Psychiatric Center GGz Centraal, Amersfoort, Research Department, Postbus 3051, 3800 DB Amersfoort, The Netherlands; Department of Psychiatry, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, CH-3000 Bern 60, Switzerland.
Neurosci Biobehav Rev. 2022 Jan;132:691-705. doi: 10.1016/j.neubiorev.2021.11.027. Epub 2021 Nov 20.
Schizophrenia spectrum disorders have heterogeneous outcomes and currently no marker predicts the course of illness. Motor abnormalities (MAs) are inherent to psychosis, the risk of psychosis, symptom severity, and brain alterations. However, the prognostic value of MAs is still unresolved. Here, we provide a systematic review of longitudinal studies on the prognostic role of MAs spanning individuals at clinical high risk for psychosis (CHR), patients with first-episode psychosis (FEP), and chronic schizophrenia. We included 68 studies for a total of 23,630 subjects that assessed neurological soft signs (NSS), hypo- or hyperkinetic movement disorders and/or catatonia as a prognostic factor on clinical and functional outcomes. We found increased levels of MAs, in particular NSS, parkinsonism, and dyskinesia, were related to deteriorating symptomatic and poor functional outcome over time. Collectively, the findings emphasize the clinical, prognostic and scientific relevance of MA assessment and detection in individuals with or at risk of psychosis. In the future, instrumental measures of MA are expected to further augment detection, early intervention and treatment strategies in psychosis.
精神分裂症谱系障碍的结局具有异质性，目前尚无标志物能够预测疾病的进程。运动异常（MAs）是精神病固有的，也是精神病风险、症状严重程度和大脑改变的原因。然而，MAs 的预后价值仍未得到解决。在这里，我们对跨越精神病临床高风险（CHR）个体、首发精神病（FEP）患者和慢性精神分裂症患者的 MAs 的预后作用的纵向研究进行了系统综述。我们共纳入了 68 项研究，总计 23630 名受试者，评估了神经软体征（NSS）、运动障碍（低活动或高活动）和/或紧张症作为临床和功能结局的预后因素。我们发现，MAs 水平升高，特别是 NSS、帕金森病和运动障碍，与症状恶化和功能不良的长期预后有关。总的来说，这些发现强调了 MA 评估和检测在精神病患者或有精神病风险的个体中的临床、预后和科学相关性。未来，MA 的仪器测量有望进一步提高精神病的检测、早期干预和治疗策略。
