精神分裂症患者抓握动作的感觉运动功能障碍：抗精神病药物治疗的副作用？
Sensorimotor dysfunction of grasping in schizophrenia: a side effect of antipsychotic treatment?
作者信息
Nowak D A, Connemann B J, Alan M, Spitzer M
机构信息
Department of Psychiatry III, University of Ulm, Leimgrubenweg 12, D-89075 Ulm, Germany.
出版信息
J Neurol Neurosurg Psychiatry. 2006 May;77(5):650-7. doi: 10.1136/jnnp.2005.084749.
BACKGROUND
Antipsychotic treatment in schizophrenia is frequently associated with extrapyramidal side effects. Objective behavioural measures to evaluate the severity of extrapyramidal side effects in the clinical setting do not exist.
OBJECTIVES
This study was designed to investigate grasping movements in five drug naive and 13 medicated subjects with schizophrenia and to compare their performance with that of 18 healthy control subjects. Deficits of grip force performance were correlated with clinical scores of both parkinson-like motor disability and psychiatric symptom severity
METHODS
Participants performed vertical arm movements with a handheld instrumented object and caught a weight that was dropped into a handheld cup either expectedly from the opposite hand or unexpectedly from the experimenter's hand. The scaling of grip force and the temporospatial coupling between grip and load force profiles was analysed. The psychiatric symptom severity was assessed by the positive and negative symptom score of schizophrenia and the brief psychiatric rating scale. Extrapyramidal symptoms were assessed by the unified Parkinson's disease rating scale.
RESULTS
Drug naive subjects with schizophrenia performed similar to healthy controls. In contrast, medicated subjects with schizophrenia exhibited excessive grip force scaling and impaired coupling between grip and load force profiles. These performance deficits were strongly correlated with the severity of both extrapyramidal side effects related to antipsychotic therapy and negative symptoms related to the underlying pathology.
CONCLUSIONS
These data provide preliminary evidence that deficits of sensorimotor performance in schizophrenia are, at least in part, related to the side effects of antipsychotic treatment. The investigation of grasping movements may provide a sensitive measure to objectively evaluate extrapyramidal side effects related to antipsychotic therapy.
背景
精神分裂症的抗精神病药物治疗常伴有锥体外系副作用。目前尚无用于评估临床环境中锥体外系副作用严重程度的客观行为测量方法。
目的
本研究旨在调查5名未服用药物和13名服用药物的精神分裂症患者的抓握动作，并将他们的表现与18名健康对照者进行比较。握力表现缺陷与帕金森样运动障碍的临床评分和精神症状严重程度相关。
方法
参与者使用手持仪器物体进行垂直手臂运动，接住从对侧手预期掉落或从实验者手中意外掉落到手持杯子中的重物。分析握力的缩放以及握力和负载力曲线之间的时空耦合。精神症状严重程度通过精神分裂症的阳性和阴性症状评分以及简明精神病评定量表进行评估。锥体外系症状通过统一帕金森病评定量表进行评估。
结果
未服用药物的精神分裂症患者表现与健康对照者相似。相比之下，服用药物的精神分裂症患者表现出过度的握力缩放以及握力和负载力曲线之间的耦合受损。这些表现缺陷与抗精神病治疗相关的锥体外系副作用的严重程度以及潜在病理相关的阴性症状的严重程度密切相关。
结论
这些数据提供了初步证据，表明精神分裂症患者的感觉运动表现缺陷至少部分与抗精神病药物治疗的副作用有关。对抓握动作的研究可能提供一种敏感的方法来客观评估与抗精神病治疗相关的锥体外系副作用。
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