Author/Authors :
Soleimani, Robabeh Department of Psychiatry, Cognitive and Addiction Research Center, Shafa Hospital, Guilan University of Medical Sciences , Kousha, Maryam Department of Child Psychiatry, Shafa Hospital, Guilan University of Medical Sciences, , Zarrabi, Homa Department of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences , Tavafzadeh-haghi, Mahnaz Department of Psychiatry, Shafa Hospital, Guilan University of Medical Sciences , Jalali, Mir Mohammad School of Medicine, Guilan University of Medical Sciences
Abstract :
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.
Keywords :
Motor skills , Methylphenidate , Psychomotor performance , Attention deficit disorder with hyperactivity
