Chouinard Guy, Margolese Howard C
Clinical Psychopharmacology Unit, Allan Memorial Institute, McGill University Health Centre, and Department of Psychiatry, McGill University, Montreal, QC, Canada, H3A 1A1.
Schizophr Res. 2005 Jul 15;76(2-3):247-65. doi: 10.1016/j.schres.2005.02.013. Epub 2005 Apr 18.
The Extrapyramidal Symptom Rating Scale (ESRS) was developed to assess four types of drug-induced movement disorders (DIMD): Parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD). Comprehensive ESRS definitions and basic instructions are given. Factor analysis provided six ESRS factors: 1) hypokinetic Parkinsonism; 2) orofacial dyskinesia; 3) trunk/limb dyskinesia; 4) akathisia; 5) tremor; and 6) tardive dystonia. Two pivotal studies found high inter-rater reliability correlations in both antipsychotic-induced movement disorders and idiopathic Parkinson disease. For inter-rater reliability and certification of raters, >or=80% of item ratings of the complete scale should be +/-1 point of expert ratings and >or=70% of ratings on individual items of each ESRS subscale should be +/-1 point of expert ratings. During a cross-scale comparison, AIMS and ESRS were found to have a 96% (359/374) agreement between TD-defined cases by DSM-IV TD criteria. Two recent international studies using the ESRS included over 3000 patients worldwide and showed an incidence of TD ranging from 10.2% (2000) to 12% (1998). ESRS specificity was investigated through two different approaches, path analyses and ANCOVA PANSS factors changes, which found that ESRS measurement of drug-induced EPS is valid and discriminative from psychiatric symptoms.
锥体外系症状评定量表（ESRS）旨在评估四种药物诱发的运动障碍（DIMD）：帕金森症、静坐不能、肌张力障碍和迟发性运动障碍（TD）。文中给出了ESRS的全面定义和基本说明。因子分析得出了六个ESRS因子：1）运动减少型帕金森症；2）口面部运动障碍；3）躯干/肢体运动障碍；4）静坐不能；5）震颤；6）迟发性肌张力障碍。两项关键研究发现，在抗精神病药物诱发的运动障碍和特发性帕金森病中，评分者间的可靠性相关性都很高。为确保评分者间的可靠性和评分者的资质认证，完整量表中>或=80%的项目评分应与专家评分相差±1分，每个ESRS子量表中单个项目>或=70%的评分应与专家评分相差±1分。在跨量表比较中，根据DSM-IV TD标准，发现AIMS和ESRS在TD定义病例上的一致性为96%（359/374）。最近两项使用ESRS的国际研究涵盖了全球3000多名患者，结果显示TD的发病率在10.2%（2000年）至12%（1998年）之间。通过两种不同方法（路径分析和协方差分析PANSS因子变化）对ESRS的特异性进行了研究，结果发现ESRS对药物诱发的锥体外系反应的测量是有效的，且能与精神症状相区分。
