University of Bern, University Hospital of Psychiatry, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland.
Psychiatry Res. 2015 Sep 30;233(3):293-8. doi: 10.1016/j.pscychresns.2015.06.010.
Schizophrenia is a devastating disorder thought to result mainly from cerebral pathology. Neuroimaging studies have provided a wealth of findings of brain dysfunction in schizophrenia. However, we are still far from understanding how particular symptoms can result from aberrant brain function. In this context, the high prevalence of motor symptoms in schizophrenia such as catatonia, neurological soft signs, parkinsonism, and abnormal involuntary movements is of particular interest. Here, the neuroimaging correlates of these motor symptoms are reviewed. For all investigated motor symptoms, neural correlates were found within the cerebral motor system. However, only a limited set of results exists for hypokinesia and neurological soft signs, while catatonia, abnormal involuntary movements and parkinsonian signs still remain understudied with neuroimaging methods. Soft signs have been associated with altered brain structure and function in cortical premotor and motor areas as well as cerebellum and thalamus. Hypokinesia is suggested to result from insufficient interaction of thalamocortical loops within the motor system. Future studies are needed to address the neural correlates of motor abnormalities in prodromal states, changes during the course of the illness, and the specific pathophysiology of catatonia, dyskinesia and parkinsonism in schizophrenia.
精神分裂症是一种严重的疾病，主要被认为是由大脑病理引起的。神经影像学研究为精神分裂症的大脑功能障碍提供了丰富的发现。然而，我们仍然远未理解特定的症状如何会导致异常的大脑功能。在这种情况下，精神分裂症中运动症状的高患病率（如紧张症、神经软体征、帕金森病和异常不自主运动）特别令人关注。在这里，我们回顾了这些运动症状的神经影像学相关性。对于所有研究的运动症状，都在大脑运动系统内发现了神经相关性。然而，只有针对运动减少和神经软体征的有限的结果存在，而紧张症、异常不自主运动和帕金森病征象仍然是用神经影像学方法进行的研究较少。软体征与皮质运动前区和运动区以及小脑和丘脑的大脑结构和功能改变有关。运动减少被认为是由于运动系统内的丘脑皮质环路的相互作用不足所致。未来的研究需要解决前驱状态、疾病过程中的变化以及精神分裂症中紧张症、运动障碍和帕金森病的特定病理生理学的运动异常的神经相关性。
