Grootens Koen P, Vermeeren Lianne, Verkes Robbert Jan, Buitelaar Jan K, Sabbe Bernard G C, van Veelen Nicoletta, Kahn Rene S, Hulstijn Wouter
Department of Psychiatry, University Medical Center St Radboud, and Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Schizophr Res. 2009 Feb;107(2-3):294-302. doi: 10.1016/j.schres.2008.09.032. Epub 2008 Nov 13.
Psychomotor slowing is regarded as an important clinical phenomenon in schizophrenia and simple graphic tasks consistently revealed deficits in the (implicit) planning and execution of motor actions in patients with chronic schizophrenia. The aim of the present study is to test the hypothesis that such deficits are already present in patients with recent-onset schizophrenia.
Psychomotor performance and several aspects of movement planning were analyzed in 36 patients with recent-onset schizophrenia and a group of 33 matched healthy controls. Participants were required to draw patterns varying in complexity in three different figure-copying tasks, match and draw simple symbols in the Digit Symbol Substitution Test (DSST) and connect target circles with varying orientations in a newly developed Line Sequencing Task.
Relative to the controls, the patients showed significantly longer initiation times when the patterns in the copying tasks became more complex, suggesting increased difficulty in movement planning. Overall, they were not slowed in the execution stages. In the cognitively more demanding DSST, the patients were significantly slowed in both the initiation and movement phases. Moreover, they selected less optimal movement directions in the Line Sequencing Task.
Psychomotor planning deficits are already present in the early stages of schizophrenia and involve deficient planning but intact motor action. Planning difficulties can be detected in motor sequences as well. The results indicate that the cognitive deficit in schizophrenia also affects the implicit planning of very simple movements.
精神运动迟缓被视为精神分裂症的一种重要临床现象,简单的图形任务一直显示慢性精神分裂症患者在(隐性)运动动作的计划和执行方面存在缺陷。本研究的目的是检验这样一种假设,即这种缺陷在近期发病的精神分裂症患者中已经存在。
对36例近期发病的精神分裂症患者和33名匹配的健康对照者进行了精神运动表现及运动计划的多个方面的分析。参与者被要求在三项不同的图形复制任务中绘制复杂度不同的图案,在数字符号替换测验(DSST)中匹配并绘制简单符号,以及在一项新开发的线条排序任务中连接不同方向的目标圆圈。
相对于对照组,在复制任务中图案变得更复杂时,患者显示出明显更长的启动时间,表明运动计划难度增加。总体而言,他们在执行阶段没有变慢。在认知要求更高的DSST中,患者在启动和运动阶段均明显变慢。此外,他们在线条排序任务中选择的运动方向不太理想。
精神运动计划缺陷在精神分裂症早期就已存在,涉及计划不足但运动动作完整。运动序列中的计划困难也能被检测到。结果表明,精神分裂症中的认知缺陷也会影响非常简单动作的隐性计划。