Caligiuri Michael P, Weiden Peter J, Legedza Anna, Yagoda Sergey, Claxton Amy
Department of Psychiatry, University of California, San Diego, CA, USA.
Alkermes, Inc., Waltham, MA, USA.
Schizophr Bull Open. 2022 Mar 7;3(1):sgac018. doi: 10.1093/schizbullopen/sgac018. eCollection 2022 Jan.
Handwriting kinematics (HWKs) were assessed in the randomized controlled ALPINE study of 2 long-acting injectable antipsychotics started during an acute exacerbation of schizophrenia. This exploratory analysis examined the relationship between baseline HWKs and response to acute antipsychotic treatment. Adults with acute schizophrenia were assigned to aripiprazole lauroxil or paliperidone palmitate (groups combined for this analysis). Treatment response was defined as ≥20% reduction from baseline in Positive and Negative Syndrome Scale (PANSS) total score at week 4. Two HWK measures, peak velocity (decreases with greater dysfunction) and percentage of nonballistic movements (%NBM; increases with greater dysfunction), were captured in 4 handwriting tasks (complex loops, maximum speed circles, overlay circles, and left-right loops). Peak velocity and %NBM at baseline were compared between responders and nonresponders. The analysis included 143 patients (mean baseline PANSS total score, 94.5). PANSS responders ( = 67 [46.9%]) had a lower mean peak velocity (i.e., slower pen movements) on all HWK tasks at baseline compared with nonresponders ( = 76): complex loops, 8.8 versus 12.1 cm/s; maximum speed circles, 18.0 versus 23.7 cm/s; overlay circles, 12.6 versus 17.2 cm/s; and left-right loops, 11.2 versus 14.6 cm/s. PANSS responders had a greater %NBM on 3 tasks compared with nonresponders: complex loops, 57.1% versus 47.4%; overlay circles, 30.6% versus 24.3%; and left-right loops, 58.7% versus 47.0%. In this exploratory analysis, PANSS responders to aripiprazole lauroxil or paliperidone palmitate treatment at week 4 had lower baseline HWK movement velocities and greater baseline %NBM versus nonresponders, suggesting that baseline HWKs might predict response to these antipsychotic drugs.
在一项针对2种长效注射用抗精神病药物的随机对照ALPINE研究中，对精神分裂症急性加重期患者的笔迹运动学（HWKs）进行了评估。这项探索性分析研究了基线HWKs与急性抗精神病药物治疗反应之间的关系。成年急性精神分裂症患者被分配至阿立哌唑月桂酸盐组或帕利哌酮棕榈酸酯组（本分析将两组合并）。治疗反应定义为第4周时阳性和阴性症状量表（PANSS）总分较基线降低≥20%。在4项笔迹任务（复杂环路、最大速度圆圈、叠加圆圈和左右环路）中记录了2项HWK指标，即峰值速度（功能障碍越严重，速度越低）和非弹道运动百分比（%NBM；功能障碍越严重，该指标越高）。比较了反应者和无反应者的基线峰值速度和%NBM。该分析纳入了143例患者（基线PANSS总分均值为94.5）。与无反应者（n = 76）相比，PANSS反应者（n = 67 [46.9%]）在基线时所有HWK任务上的平均峰值速度均较低（即笔运动较慢）：复杂环路任务中，分别为8.8 cm/s和12.1 cm/s；最大速度圆圈任务中，分别为18.0 cm/s和23.7 cm/s；叠加圆圈任务中，分别为12.6 cm/s和17.2 cm/s；左右环路任务中，分别为11.2 cm/s和14.6 cm/s。与无反应者相比，PANSS反应者在3项任务中的%NBM更高：复杂环路任务中，分别为57.1%和47.4%；叠加圆圈任务中，分别为30.6%和24.3%；左右环路任务中，分别为58.7%和47.0%。在这项探索性分析中，第4周时对阿立哌唑月桂酸盐或帕利哌酮棕榈酸酯治疗有反应的PANSS患者，与无反应者相比，基线HWK运动速度较低，基线%NBM较高，这表明基线HWKs可能预测这些抗精神病药物的治疗反应。
