title: Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise.
abstract: OBJECTIVE
  The degree of functional impairment and adverse developmental outcomes in individuals with attention-deficit/hyperactivity disorder (ADHD) likely reflect interplay between genes and environment. To establish whether physical exercise might reduce the level of ADHD symptoms or ADHD-related impairments, we conducted a comprehensive review of the effect of exercise in children with ADHD. Findings on the impact of exercise in animals and typically developing human beings, and an overview of putative mechanisms involved, are also presented to provide the context in which to understand this review.
  
  
  METHODS
  The electronic databases PubMed, OVID, and Web of Knowledge were searched for all studies investigating the effect of exercise in children and adolescents with ADHD, as well as animal models of ADHD behaviors (available in January 2013). Of 2,150 initially identified records, 16 were included.
  
  
  RESULTS
  Animal studies indicate that exercise, especially early in development, may be beneficial for ADHD symptom reduction. The limited research investigating the effect of exercise in children and adolescents with ADHD suggests that exercise may improve executive functioning and behavioral symptoms associated with ADHD. Although animal research suggests that brain-derived neurotrophic factor (BDNF) and catecholamines (CAs) play a role in mediating these effects, the association between BDNF and ADHD remains unclear in human beings.
  
  
  CONCLUSIONS
  The potential protective qualities of exercise with regard to reducing symptoms and impairments commonly associated with ADHD may hold promise for the future. Further research is needed to firmly establish whether there are clinically significant effects of exercise on the severity of ADHD symptoms, impairments, and associated developmental outcomes.
authors: Medical Research Council Social, Genetic and Developmental Psychiatry Centre, the Institute of Psychiatry, King's College London. anna.rommel@kcl.ac.uk
authors: Anna-Sophie
authors: AS
authors: Rommel
authors: Jeffrey M
authors: JM
authors: Halperin
authors: Jonathan
authors: J
authors: Mill
authors: Philip
authors: P
authors: Asherson
authors: Jonna
authors: J
authors: Kuntsi
mesh_terms: D000818:Animals; D001289:Attention Deficit Disorder with Hyperactivity / Q000235:genetics* / Q000628:therapy*; D002648:Child; D004195:Disease Models, Animal; D015444:Exercise; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease / Q000235:genetics* / Q000517:prevention & control*; D006801:Humans; D012307:Risk Factors
keywords: attention-deficit/hyperactivity disorder (ADHD); epigenetics; exercise; physical activity; protective factors
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