细微运动迹象可作为注意缺陷多动障碍儿童正念运动干预的生物标志物。
Subtle Motor Signs as a Biomarker for Mindful Movement Intervention in Children with Attention-Deficit/Hyperactivity Disorder.
机构信息
Kennedy Krieger Institute, Center for Neurodevelopmental and Imaging Research, Baltimore, MD. Dr. Clark is now working at Gigantum, Washington, DC.
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
出版信息
J Dev Behav Pediatr. 2020 Jun/Jul;41(5):349-358. doi: 10.1097/DBP.0000000000000795.
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.
目的
之前关于太极拳或基于正念的干预措施治疗注意缺陷多动障碍（ADHD）的研究依赖于自我报告或父母报告的结果测量；然而，非常需要验证治疗的客观生物标志物。因此，我们为患有 ADHD 的儿童实施了一项正念运动干预措施，假设与 ADHD 相关的运动控制测量可以作为治疗相关改善的预测生物标志物。
方法
共纳入 34 名参与者，年龄为 8 至 12 岁，符合 DSM-5 中 ADHD 的诊断标准。参与者参加了正念运动治疗，这是一项为期 8 周的每周 2 节课、每节课 60 分钟的方案。在治疗前后，通过身体和神经细微症状检查（PANESS）评估 ADHD 症状及其相关损害和运动控制。
结果
结果显示，治疗后 PANESS 步态和站位（p ≤ 0.001）、总溢出（p = 0.009）和总分（p = 0.001）显著降低，其中步态和站位的效果最大。结果还显示，注意力不集中（p ≤ 0.001）、多动/冲动（p ≤ 0.001）、对立违抗障碍（p = 0.001）和执行功能障碍（p ≤ 0.001）的症状均显著减轻。PANESS 步态和站位的变化与注意力不集中（p = 0.02）和多动/冲动症状（p = 0.02）的变化之间存在显著正相关。PANESS 总分的变化与注意力不集中（p = 0.007）和多动/冲动症状（p = 0.042）的变化之间也存在显著正相关。PANESS 总分的变化（β = 0.295，p = 0.002）预测治疗后 ADHD 严重程度高于注意力不集中或多动/冲动症状的变化。
结论
结果表明正念运动治疗对 ADHD 症状有效，并提示 PANESS 可能成为未来正念运动试验的候选运动生物标志物。
临床试验注册
ClinicalTrials.gov，NCT02234557，https://clinicaltrials.gov/ct2/show/NCT02234557。
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