Kim Ju Yeon, Jung Eunji, Lee Taeyeop, Park Kee Jeong, Joung Yoo-Sook, Kim Hyo-Won
Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
Psychiatry Investig. 2025 Jan;22(1):84-92. doi: 10.30773/pi.2024.0198. Epub 2025 Jan 15.
To investigate the effects of methylphenidate and atomoxetine treatment on motor coordination in children with attention-deficit/hyperactivity disorder (ADHD).
In this single-site, open-label, naturalistic follow-up study, 157 children (7.6±1.4 years; 139 males) with ADHD were recruited between March 2015 and May 2020 from the Department of Psychiatry, Asan Medical Center, and treated for 12 weeks with methylphenidate (n=48) or atomoxetine (n=109). Children completed the Advanced Test of Attention (ATA), and caregivers completed the ADHD Rating Scale (ARS) questionnaire and Developmental Coordination Disorder Questionnaire (DCDQ) at baseline and at 12 weeks. Paired t-tests, a mixed-effects model, and linear regression were used to compare treatment groups and assess factors influencing motor coordination changes.
Methylphenidate and atomoxetine resulted in significant improvement in DCDQ fine motor/handwriting, general coordination, and total scores over 12 weeks. Fine motor/handwriting had a significant main effect for time (F1=16.64, p<0.001, η2=0.097); however, the interaction effect between group and time was not significant (F1=0.24, p=0.625, η2=0.002). Changes in parent-reported ARS inattention scores (β=-0.174, p=0.029) and auditory commission errors of ATA (β=0.191, p=0.022) were significantly associated with changes in fine motor/handwriting. Additionally, changes in parent-reported ARS inattention scores (β=-0.177, p=0.034) and rater-reported ARS inattention scores (β=-0.198, p=0.017) were significant predictors of improvements in general coordination in separate models.
Methylphenidate and atomoxetine had a positive effect on motor coordination in children with ADHD. Improvement in motor coordination was associated with ADHD symptom improvement.
探讨哌甲酯和托莫西汀治疗对注意缺陷多动障碍（ADHD）儿童运动协调性的影响。
在这项单中心、开放标签、自然随访研究中，2015年3月至2020年5月期间从峨山医疗中心精神科招募了157名ADHD儿童（7.6±1.4岁；139名男性），分别接受哌甲酯（n = 48）或托莫西汀（n = 109）治疗12周。儿童完成高级注意力测试（ATA），照料者在基线和12周时完成ADHD评定量表（ARS）问卷和发育性协调障碍问卷（DCDQ）。采用配对t检验、混合效应模型和线性回归比较治疗组并评估影响运动协调性变化的因素。
哌甲酯和托莫西汀在12周内使DCDQ精细运动/书写、总体协调性和总分有显著改善。精细运动/书写在时间上有显著主效应（F1 = 16.64，p < 0.001，η2 = 0.097）；然而，组间与时间的交互效应不显著（F1 = 0.24，p = 0.625，η2 = 0.002）。家长报告的ARS注意力不集中得分变化（β = -0.174，p = 0.029）和ATA听觉遗漏错误（β = 0.191，p = 0.022）与精细运动/书写变化显著相关。此外，在单独模型中，家长报告的ARS注意力不集中得分变化（β = -0.177，p = 0.034）和评估者报告的ARS注意力不集中得分变化（β = -0.198，p = 0.017）是总体协调性改善的显著预测因素。
哌甲酯和托莫西汀对ADHD儿童的运动协调性有积极影响。运动协调性的改善与ADHD症状改善相关。
