Subtle Motor Signs as a Biomarker for Mindful Movement Intervention in Children with ADHD

Objective: Prior studies of Tai Chi or mindfulness-based interventions in 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.

Method: Participants included 34, 8–12 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: Results showed a significant reduction for PANESS Gaits and Station (p≤.001), Total Overflow (p=.009), and Total score (p=.001) following treatment, with the largest effect for Gaits and Stations. Results also showed a significant reduction in symptoms of inattention (p≤.001), hyperactivity/impulsivity (p≤.001), Oppositional Defiant Disorder (p=.001) and executive dysfunction (p≤.001). There were significant positive correlations between change in PANESS Gaits and Stations and change in both inattentive (p=.02) and hyperactive/impulsive symptoms (p=.02). There was also a significant positive correlation between change in PANESS Total score and change in inattentive (p=.007) and hyperactive/impulsive symptoms (p=.042). Change in PANESS Total score (β=.295, p=.002) predicted post-treatment ADHD severity above change in inattentive or hyperactive/impulsive symptoms.

Conclusion: 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 trial.