Occupational Therapy Division, The Ohio State University, Columbus, OH, USA.
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
Child Neuropsychol. 2021 Apr;27(3):317-332. doi: 10.1080/09297049.2020.1847265. Epub 2020 Nov 26.
This study examined the developmental trajectory of neurodevelopmental motor signs among boys and girls with attention-deficit/hyperactivity disorder (ADHD) and typically-developing (TD) children. Seventy children with ADHD and 48 TD children, aged 8-17 years, were evaluated on at least two time-points using the Physical and Neurological Assessment of Subtle Signs (PANESS). Age-related changes in subtle motor signs (overflow, dysrhythmia, speed) were modeled using linear mixed-effects models to compare the developmental trajectories among four subgroups (ADHD girls and boys and TD girls and boys). Across visits, both boys and girls with ADHD showed greater overflow, dysrhythmia, and slower speed on repetitive motor tasks compared to TD peers; whereas, only girls with ADHD were slower on sequential motor tasks than TD girls. Developmental trajectory analyses revealed a greater reduction in overflow with age among boys with ADHD than TD boys; whereas, trajectories did not differ among girls with and without ADHD, or among boys and girls with ADHD. For dysrhythmia and speed, there were no trajectory differences between the subgroups, with all groups showing similar reductions with age. Children with ADHD show developmental trajectories of subtle motor signs that are consistent with those of TD children, with one clear exception: Boys with ADHD show more significant reductions in overflow from childhood to adolescence than do their TD peers. Our findings affirm the presence of subtle motor signs in children with ADHD and suggest that some of these signs, particularly motor overflow in boys, resolve through adolescence while dysrhythmia and slow speed, may persist.
本研究考察了注意缺陷多动障碍（ADHD）男孩和女孩与典型发育（TD）儿童之间神经发育运动迹象的发展轨迹。70 名 ADHD 儿童和 48 名 TD 儿童，年龄 8-17 岁，使用物理和神经细微迹象评估（PANESS）至少在两个时间点进行评估。使用线性混合效应模型对细微运动迹象（溢出、节律紊乱、速度）的年龄相关变化进行建模，以比较四个亚组（ADHD 女孩和男孩以及 TD 女孩和男孩）之间的发展轨迹。在各次就诊中，ADHD 男孩和女孩在重复运动任务中均表现出比 TD 同龄人更大的溢出、节律紊乱和更慢的速度；而只有 ADHD 女孩在连续运动任务中比 TD 女孩慢。发展轨迹分析显示，ADHD 男孩的溢出量随年龄的增长而减少幅度大于 TD 男孩；而 ADHD 女孩和男孩之间，或 ADHD 女孩和男孩之间，轨迹没有差异。对于节律紊乱和速度，亚组之间没有轨迹差异，所有组都表现出随年龄的相似减少。ADHD 儿童表现出细微运动迹象的发展轨迹与 TD 儿童一致，有一个明显的例外：与他们的 TD 同龄人相比，ADHD 男孩的溢出量从儿童期到青春期减少幅度更大。我们的发现证实了 ADHD 儿童存在细微运动迹象，并表明其中一些迹象，特别是男孩的运动溢出，在青春期得到缓解，而节律紊乱和速度较慢可能持续存在。
