Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
Eur Arch Psychiatry Clin Neurosci. 2020 Apr;270(3):373-382. doi: 10.1007/s00406-019-01004-1. Epub 2019 Apr 11.
Motor abnormalities have been indicated to be a core manifestation of schizophrenia and not just motor side-effects of antipsychotics. However, little is known about whether all of the complete motor function, including fine motor function, muscle strength, and balance is linked to psychotic symptoms. Therefore, this study was to investigate association between complete motor function and psychotic symptoms in young-adult schizophrenia patients who had no extrapyramidal motor symptoms, which were assessed using the Extrapyramidal Symptom Rating Scale. Seventy schizophrenia patients were recruited. Fine motor function, muscle strength, and balance were assessed using The McCarron Assessment of Neuromuscular Development. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. Given gender differences in muscle power, the correlation between muscle strength and psychotic symptoms was analyzed by gender separately. Partial correlation controlling for effects of the chlorpromazine equivalent dosage of antipsychotics was conducted. Better fine motor function was correlated with less-severe negative symptoms (r = - 0.49, p < 0.001) in the total sample. In men, better muscle strength was correlated with more severe positive symptoms and less-severe negative symptoms (r = 0.41, p = 0.008; r = - 0.55, p < 0.001). The link between motor function and psychotic symptoms may support the cerebellar and basal ganglia hypotheses of schizophrenia, proposing that diverse schizophrenia symptoms may share the same neural deficiency, that is, dysfunction of cerebellum or basal ganglia. Considering the moderate-to-strong association between muscle strength and psychotic symptoms, muscle strength might be a powerful physical predictor of psychotic progression.
运动异常被认为是精神分裂症的核心表现，而不仅仅是抗精神病药物的运动副作用。然而，对于完整的运动功能，包括精细运动功能、肌肉力量和平衡是否与精神病症状有关，目前知之甚少。因此，本研究旨在调查无锥体外系运动症状的年轻成年精神分裂症患者的完整运动功能与精神病症状之间的关系，锥体外系运动症状使用锥体外系症状评定量表进行评估。招募了 70 名精神分裂症患者。使用 McCarron 评估神经肌肉发育来评估精细运动功能、肌肉力量和平衡。使用阳性和阴性症状量表评估精神病症状。由于肌肉力量存在性别差异，因此按性别分别分析肌肉力量与精神病症状之间的相关性。进行了包含抗精神病药物氯丙嗪等效剂量影响的偏相关分析。总样本中，精细运动功能越好与阴性症状越轻呈负相关(r=-0.49，p<0.001)。在男性中，肌肉力量越好与阳性症状越严重和阴性症状越轻呈正相关(r=0.41，p=0.008；r=-0.55，p<0.001)。运动功能与精神病症状之间的联系可能支持精神分裂症的小脑和基底节假说，该假说提出，不同的精神分裂症症状可能具有相同的神经缺陷，即小脑或基底节功能障碍。考虑到肌肉力量与精神病症状之间的中度至强关联，肌肉力量可能是精神病进展的有力身体预测指标。
