The Impact of Methylphenidate on Motor Performance in Children with both Attention Deficit Hyperactivity Disorder and
Robabeh Soleimani1, Maryam Kousha2, Homa Zarrabi3
1Department of Psychiatry, Cognitive and Addiction Research Center, Shafa Hospital, Guilan University of Medical Sciences, Guilan, Iran.
Insights
Methylphenidate (MPH) did not significantly improve motor function in children with ADHD/DCD compared to placebo, despite improving ADHD symptoms. Further research is needed on MPH dosage and subtypes for motor deficits.
Area of Science:
- Pediatric Neurology
- Child Psychology
Background:
- Attention deficit hyperactivity disorder/developmental coordination disorder (ADHD/DCD) presents significant motor skill deficits in children.
- Current pharmacological treatments for ADHD/DCD motor impairments are limited.
Purpose of the Study:
- To evaluate the efficacy of methylphenidate (MPH) in improving motor performance in children diagnosed with ADHD/DCD.
Main Methods:
- A double-blind, placebo-controlled, crossover randomized clinical trial was conducted with 17 children (mean age 7.5 years) diagnosed with ADHD/DCD.
- Motor function was assessed using the Bruininks-Oseretsky Test (BOT-2), with outcomes compared between MPH and placebo interventions.
- Response to MPH was defined as a ≥25% reduction in ADHD rating scale-IV scores.
Main Results:
- A mean minimal effective dose of 17.3 mg/day (0.85 mg/kg) of MPH was determined.
- Children with higher ADHD scores exhibited significantly poorer motor function (BOT-2 standard score, P=0.03).
- While 26.6% of children showed clinically significant motor improvement with MPH, this was not statistically different from placebo.
Conclusions:
- Methylphenidate (MPH) effectively improved ADHD symptoms but did not yield statistically significant improvements in motor performance in children with ADHD/DCD.
- Further investigation into higher MPH dosages or specific ADHD subtypes may be warranted to address persistent motor deficits.
Background:
Children with attention deficit hyperactivity disorder/developmental coordination disorder (ADHD/DCD) suffer from problems associated with gross and fine motor skills. There is no effective pharmacological therapy for such patients. We aimed to assess the impact of methylphenidate (MPH) on motor performance of children with ADHD/DCD.
Methods:
In this double-blind placebo-controlled, 17 children (12 boys) with ADHD/DCD with a mean age of 7 years 6 months were recruited in Shafa Hospital, Rasht, Iran. The response was defined as ≥25% reduction in the total score of ADHD rating scale-IV from the baseline. Sixteen boys entered phase 2 of the study in which the impact of MPH on motor function was determined through a crossover randomized clinical trial. Eligible individuals were scheduled for baseline and two assessment visits after a one-week period of intervention. We used the short form of Bruininks-Oseretsky test (BOT-2) to identify the disability of motor function. Children were randomly assigned to receive MPH or inert ingredients (placebo). In the second period, medication (MPH/placebo) was crossed over. The effects of MPH were analyzed using χ2 test for related samples to compare the performance during baseline, placebo, and MPH trials. The results were analyzed using the SPSS software version 16.0.
Results:
The mean minimal effective dose of MPH per day was 17.3 mg (0.85 mg/kg). Children with higher ADHD rating scale had a significantly lower standard score in BOT-2 (P=0.03). Following MPH intake, 26.6% of the children showed clinically significant improvement in motor function. However, the improvement was not statistically different between the MPH and placebo.
Conclusion:
Although MPH improved ADHD symptoms, problems with motor performance still remained. Further work is required to determine the probable effects of MPH in a higher dosage or in different subtypes of ADHD.
Trial Registration Number:
IRCT201107071483N2.
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