Vestibular changes in children diagnosed with attention deficit hyperactivity disorder and the effect of methylphenidate treatment on the vestibular system

Aim: The aim of the study is to investigate the potential connection between vestibular functions and Attention Deficit Hyperactivity Disorder (ADHD), to explore the presence of vestibular function disorders in children diagnosed with ADHD, and to examine the effect of methylphenidate (MPH) on the vestibular system. Material and Method: This study included children aged 7-15 years. In the first stage of the study, 15 children who had recently been diagnosed with ADHD after applying to the child psychiatry clinic and 12 healthy children participated. In the second stage, 19 children newly diagnosed with ADHD were evaluated for at least 3 months using an appropriate dose of methylphenidate at the clinic. After psychiatric examinations of the children, participants were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version-Turkish Version (KSADS-PL), the Conner's ADHD Parent Rating Scale Short Form, the Atilla Turgay Screening and Evaluation Scale based on DSM-IV for Disruptive Behavior Disorders in Children and Adolescents, and the Berg Pediatric Balance Scale (BPBS). The vestibular assessment was performed using Cervical Vestibular Evoked Myogenic Potential Test (c-VEMP), Ocular Vestibular Evoked Myogenic Potential (o-VEMP) and Video Head Impulse Test (VHIT). Results: Comparing the healthy group with the newly diagnosed group with ADHD, VHIT Lateral Gain, Anterior Gain, and Posterior Gain values were higher than newly diagnosed with ADHD. A significant difference was observed in VHIT Lateral Asymmetry and VHIT Larp Asymmetry values, with higher values found in the ADHD group. In c-VEMP N1 and P1N1 latency measurements, a notable difference was observed between the groups. In balance assessment, BPBS scores were found to be higher in the healthy group, indicating a significant difference. Methylphenidate treatment has significantly changed VHIT RALP asymmetry, VHIT LARP asymmetry values and BPBS scores, Conners Behavioral Problems Subscale, Conners Hyperactivity Subscale, Conners Anxiety Subscale, and Conners Learning Problems Subscale scores. Conclusion: In conclusion, the study has shown that children diagnosed with ADHD, similar to those with other neurodevelopmental disorders, exhibit motor coordination and balance difficulties, along with observed disruptions in vestibular functions. While the MPH treatment has demonstrated an improvement in balance skills, it is concluded that it does not have a direct impact on vestibular measurement values Keywords: ADHD, balance, vestibular, video head impulse test, vestibular evoked myogenic potentials.