A study on comparison of neurological soft signs and minor physical anomalies between siblings of attention deficit hyperactivity disorder children and normal controls.

INTRODUCTION Attention deficit hyperactivity disorder is the most common neurobehavioural disorder of the childhood. It is characterised by inattention, hyperactivity and impulsivity. Neurological Soft Signs represent subtle neurological signs that could not be localised to a particular region of brain. Minor Physical Anomalies are subtle phenotypic abnormalities that don’t fit into dysmorphic syndromes. Both the NSS and MPA indicate a diffuse brain injury. And both are present in many of psychiatric disorders and behavioural disorders especially ADHD. AIMS & OBJECTIVES To study the Neurological Soft Signs and Minor Physical Anomalies in ADHD siblings in comparison with age matched controls. To study the correlations of Neurological Soft Signs and Minor Physical anomalies with respect to gender and socioeconomic class of the children. To study the interrelationship between various domains of soft signs with minor physical Anomalies. SUBJECTS AND METHODS Study was conducted in child psychiatry department. Siblings of the children diagnosed of ADHD during the study period, who doesn’t have a feature of neurological or psychiatric abnormality including ADHD, from 8 to 13 years were included in the case group. Normal children were included in the control group. The number of children included in both case and control group were 57. The children included in the study were given revised Physical and Neurological Evaluation of Soft Signs (PANESS) and WALDROP Minor Physical Anomaly Scale and scores were assessed. STATISTICAL ANALYSIS The scores of various domains of Neurological Soft Signs and Minor Physical Anomalies were drawn. Independent t test were applied between the two groups. P <0.05 were taken as significant. Similarly correlations were drawn among gender and socioeconomic class with NSS/MPA by Pearson’s correlation. Statistical analysis were done by SPSS version 17.0. RESULTS Total number of children included in the study was 114. Of that 74 were male and 40 were female. Socio economic class was obtained for each child by modified kuppusamy scale. There is a statistical significance of p< 0.05 in overflow items, gaits and stations, total timed and total PANESS. p> 0.05is noted for minor physical anomalies for both case and control group. There is no statistical difference for males and females for NSS/MPA separately for both the case and control group. There is a positive correlation for overflow items & timed movements with minor physical anomalies for ADHD siblings in lower middle and upper lower socioeconomic groups. CONCLUSION ADHD siblings showed a significant increase in Neurological soft Signs when compared with normal children. While ADHD siblings fail to show a significant increase in Minor Physical Anomalies compared with Normal children. The inter correlation of Minor Physical Anomalies with various domains of soft signs showed positivity for overflow and timed movements, especially for sibling group in lower middle and upper lower group. There is no significant difference between males and females in both sibling group and normal children in Neurological Soft Signs and Minor Physical Anomalies