ABSTRACT
OBJECTIVE: This research evaluates effects of vestibular stimulation by Comprehensive Motion Apparatus (CMA) in ADHD. METHOD: Children ages 6 to 12 (48 boys, 5 girls) with ADHD were randomized to thrice-weekly 30-min treatments for 12 weeks with CMA, stimulating otoliths and semicircular canals, or a single-blind control of equal duration and intensity, each treatment followed by a 20-min typing tutorial. RESULTS: In intent-to-treat analysis (n = 50), primary outcome improved significantly in both groups (p = .0001, d = 1.09 to 1.30), but treatment difference not significant (p = .7). Control children regressed by follow-up (difference p = .034, d = 0.65), but overall difference was not significant (p = .13, d = .47). No measure showed significant treatment differences at treatment end, but one did at follow-up. Children with IQ-achievement discrepancy > or = 1 SD showed significantly more CMA advantage on three measures. CONCLUSION: This study illustrates the importance of a credible control condition of equal duration and intensity in trials of novel treatments. CMA treatment cannot be recommended for combined-type ADHD without learning disorder.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Electric Stimulation/methods , Vestibule, Labyrinth/physiology , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/epidemiology , Child , Female , Follow-Up Studies , Humans , Male , Mass Screening , Semicircular Canals/physiology , Single-Blind MethodABSTRACT
OBJECTIVE: The purpose of this study was to determine whether risks of impaired cognitive function could be predicted for children or groups of children with adenotonsillar hypertrophy who were suspected of having obstructive sleep-disordered breathing, from historical and polysomnographic variables used separately or in combination. METHODS: We studied 114 consecutive 6- to 12-year-old children with adenotonsillar hypertrophy, who were referred because of suspected obstructive sleep-disordered breathing, with questionnaires, assessment of tonsil size, general and memory cognitive tests, and attended polysomnography with the use of nasal pressure recording to detect flow. RESULTS: There were important significant relationships between snore group (snored every night versus less often), sleep efficiency, and race and 2 of 3 general cognitive tests (vocabulary and similarities). Significant but weaker relationships were observed between sleep latency and 2 memory indices (verbal memory and general memory) and between sleep efficiency and 2 behavior indices (attention-deficit/hyperactivity disorder summary and hyperactive-impulsive summary). The number of episodes of apnea and hypopnea per 1 hour of sleep predicted the vocabulary score as well as did the snore group, but it did not predict other tests as well as other variables. Tonsil size did not predict any cognitive or behavior score. Confidence intervals for group means were small, whereas prediction intervals for individual children were large. CONCLUSIONS: Risk of impaired cognitive function and behavior can be predicted from snoring history, sleep efficiency, sleep latency, and race but not tonsil size. The combination of snoring history and polysomnographic variables predicted impaired cognitive scores better than did either alone. The snoring history predicted more test scores than the number of episodes of apnea and hypopnea per 1 hour of sleep.
Subject(s)
Adenoids/pathology , Cognition Disorders/etiology , Palatine Tonsil/pathology , Sleep Apnea, Obstructive/complications , Child , Child Behavior , Cognition Disorders/classification , Female , Humans , Hypertrophy , Male , Polysomnography , Predictive Value of Tests , Risk Factors , Sleep Apnea, Obstructive/psychologyABSTRACT
Maintenance genes can be used for normalization in the comparison of gene expressions. Even though the absolute expression levels of maintenance genes may vary considerably among different tissues or cells, a set of maintenance genes may provide suitable normalization if their expression levels are relatively constant in the specific tissues or cells of interest. A statistical procedure is proposed to select maintenance genes for normalization of gene expression data from tissues or cells of interest. This procedure is based on simultaneous confidence intervals for practical equivalence of relative gene expressions in these tissues or cells. As an illustration, the procedure is applied to the maintenance gene expression data from Vandesompele et al. (2002).
