Locomotor activity measures in the diagnosis of attention deficit hyperactivity disorder: Meta-analyses and new findings

Lourdes García Murillo, Samuele Cortese, David Anderson, Adriana Di Martino, Francisco Xavier Castellanos

Research output: Contribution to journalArticlepeer-review


Introduction: 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.

Original languageEnglish
Pages (from-to)14-26
Number of pages13
JournalJournal of Neuroscience Methods
Publication statusPublished - Oct 10 2014


  • Actigraphy
  • ADHD
  • Diagnosis
  • Hyperactivity
  • McLean motion and attention test
  • Meta-analysis

ASJC Scopus subject areas

  • Neuroscience(all)


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