Exercise approaches to ADHD

Do any studies indicate a beneficial effect for yoga, tai chi, or meditation in patients, particularly children, with attention-deficit hyperactivity disorder (ADHD)?—Felix N. Chien, DO, Newport Beach, Calif.

Exercise can increase levels of brain-derived neurotrophic factor, a protein encoded by the BDNF gene that supports the development and differentiation of neurons and synapses in the hippocampus, cortex, and basal forebrain. These areas are strongly linked to learning, memory, and higher-level thinking. Similarly, exercise can temporarily increase brain levels of dopamine and norepinephrine, which may result in a stimulant-like effect. Psychologists also suggest that exercise can help patients, particularly children, achieve measurable success in efforts that allow them to work beyond the learned helplessness that plagues many children with ADHD. For these reasons, it has been hypothesized that exercise can be a powerful complementary nonpharmacologic therapy for children with ADHD. This topic has been explored in depth in a book entitled
Spark: The Revolutionary New Science of Exercise and the Brain (New York, N.Y.: Little, Brown & Company; 2008) by John J. Ratey, MD, associate clinical professor of psychiatry at Harvard Medical School, in Boston. A feasibility study found that mindfulness meditation training in adolescents and adults with ADHD improved self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition (J Atten Disord. 2008;11:737-746). The data may be preliminary, but they appear quite promising.—Daniel G. Tobin, MD (131-3)
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