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Altinok DCA, Ohl K, Volkmer S, Brandt GA, Fritze S, Hirjak D. 3D-optical motion capturing examination of sensori- and psychomotor abnormalities in mental disorders: Progress and perspectives. Neurosci Biobehav Rev 2024; 167:105917. [PMID: 39389438 DOI: 10.1016/j.neubiorev.2024.105917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 09/19/2024] [Accepted: 10/03/2024] [Indexed: 10/12/2024]
Abstract
Sensori-/psychomotor abnormalities refer to a wide range of disturbances in individual motor, affective and behavioral functions that are often observed in mental disorders. However, many of these studies have mainly used clinical rating scales, which can be potentially confounded by observer bias and are not able to detect subtle sensori-/psychomotor abnormalities. Yet, an innovative three-dimensional (3D) optical motion capturing technology (MoCap) can provide more objective and quantifiable data about movements and posture in psychiatric patients. To draw attention to recent rapid progress in the field, we performed a systematic review using PubMed, Medline, Embase, and Web of Science until May 01st 2024. We included 55 studies in the qualitative analysis and gait was the most examined movement. The identified studies suggested that sensori-/psychomotor abnormalities in neurodevelopmental, mood, schizophrenia spectrum and neurocognitive disorders are associated with alterations in spatiotemporal parameters (speed, step width, length and height; stance time, swing time, double limb support time, phases duration, adjusting sway, acceleration, etc.) during various movements such as walking, running, upper body, hand and head movements. Some studies highlighted the advantages of 3D optical MoCap systems over traditional rating scales and measurements such as actigraphy and ultrasound gait analyses. 3D optical MoCap systems are susceptible to detecting differences not only between patients with mental disorders and healthy persons but also among at-risk individuals exhibiting subtle sensori-/psychomotor abnormalities. Overall, 3D optical MoCap systems hold promise for objectively examining sensori-/psychomotor abnormalities, making them valuable tools for use in future clinical trials.
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Affiliation(s)
- Dilsa Cemre Akkoc Altinok
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Kristin Ohl
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sebastian Volkmer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Geva A Brandt
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Centre for Mental Health (DZPG), Partner Site Mannheim, Germany.
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Task specificity impacts dual-task interference in older adults. Aging Clin Exp Res 2021; 33:581-587. [PMID: 32377966 DOI: 10.1007/s40520-020-01575-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Task prioritization is an important factor determines the magnitude and direction of dual-task interference in older adults. Greater dual-task cost during walking may lead to falling, sometimes causing lasting effects on mobility. AIMS We investigated dual-task interference for walking and cognitive performance. METHODS Twenty healthy, older adults (71 ± 5 years) completed three cognitive tasks: letter fluency, category fluency, and serial subtraction during seated and walking conditions on a self-paced treadmill for 3 min each, in addition to walking only condition. Walking speed, step length and width were measured during walking and each dual-task condition. RESULTS Comparing the percentage of correct answers in cognitive tasks across single and dual-task conditions, there was a main effect of cognitive task (p = 0.021), showing higher scores during letter fluency compared to serial subtraction (p = 0.011). Step width was significantly wider during dual-task letter fluency compared to walking alone (p = 0.003), category fluency (p = 0.001), and serial subtraction (p = 0.007). DISCUSSION During both fluency tasks, there was a cost for gait and cognition, with category showing a slightly higher cognitive cost compared to letter fluency. During letter fluency, to maintain cognitive performance, gait was sacrificed by increasing step width. During serial subtraction, there was a cost for gait, yet a benefit for cognitive performance. CONCLUSION Differential effect of cognitive task on dual-task performance is critical to be understood in designing future research or interventions to improve dual-task performance of most activities of daily living.
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Presta V, Paraboschi F, Marsella F, Lucarini V, Galli D, Mirandola P, Banchini A, Marchesi C, Galuppo L, Vitale M, Tonna M, Gobbi G. Posture and gait in the early course of schizophrenia. PLoS One 2021; 16:e0245661. [PMID: 33465166 PMCID: PMC7815098 DOI: 10.1371/journal.pone.0245661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 01/05/2021] [Indexed: 12/02/2022] Open
Abstract
While correlations between postural stability deficits and schizophrenia are well documented, information on dynamic motor alterations in schizophrenia are still scarce, and no data on their onset are available yet. Therefore, the aim of this study was i) to measure gait pattern(s) in patients with schizophrenia; ii) to identify posture and gait alterations which could potentially be used as a predictive clinical tool of the onset of the disorder. Body composition, posture and gait parameters were assessed in a group of 30 patients with schizophrenia and compared to 25 healthy subjects. Sway area was significantly higher in the schizophrenia group compared to controls regardless of whether the participants were in eyes open or eyes closed condition. Gait cadence and speed were significantly lower in patients with schizophrenia, while stride length was similar. We concluded that the combination of an increased sway area (independent from eye closure) and a gait cadence reduction—in the presence of normal gait speed and stride length—might be considered peculiar postural and gait profile characteristic of early schizophrenia.
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Affiliation(s)
- Valentina Presta
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
- Department of Medicine and Surgery, Human Anatomy, University of Parma, Parma, Italy
| | | | - Filippo Marsella
- Department of Neuroscience, Psychiatric Unit, University of Parma, Parma, Italy
| | - Valeria Lucarini
- Department of Neuroscience, Psychiatric Unit, University of Parma, Parma, Italy
| | - Daniela Galli
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
| | - Prisco Mirandola
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
| | - Antonio Banchini
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
| | - Carlo Marchesi
- Department of Neuroscience, Psychiatric Unit, University of Parma, Parma, Italy
| | | | - Marco Vitale
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
- Movement Analysis Laboratory (LAM)–Parma University Hospital, Parma, Italy
- * E-mail:
| | - Matteo Tonna
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Giuliana Gobbi
- Department of Medicine and Surgery–Human Anatomy, University of Parma, Parma, Italy
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Apthorp D, Bolbecker AR, Bartolomeo LA, O’Donnell BF, Hetrick WP. Postural Sway Abnormalities in Schizotypal Personality Disorder. Schizophr Bull 2019; 45:512-521. [PMID: 30376125 PMCID: PMC6483590 DOI: 10.1093/schbul/sby141] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Motor abnormalities are among the most robust findings in schizophrenia, and increasing evidence suggests they are a core feature of the disorder. Postural sway during balance tasks is a highly sensitive probe of sensorimotor systems including the cerebellum, basal ganglia, and motor cortices. Postural sway deficits are present in schizophrenia as well as groups at high risk for psychosis, suggesting altered postural control may be sensitive to the pathophysiological processes associated with risk and expression of schizophrenia spectrum disorders. This study examined postural sway performance in schizotypal personality disorder (SPD). Individuals with SPD have attenuated psychotic symptoms and share genetic risk with schizophrenia but are usually free from antipsychotic medication and other illness confounds, making SPD useful for assessing candidate biomarkers. We measured postural sway using force plates in 27 individuals with SPD, 27 carefully matched controls, and 27 matched patients with schizophrenia. It was predicted that postural sway in the SPD group would fall intermediate to schizophrenia and controls. In all conditions (eyes open and closed, with feet together or apart), the SPD group swayed significantly more than the controls, as measured by path length and sway area. Moreover, the magnitude of the sway deficit was comparable in the SPD and schizophrenia groups. These findings suggest that postural sway measures may represent a sensorimotor biomarker of schizophrenia spectrum disorders.
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Affiliation(s)
- Deborah Apthorp
- School of Psychology and Behavioural Science, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia,To whom correspondence should be addressed; tel: 61 2 6773 4316, fax: 61 2 6773 3820, e-mail:
| | - Amanda R Bolbecker
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN
| | | | - Brian F O’Donnell
- Department of Psychiatry, Indiana University Medical Centre, Bloomington, IN,Program in Neuroscience, Indiana University, Bloomington, IN
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN,Program in Neuroscience, Indiana University, Bloomington, IN
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A Concurrent Cognitive Task Does Not Perturb Quiet Standing in Fibromyalgia and Chronic Fatigue Syndrome. Pain Res Manag 2018; 2018:9014232. [PMID: 30159106 PMCID: PMC6109464 DOI: 10.1155/2018/9014232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 06/20/2018] [Accepted: 07/17/2018] [Indexed: 11/25/2022]
Abstract
Background and Objectives Cognitive complaints are common in fibromyalgia (FM) and chronic fatigue syndrome (CFS). Fatigue as well as pain may require greater effort to perform cognitive tasks, thereby increasing the load on processing in the central nervous system and interfering with motor control. Methods The effect of a concurrent arithmetic cognitive task on postural control during quiet standing was investigated in 75 women (aged 19–49 years) and compared between FM, CFS, and matched controls (n=25/group). Quiet standing on a force plate was performed for 60 s/condition, with and without a concurrent cognitive task. The center of pressure data was decomposed into a slow component and a fast component representing postural sway and adjusting ankle torque. Results Compared to controls, CFS and FM displayed lower frequency in the slow component (p < 0.001), and CFS displayed greater amplitude in the slow (p=0.038 and p=0.018) and fast (p=0.045) components. There were no interactions indicating different responses to the added cognitive task between any of the three groups. Conclusion Patients displayed insufficient postural control across both conditions, while the concurrent cognitive task did not perturb quiet standing. Fatigue but not pain correlated with postural control variables.
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Teng YL, Chen CL, Lou SZ, Wang WT, Wu JY, Ma HI, Chen VCH. Postural Stability of Patients with Schizophrenia during Challenging Sensory Conditions: Implication of Sensory Integration for Postural Control. PLoS One 2016; 11:e0158219. [PMID: 27355830 PMCID: PMC4927090 DOI: 10.1371/journal.pone.0158219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 06/13/2016] [Indexed: 11/19/2022] Open
Abstract
Postural dysfunctions are prevalent in patients with schizophrenia and affect their daily life and ability to work. In addition, sensory functions and sensory integration that are crucial for postural control are also compromised. This study intended to examine how patients with schizophrenia coordinate multiple sensory systems to maintain postural stability in dynamic sensory conditions. Twenty-nine patients with schizophrenia and 32 control subjects were recruited. Postural stability of the participants was examined in six sensory conditions of different level of congruency of multiple sensory information, which was based on combinations of correct, removed, or conflicting sensory inputs from visual, somatosensory, and vestibular systems. The excursion of the center of pressure was measured by posturography. Equilibrium scores were derived to indicate the range of anterior-posterior (AP) postural sway, and sensory ratios were calculated to explore ability to use sensory information to maintain balance. The overall AP postural sway was significantly larger for patients with schizophrenia compared to the controls [patients (69.62±8.99); controls (76.53±7.47); t1,59 = -3.28, p<0.001]. The results of mixed-model ANOVAs showed a significant interaction between the group and sensory conditions [F5,295 = 5.55, p<0.001]. Further analysis indicated that AP postural sway was significantly larger for patients compared to the controls in conditions containing unreliable somatosensory information either with visual deprivation or with conflicting visual information. Sensory ratios were not significantly different between groups, although small and non-significant difference in inefficiency to utilize vestibular information was also noted. No significant correlations were found between postural stability and clinical characteristics. To sum up, patients with schizophrenia showed increased postural sway and a higher rate of falls during challenging sensory conditions, which was independent of clinical characteristics. Patients further demonstrated similar pattern and level of utilizing sensory information to maintain balance compared to the controls.
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Affiliation(s)
- Ya-Ling Teng
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
- Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chiung-Ling Chen
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
- Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shu-Zon Lou
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Tsan Wang
- Department of Psychiatry, Cen-Der Hospital, Taichung, Taiwan
| | - Jui-Yen Wu
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hui-Ing Ma
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail:
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital & Chang Gung University, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Beurskens R, Haeger M, Kliegl R, Roecker K, Granacher U. Postural Control in Dual-Task Situations: Does Whole-Body Fatigue Matter? PLoS One 2016; 11:e0147392. [PMID: 26796320 PMCID: PMC4721871 DOI: 10.1371/journal.pone.0147392] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 01/04/2016] [Indexed: 11/25/2022] Open
Abstract
Postural control is important to cope with demands of everyday life. It has been shown that both attentional demand (i.e., cognitive processing) and fatigue affect postural control in young adults. However, their combined effect is still unresolved. Therefore, we investigated the effects of fatigue on single- (ST) and dual-task (DT) postural control. Twenty young subjects (age: 23.7 ± 2.7) performed an all-out incremental treadmill protocol. After each completed stage, one-legged-stance performance on a force platform under ST (i.e., one-legged-stance only) and DT conditions (i.e., one-legged-stance while subtracting serial 3s) was registered. On a second test day, subjects conducted the same balance tasks for the control condition (i.e., non-fatigued). Results showed that heart rate, lactate, and ventilation increased following fatigue (all p < 0.001; d = 4.2–21). Postural sway and sway velocity increased during DT compared to ST (all p < 0.001; d = 1.9–2.0) and fatigued compared to non-fatigued condition (all p < 0.001; d = 3.3–4.2). In addition, postural control deteriorated with each completed stage during the treadmill protocol (all p < 0.01; d = 1.9–3.3). The addition of an attention-demanding interference task did not further impede one-legged-stance performance. Although both additional attentional demand and physical fatigue affected postural control in healthy young adults, there was no evidence for an overadditive effect (i.e., fatigue-related performance decrements in postural control were similar under ST and DT conditions). Thus, attentional resources were sufficient to cope with the DT situations in the fatigue condition of this experiment.
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Affiliation(s)
- Rainer Beurskens
- Research Focus Cognition Sciences, Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
- Geriatric Center at the University of Heidelberg, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Matthias Haeger
- Research Focus Cognition Sciences, Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Reinhold Kliegl
- Department of Psychology, Division of Cognitive Psychology, University of Potsdam, Potsdam, Germany
| | - Kai Roecker
- Faculty of Applied Public Health, University of Furtwangen, Furtwangen, Germany
| | - Urs Granacher
- Research Focus Cognition Sciences, Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
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Abstract
Postural instability is a feature that is frequently observed in patients with psychotic disorders. Previous studies applied rating scales or behavioral test to assess postural instabilities. Recently, a pressure-sensitive platform has been used to study detailed characteristics of postural sway and regulation. However, characteristics of posturography indices in patients with psychotic disorders have not been well documented. To integrate the findings from studies that assessed postural sway using posturography in patients with psychotic disorders, we conducted a systematic review. Following database literature search, we identified nine eligible articles. Assessment conditions and indices of postural stability varied between studies. Postural control was associated with negative and general psychopathology in two studies. Two studies reported associations between posturographic variables and medication dose, whereas four studies reported no associations. This review identified the need to develop standards to assess postural sway in patients with psychiatric disorders. Further studies need to report associations between postural sway and confounding factors.
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Affiliation(s)
- Haruo Fujino
- Graduate School of Human Sciences, Osaka University, 1-2, Yamadaoka, Suita, Osaka, 5650871, Japan.
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, 1-2, Yamadaoka, Suita, Osaka, 5650871, Japan.
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Bernard JA, Mittal VA. Cerebellar-motor dysfunction in schizophrenia and psychosis-risk: the importance of regional cerebellar analysis approaches. Front Psychiatry 2014; 5:160. [PMID: 25505424 PMCID: PMC4243486 DOI: 10.3389/fpsyt.2014.00160] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/25/2014] [Indexed: 12/21/2022] Open
Abstract
Motor abnormalities in individuals with schizophrenia and those at-risk for psychosis are well documented. An accumulating body of work has also highlighted motor abnormalities related to cerebellar dysfunction in schizophrenia including eye-blink conditioning, timing, postural control, and motor learning. We have also recently found evidence for motor dysfunction in individuals at ultra high-risk for psychosis (1-3). This is particularly relevant as the cerebellum is thought to be central to the cognitive dysmetria model of schizophrenia, and these overt motor signs may point to more general cerebellar dysfunction in the etiology of psychotic disorders. While studies have provided evidence indicative of motor cerebellar dysfunction in at-risk populations and in schizophrenia, findings with respect to the cerebellum have been mixed. One factor potentially contributing to these mixed results is the whole-structure approach taken when investigating the cerebellum. In non-human primates, there are distinct closed-loop circuits between the cerebellum, thalamus, and brain with motor and non-motor cortical regions. Recent human neuroimaging has supported this finding and indicates that there is a cerebellar functional topography (4), and this information is being missed with whole-structure approaches. Here, we review cerebellar-motor dysfunction in individuals with schizophrenia and those at-risk for psychosis. We also discuss cerebellar abnormalities in psychosis, and the cerebellar functional topography. Because of the segregated functional regions of the cerebellum, we propose that it is important to look at the structure regionally in order to better understand its role in motor dysfunction in these populations. This is analogous to approaches taken with the basal ganglia, where each region is considered separately. Such an approach is necessary to better understand cerebellar pathophysiology on a macro-structural level with respect to the pathogenesis of psychosis.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder , Boulder, CO , USA
| | - Vijay A Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder , Boulder, CO , USA ; Center for Neuroscience, University of Colorado Boulder , Boulder, CO , USA
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