title: Locomotor activity measures in the diagnosis of attention deficit hyperactivity disorder: Meta-analyses and new findings.
abstract: BACKGROUND
  Our aim was to assess differences in movement measures in attention-deficit/hyperactivity disorder (ADHD) vs. typically developing (TD) controls.
  
  
  METHODS
  We performed meta-analyses of published studies on motion measures contrasting ADHD with controls. We also conducted a case-control study with children/adolescents (n = 61 TD, n = 62 ADHD) and adults (n = 30 TD, n = 19 ADHD) using the McLean motion activity test, semi-structured diagnostic interviews and the behavior rating inventory of executive function and Conners (parent, teacher; self) rating scales.
  
  
  RESULTS
  Meta-analyses revealed medium-to-large effect sizes for actigraph (standardized mean difference [SMD]: 0.64, 95% confidence interval (CI): 0.43, 0.85) and motion tracking systems (SDM: 0.92, 95% CI: 0.65, 1.20) measures in differentiating individuals with ADHD from controls. Effects sizes were similar in studies of children/adolescents ([SMD]: 0.75, 95% CI: 0.50, 1.01) and of adults ([SMD]: 0.73, 95% CI: 0.46, 1.00). In our sample, ADHD groups differed significantly in number of head movements (p = 0.02 in children; p = 0.002 in adults), displacement (p = 0.009/p < 0.001), head area (p = 0.03/p < 0.001), spatial complexity (p = 0.06/p = 0.02) and temporal scaling (p = 0.05/p = 0.04). Mean effect sizes were non-significantly larger (d = 0.83, 95% CI: 0.20, 1.45) in adults vs. children/adolescents with ADHD (d = 0.45, 95% CI: 0.08, 0.82). In the concurrent go/no-go task, reaction time variability was significantly greater in ADHD (p < 0.05 in both age groups) than controls.
  
  
  CONCLUSIONS
  Locomotor hyperactivity remains core to the construct of ADHD even in adults. Our results suggest that objective locomotion measures may be particularly useful in evaluating adults with possible ADHD.
authors.affiliation: The Child Study Center at NYU Langone Medical Center, New York, USA.
authors.forename: Lourdes
authors.initials: L
authors.lastname: García Murillo
authors.affiliation: The Child Study Center at NYU Langone Medical Center, New York, USA; Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK; School of Medicine, University of Nottingham, UK; Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK.
authors.forename: Samuele
authors.initials: S
authors.lastname: Cortese
authors.affiliation: The Child Study Center at NYU Langone Medical Center, New York, USA; Child Mind Institute, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Anderson
authors.affiliation: The Child Study Center at NYU Langone Medical Center, New York, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Di Martino
authors.affiliation: The Child Study Center at NYU Langone Medical Center, New York, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA. Electronic address: Francisco.Castellanos@nyumc.org.
authors.forename: Francisco Xavier
authors.initials: FX
authors.lastname: Castellanos
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000503:physiopathology*; D002648:Child; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*
keywords: ADHD; Actigraphy; Diagnosis; Hyperactivity; McLean motion and attention test; Meta-analysis