Neurological soft signs in children with attention deficit hyperactivity disorder

Abstract

Context:Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with wide repercussions. Since it is etiologically related to delayed maturation, neurological soft signs (NSS) could be a tool to assess this. Further the correlation of NSS with severity and type of ADHD and presence of Specific Learning Disability (SLD) would give further insight into it.Aims:To study neurological soft signs and risk factors (type, mode of delivery, and milestones) in children with ADHD and to correlate NSS with type and severity of ADHD and with co-morbid Specific Learning Disability.Settings and Design:The study was carried out in Child care services of a tertiary teaching urban hospital. It was a cross-sectional single interview study.Materials and Methods:52 consecutive children diagnosed as having ADHD were assessed for the presence of neurological soft signs using Revised Physical and Neurological Examination soft Signs scale (PANESS). The ADHD was rated by parents using ADHD parent rating scale.Statistical Analysis:The data was analyzed using the chi-squared test and Pearson's co-relational analysis.Results and Conclusions:Neurological soft signs are present in 84% of children. They are equally present in both the inattentive-hyperactive and impulsive-hyperactive types of ADHD. The presence of neurological soft signs in ADHD are independent of the presence of co-morbid SLD. Dysrrhythmias and overflow with gait were typically seen for impulsive-hyperactive type and higher severity of ADHD is related to more errors.

Neurological Soft Signs in Individuals with Pathological Gambling

“…In contrast to hard neurological signs localizable to a specific brain site, their soft counterparts are attributed to wider brain regions and functionally connected neuroanatomical systems, involved in integrative neurological functions such as sensory perception, coordination and motor sequencing [32], [33]. Neurological soft signs have been observed in a growing number of neuropsychiatric syndromes including mood disorders [34]–[36], obsessive-compulsive disorder (OCD) [37]–[39], post-traumatic stress disorder [26], [27], impulse control disorder [40], schizophrenia [32], [34], [41], and attention deficit hyperactivity disorder [42]. Furthermore, an inverse relationship between NSSs scores and total brain volume has been noted in psychopathological populations [27], [43] adding support to the generalized rather than localized NSSs' nature.…”

Prevalence and correlates of neurological soft signs in healthy controls without family history of any mental disorder: A neurodevelopmental variation rather than a specific risk factor?

“…Many authors suggest that their presence beyond this age is indicative of some kind of maturational delay (Largo et al, 2001a,b). They are often found in patients suffering from mental disorders (Dazzan et al, 2008;Goswami et al, 2006;Negash et al, 2004;Zhao et al, 2013;Fountoulakis et al, 2017b;Panagiotidis et al, 2013), and also in children with ADHD (Patankar et al, 2012) or other developmental disorders (Dickstein et al, 2005;Szatmari and Taylor, 1984;Vitiello et al, 1990;Gottesman et al, 1984).…”

Increased Anterior Pelvic Angle Characterizes the Gait of Children with Attention Deficit/Hyperactivity Disorder (ADHD)

“…Previous studies have reported that poor coordination and impairments in fine and gross motor function are caused by difficulty in directing attention and by display of impulsive behavior [7, 8]. To date, motor function, including gait function, has been clinically assessed as a neurological soft sign in children with ADHD [9]. Gait function is one of the fundamental motor skills requiring both attention and executive function [7, 10].…”