Stations and change in both inattentive (p = 0.02) and hyperactive/impulsive symptoms (p = 0.02). There was also a significant positive correlation between change in the PANESS total score and change in inattentive (p = 0.007) and hyperactive/impulsive symptoms (p = 0.042). The change in the PANESS total score (β = 0.295, p = 0.002) predicted post-treatment ADHD severity above the change in inattentive or hyperactive/impulsive symptoms.



CONCLUSION: The results suggest the effectiveness of a mindful movement treatment on ADHD symptoms and suggest the PANESS as a candidate motor biomarker for future mindful movement trials.



CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02234557, https://clinicaltrials.gov/ct2/show/NCT02234557.



PMID: 32301851  DOI: 10.1097/DBP.0000000000000795