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:
1Kennedy Krieger Institute, Center for Neurodevelopmental and Imaging Research, Baltimore, MD. Dr. Clark is now working at Gigantum, Washington, DC.
2Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
3Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD.
4Department 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
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