The use of actigraphy in the monitoring of methylphenidate versus placebo in ADHD: a meta-analysis
Open accessAbstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. There is an increasing need to find objective measures and markers of the disorder in order to assess the efficacy of the therapy and to improve follow-up strategies. Actigraphy is an objective method for recording motor activity and sleep parameters using small, computerized, watch-like devices worn on the body, and it has been used in many clinical trials to assess methylphenidate efficacy and adverse effects in ADHD. Our article aim is to systematically review and perform a meta-analysis of the current evidence on the role of actigraphy in both the detection of changes in activity and in sleep patterns in randomized clinical trials that compared methylphenidate against placebo in the treatment of ADHD. A comprehensive literature search of PubMed/MEDLINE, Scopus, Embase, Cochrane Library, CINHAL and PsycINFO databases was carried out to find randomized clinical trials comparing methylphenidate versus placebo in children with ADHD, using actigraphic measures as an outcome. No start date limit was used and the search was updated until June 2013. The primary outcome measures were 'total sleep time' and daytime 'activity mean'. As secondary outcomes, we analyzed 'sleep onset latency', 'sleep efficiency' and 'wake after sleep onset'. Eight articles comprising 393 patients were included in the analysis. Children with ADHD using MPH compared to placebo have a significant difference of a large effect with a diminishing value in the activity mean. For the total sleep time, we found a significant and large effect in the decrease in sleep in MPH group. This study shows that MPH may effectively reduce mean activity in ADHD children, but it may negatively affect total sleep time.
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A recent meta-analysis of six actigraphic studies in children with ADHD reported statistically significant lower daytime activity, longer sleep onset latency, lower total sleep time and lower sleep efficiency with immediate-release methylphenidate treatment than with placebo.
“A recent meta-analysis of six actigraphic studies in children with ADHD reported statistically significant lower daytime activity, longer sleep onset latency, lower total sleep time and lower sleep efficiency with immediate-release methylphenidate treatment than with placebo (De Crescenzo et al. 2014).”
From Associations of sleep disturbance with ADHD: implications for treatment (2015) · cites this paper as De Crescenzo et al. 2014
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Associations of sleep disturbance with ADHD: implications for treatment
Hvolby, A. (2015) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-014-0151-0 · Cited by 339 · see citing works
Actigraphic features of bipolar disorder: A systematic review and meta-analysis
De Crescenzo, F., Economou, A., Sharpley, A. L., Gormez, A., & Quested, D. J. (2017) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.05.003 · Cited by 128 · see citing works
Self-citationTonic and phasic co-variation of peripheral arousal indices in infants
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- Authors
- De Crescenzo, F., Armando, M., Mazzone, L., Ciliberto, M., Sciannamea, M., Figueroa, C., Janiri, L., Quested, D., & Vicari, S.
- Affiliations
- Bambino Gesù Children's Hospital (IT)
- Università Cattolica del Sacro Cuore (IT)
- Sapienza University of Rome (IT)
- Warneford Hospital (GB)
- Venue
- ADHD Attention Deficit and Hyperactivity Disorders
- Published
- 2013-11-28
- Volume
- 6
- Issue
- 1
- Pages
- 49-58
- ISSN
- 1866-6116 (ISSN-L)
- 1866-6647
- OpenAlex
- W2003815464
- Cited by
- 48
- References
- 59
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 5 · 2019: 2 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 7 · 2014: 3
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- ADHD Attention Deficit and Hyperactivity Disorders (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
- SERVAL (Université de Lausanne) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- actigraphy, methylphenidate, attention deficit hyperactivity disorder, children, total sleep time, sleep latency, sleep efficiency, wake after sleep onset, diurnal activity, stimulant efficacy, placebo comparison
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Humans, Methylphenidate, Sleep, Randomized Controlled Trials as Topic, Actigraphy
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