Translational Research Center, University Hospital of Psychiatry, University of Bern, Switzerland.
Department for Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
Schizophr Res. 2018 Oct;200:42-49. doi: 10.1016/j.schres.2017.07.012. Epub 2017 Jul 11.
Schizophrenia patients present with a variety of impaired nonverbal communication skills. Performance of hand gestures is frequently impaired and associated with ratings of motor abnormalities. However, the impact of motor abnormalities to gesture performance remains unclear. To test the association between quantitative measures of motor behavior and qualitative ratings of gesture performance, we quantified movement parameters semi-automatically in videotaped recordings of gesture assessment. Thirty-one patients with schizophrenia (77.4%), schizophreniform (19.4%) or schizoaffective disorder (3.2%) and 32 healthy controls matched for age, gender and education underwent clinical assessment. Performance of the test of upper limb apraxia (TULIA) was video-taped in all subjects. The videos were analyzed with motion energy analysis software (MEA) to determine motion and time parameters. Patients and controls differed significantly in quantitative gesture performance: patients required more movement and more time to complete the tasks. Differences increased in patients with qualitatively impaired gesture production ratings (p<0.01). Group differences were most pronounced in the pantomime domain, when gestures are performed following verbal instruction. In patients, ratings of motor abnormalities correlated with duration of movement, while behavioral disorganization correlated with the amount of movements during gesture performance. Disorder related motor symptoms, aberrant action observation, planning and monitoring as well as internal clock abnormalities may explain the poor performance of hand gestures in schizophrenia. Quantitative video analysis offers a unique possibility to analyze movement patterns as a direct functional output of the motor system. In the future, it may assist monitoring, staging and prognosis in schizophrenia.
精神分裂症患者表现出多种受损的非言语交流技能。手部动作的表现常常受到损害，并与运动异常的评分相关。然而，运动异常对手势表现的影响尚不清楚。为了测试运动行为的定量测量与手势表现的定性评分之间的关联，我们对手势评估的录像进行了半自动的运动参数量化。31 名精神分裂症（77.4%）、分裂样（19.4%）或分裂情感性障碍（3.2%）患者和 32 名年龄、性别和教育程度匹配的健康对照者接受了临床评估。所有受试者都进行了上肢失用症测试（TULIA）的录像。使用运动能量分析软件（MEA）对视频进行分析，以确定运动和时间参数。患者和对照组在定量手势表现上存在显著差异：患者完成任务需要更多的运动和时间。在手势产生定性受损评分的患者中，差异增加（p<0.01）。在模仿领域，当根据口头指令进行手势时，组间差异最为明显。在患者中，运动异常评分与运动持续时间相关，而行为紊乱与手势表现过程中的运动数量相关。与疾病相关的运动症状、异常的动作观察、计划和监测以及内部时钟异常可能解释了精神分裂症患者手部手势表现不佳的原因。定量视频分析提供了一种独特的可能性，可以分析运动模式，作为运动系统的直接功能输出。在未来，它可能有助于精神分裂症的监测、分期和预后。
