Mergl Roland, Pogarell Oliver, Juckel Georg, Rihl Julian, Henkel Verena, Frodl Thomas, Müller-Siecheneder Florian, Karner Max, Tigges Peter, Schröter Andreas, Hegerl Ulrich
Dept. of Psychiatry, University Leipzig, Germany.
Clin EEG Neurosci. 2007 Apr;38(2):82-8. doi: 10.1177/155005940703800210.
Motor retardation is a relevant aspect of depression. Kinematic analysis of movements can be applied to explore which type of motor dysfunction is associated with depression and to examine motor side effects of antidepressants. Using this tool, we aimed to investigate fine motor performance in patients suffering from depression and to compare a selective noradrenaline re-uptake inhibitor (NARI) (reboxetine) and a selective serotonin reuptake inhibitor (SSRI) (citalopram) regarding motor side effects after 4 weeks of treatment. In the first study (I), we examined 37 depressed patients and 37 healthy subjects using a digitizing graphic tablet and kinematic analysis of handwriting and rapid drawing movements. Both groups were comparable regarding age, gender distribution, handedness (preponderance of right-handers) and educational level. In the second study (ll), we examined different types of hand movements in 16 depressed patients receiving citalopram (flexible dosage) and 12 depressed patients treated with reboxetine (varying dosage) using the afore-mentioned methods. Both groups were comparable regarding age, gender, handedness and the baseline Hamilton Depression Rating Scale total score. I: Depressed patients performed drawing with significantly less regular velocity than controls (p < 0.001), but normal velocity. Handwriting of depressed patients was abnormally slow (p = 0.04). II: Reboxetine led to a significant improvement of repetitive drawing movements in depression. In contrast, citalopram had no pronounced effects on hand movements in depressed patients. I: Irregular patterns of velocity peaks in depressed patients point to basal ganglia dysfunction and/or deficient activity of the sensorimotor cortex and the supplementary motor area as possible substrates of hand-motor disturbances in depression. II: Computer-aided analysis of hand movements is a sensitive tool for the registration of differential pharmaceutical effects on hand-motor function in depression.
运动迟缓是抑郁症的一个相关方面。运动的运动学分析可用于探究哪种类型的运动功能障碍与抑郁症相关，并检查抗抑郁药的运动副作用。使用该工具，我们旨在研究抑郁症患者的精细运动表现，并比较选择性去甲肾上腺素再摄取抑制剂（NARI）（瑞波西汀）和选择性5-羟色胺再摄取抑制剂（SSRI）（西酞普兰）在治疗4周后的运动副作用。在第一项研究（I）中，我们使用数字化绘图板以及对手写和快速绘图动作进行运动学分析，检查了37名抑郁症患者和37名健康受试者。两组在年龄、性别分布、利手（右利手占优势）和教育水平方面具有可比性。在第二项研究（II）中，我们使用上述方法检查了16名接受西酞普兰（灵活剂量）治疗的抑郁症患者和12名接受瑞波西汀（不同剂量）治疗的抑郁症患者的不同类型手部动作。两组在年龄、性别、利手和汉密尔顿抑郁量表总分基线方面具有可比性。I：抑郁症患者绘图时的速度明显不如对照组规律（p < 0.001），但速度正常。抑郁症患者的手写速度异常缓慢（p = 0.04）。II：瑞波西汀可显著改善抑郁症患者的重复性绘图动作。相比之下，西酞普兰对抑郁症患者的手部动作没有明显影响。I：抑郁症患者速度峰值的不规则模式表明基底神经节功能障碍和/或感觉运动皮层及辅助运动区的活动不足，这可能是抑郁症手部运动障碍的潜在原因。II：手部动作的计算机辅助分析是一种灵敏的工具，可用于记录抗抑郁药对抑郁症患者手部运动功能的不同影响。
