Postural Instability in Children with ADHD Is Improved by Methylphenidate

HIGHLIGHTS Both spatial and temporal analyses of the Center of Pressure demonstrate that children with ADHD have poorer postural control than typically developing sex-, age-, and IQ-matched children. Poor sensory integration in postural control could partially explained the deficits in postural stability in children with ADHD. MPH treatment improves postural performance in both spatial and temporal domains in children with ADHD. MPH improves postural control specifically when visual and proprioceptive inputs are misleading. Such improvement could be due to MPH effects on neurons, facilitating cerebellar processing of postural control. The aim of this study was to examine postural control in children with ADHD and explore the effect of methylphenidate (MPH), using spatial and temporal analyses of the center of pressure (CoP). Thirty-eight children with ADHD (mean age 9.82 ± 0.37 years) and 38 sex- age- and IQ-matched children with typically development were examined. Postural stability was evaluated using the Multitest Equilibre machine (Framiral®) at inclusion and after 1 month of MPH in children with ADHD. Postural stability was assessed by recording under several conditions: with eyes open and fixed on a target, with eyes closed and with vision perturbed by optokinetic stimulation, on stable and unstable platforms. At inclusion, we observed poor spatial and temporal postural stability in children with ADHD. The spectral power index was higher in children with ADHD than in controls. Canceling time was shorter at low and medium frequencies of oscillation and longer at higher frequencies in children with ADHD. After 1 month of MPH, the surface area and mean velocity of the CoP decreased significantly under the most complex conditions (unstable platform in the absence of proprioceptive and visual inputs). The spectral power index decreased significantly after MPH while the canceling time did not change. Poor postural control in children with ADHD supports the hypothesis of cerebellar dysfunction in this disorder. Postural control could be improved by a more efficient processing of sensory inputs (a high-level process), as suggested by the decrease in spectral power index after MPH without changes in the canceling time (a low-level process).

[1]  J. Piek,et al.  Motor coordination and kinaesthesis in boys with attention deficit–hyperactivity disorder , 1999, Developmental medicine and child neurology.

[2]  L Borel,et al.  Age-related changes in posture control are differentially affected by postural and cognitive task complexity. , 2009, Current aging science.

[3]  Myron Genel,et al.  Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents , 1998 .

[4]  J. Biederman,et al.  A review of the pharmacotherapy of adults with Attention-Deficit/ Hyperactivity Disorder , 2001, Journal of attention disorders.

[5]  D. Wadsworth,et al.  The comparison of school-age children's performance on two motor assessments: the Test of Gross Motor Development and the Movement Assessment Battery for Children , 2014 .

[6]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[7]  N. Rinehart,et al.  An investigation of gait in children with Attention Deficit Hyperactivity Disorder: A case controlled study , 2014, Psychiatry Research.

[8]  M. Semrud-Clikeman,et al.  A Magnetic Resonance Imaging Study of the Cerebellar Vermis in Chronically Treated and Treatment-Naïve Children with Attention-Deficit/Hyperactivity Disorder Combined Type , 2009, Biological Psychiatry.

[9]  M. Lacour,et al.  Posture control, aging, and attention resources: Models and posture-analysis methods , 2008, Neurophysiologie Clinique/Clinical Neurophysiology.

[10]  S. Aoki,et al.  Magnetic resonance , 2012, International Journal of Computer Assisted Radiology and Surgery.

[11]  Danielle N. Pappas.  ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretation , 2006 .

[12]  Catherine J. Stoodley,et al.  Distinct regions of the cerebellum show gray matter decreases in autism, ADHD, and developmental dyslexia , 2014, Front. Syst. Neurosci..

[13]  B. Collett,et al.  Ten-year review of rating scales. V: scales assessing attention-deficit/hyperactivity disorder. , 2003, Journal of the American Academy of Child and Adolescent Psychiatry.

[14]  A. Geurts,et al.  Intrasubject variability of selected force-platform parameters in the quantification of postural control. , 1993, Archives of physical medicine and rehabilitation.

[15]  R. Peterka.  Sensorimotor integration in human postural control. , 2002, Journal of neurophysiology.

[16]  I. bonan,et al.  Clinical tools for assessing balance disorders , 2008, Neurophysiologie Clinique/Clinical Neurophysiology.

[17]  Yufeng Wang,et al.  [A case-control study on balance function of attention deficit hyperactivity disorder (ADHD) children]. , 2003, Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences.

[18]  B. Maki,et al.  Aging and Postural Control , 1990, Journal of the American Geriatrics Society.

[19]  H. Diener,et al.  Chapter 17 – Coordination and Ataxia , 2007 .

[20]  R. Kohen-Raz,et al.  An Initial Evaluation of Work Fatigue and Circadian Changes as Assessed by Multiplate Posturography , 1996, Perceptual and motor skills.

[21]  B. Peterson,et al.  Cerebellar Morphology and the Effects of Stimulant Medications in Youths with Attention Deficit-Hyperactivity Disorder , 2014, Neuropsychopharmacology.

[22]  M. Pang,et al.  Children with attention deficit hyperactivity disorder have impaired balance function: involvement of somatosensory, visual, and vestibular systems. , 2009, The Journal of pediatrics.

[23]  M. Bucci,et al.  patial and temporal postural analysis : a developmental study in ealthy children , 2014 .

[24]  Marina M Schoemaker,et al.  Fine motor skills and effects of methylphenidate in children with attention‐deficit—hyperactivity disorder and developmental coordination disorder , 2006, Developmental medicine and child neurology.

[25]  T. Paillard,et al.  Are there differences in postural regulation according to the level of competition in judoists? , 2002, British journal of sports medicine.

[26]  Mizuki Asano,et al.  Effects of methylphenidate in children with attention deficit hyperactivity disorder: a near-infrared spectroscopy study with CANTAB® , 2014, Child and Adolescent Psychiatry and Mental Health.

[27]  K. Matthews,et al.  The Neuropsychological Effects of Chronic Methylphenidate on Drug-Naive Boys with Attention-Deficit/Hyperactivity Disorder , 2007, Biological Psychiatry.

[28]  Y. Zang,et al.  Objective measurement of the balance dysfunction in attention deficit hyperactivity di sorder children , 2002 .

[29]  Magali Seassau,et al.  Effect of visual attention on postural control in children with attention-deficit/hyperactivity disorder. , 2014, Research in developmental disabilities.

[30]  J. Rapoport,et al.  Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. , 1996, Archives of general psychiatry.

[31]  J. Konczak,et al.  Postural and gait performance in children with attention deficit/hyperactivity disorder. , 2009, Gait & posture.

[32]  James Hughes,et al.  Fine Motor Skills , 2017 .

[33]  Jeffrey M. Hausdorff,et al.  Gait in attention deficit hyperactivity disorder : effects of methylphenidate and dual tasking. , 2007, Journal of neurology.

[34]  Stephen W. Gutkin,et al.  Time courses of improvement and symptom remission in children treated with atomoxetine for attention-deficit/hyperactivity disorder: analysis of Canadian open-label studies , 2011, Child and adolescent psychiatry and mental health.

[35]  M. Lacour,et al.  A new translational platform for evaluating aging or pathology-related postural disorders , 2005, Acta oto-laryngologica.

[36]  I. Melzer,et al.  The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder — A double blind randomized control trial , 2009, Journal of the Neurological Sciences.

[37]  L. Nashner.  Organization and programming of motor activity during posture control. , 1979, Progress in brain research.

[38]  C. J. McGrath,et al.  Effect of exchange rate return on volatility spill-over across trading regions , 2012 .

[39]  D. Kennedy,et al.  Areas of the Brain Modulated by Single-Dose Methylphenidate Treatment in Youth with ADHD During Task-Based fMRI: A Systematic Review , 2013, Harvard Review of Psychiatry.

[40]  H. Levinson.  The Diagnostic Value of Cerebellar-Vestibular Tests in Detecting Learning Disabilities, Dyslexia, and Attention Deficit Disorder , 1990, Perceptual and motor skills.

[41]  S. Lo,et al.  Motor ability and adaptive function in children with attention deficit hyperactivity disorder , 2011, The Kaohsiung journal of medical sciences.

[42]  Christine Assaiante,et al.  An ontogenetic model for the sensorimotor organization of balance control in humans , 1995 .

[43]  E Ionescu,et al.  Vestibular assessment with Balance Quest Normative data for children and young adults. , 2006, International journal of pediatric otorhinolaryngology.

[44]  Jörn Diedrichsen,et al.  Motor coordination , 2012, Scholarpedia.

[45]  Angelo Cappello,et al.  Stabilometric parameters are affected by anthropometry and foot placement. , 2002, Clinical biomechanics.