Bucci Maria P, Stordeur Coline, Acquaviva Eric, Peyre Hugo, Delorme Richard
UMR 1141 Institut National de la Santé et de la Recherche Médicale-Université Paris Diderot, Robert Debré Hospital Paris, France.
Child and Adolescent Psychiatry Department, Robert Debré Hospital Paris, France.
Front Neurosci. 2016 May 4;10:163. doi: 10.3389/fnins.2016.00163. eCollection 2016.
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).
压力中心的空间和时间分析均表明，与性别、年龄和智商匹配的正常发育儿童相比，患有注意力缺陷多动障碍（ADHD）的儿童姿势控制能力较差。姿势控制中不良的感觉统合可能部分解释了ADHD儿童姿势稳定性的缺陷。哌甲酯（MPH）治疗可改善ADHD儿童在空间和时间领域的姿势表现。当视觉和本体感觉输入产生误导时，MPH能特别改善姿势控制。这种改善可能归因于MPH对神经元的作用，促进了小脑对姿势控制的处理。本研究旨在通过压力中心（CoP）的空间和时间分析，检查ADHD儿童的姿势控制，并探索哌甲酯（MPH）的效果。研究了38名ADHD儿童（平均年龄9.82±0.37岁）和38名性别、年龄和智商匹配的正常发育儿童。在入组时以及ADHD儿童服用MPH 1个月后，使用多功能平衡仪（Framiral®）评估姿势稳定性。在几种条件下记录姿势稳定性：眼睛睁开并固定在一个目标上、眼睛闭上以及视觉受到视动刺激干扰时，在稳定和不稳定平台上。入组时，我们观察到ADHD儿童在空间和时间上的姿势稳定性较差。ADHD儿童的频谱功率指数高于对照组。ADHD儿童在低频和中频振荡时的抵消时间较短，在高频时较长。服用MPH 1个月后，在最复杂的条件下（在没有本体感觉和视觉输入的不稳定平台上），CoP的表面积和平均速度显著降低。服用MPH后频谱功率指数显著降低，而抵消时间没有变化。ADHD儿童不良的姿势控制支持了该疾病中小脑功能障碍的假说。如服用MPH后频谱功率指数降低而抵消时间（一个低水平过程）未改变所表明的，通过更有效地处理感觉输入（一个高水平过程），姿势控制可以得到改善。
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