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Yorca-Ruiz Á, Magdaleno Herrero R, Ortiz García de la Foz V, Murillo-García N, Ayesa-Arriola R. Breaking down processing speed: Motor and cognitive insights in first-episode psychosis and unaffected first-degree relatives. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00036-X. [PMID: 38908403 DOI: 10.1016/j.sjpmh.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/17/2024] [Accepted: 06/16/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION Processing speed (PS) deficits represent a fundamental aspect of cognitive impairment, evident not only in schizophrenia but also in individuals undergoing their first episode of psychosis (FEP) and their unaffected first-degree relatives. Heterogeneity in tests assessing PS reflects the participation of motor and cognitive subcomponents to varying degrees. We aim to explore differences in performance of the subcomponents of PS in FEP patients, parents, siblings, and controls. MATERIALS AND METHODS Results from tests, including Trail Making Test part A and part B, Digit Symbol Coding Test, Grooved Pegboard Test, and Stroop Word and Stroop Color subtests, were obtained from 133 FEP patients, 146 parents, and 202 controls. Exploratory factor analysis (EFA) was employed in controls to establish the structure, followed by confirmatory factor analysis (CFA) to verify if the other groups share this structure. RESULTS EFA revealed a two-factor model: Factor 1 for the motor subcomponent and Factor 2 for the cognitive subcomponent. Subsequently, CFA indicated a good fit for the remaining groups with differences in the relationship between the factors. CONCLUSIONS Differences in the relationships of factors within a common structure suggest the involvement of different compensatory strategies among groups, providing insights into the underlying mechanisms of PS deficits in patients and relatives.
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Affiliation(s)
- Ángel Yorca-Ruiz
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rebeca Magdaleno Herrero
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Víctor Ortiz García de la Foz
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain; Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Nancy Murillo-García
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain; Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain; Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain.
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Gray LE, Buchanan RW, Keshavan MS, Torous J. Potential Role of Smartphone Technology in Advancing Work on Neurological Soft Signs with a Focus on Schizophrenia. Harv Rev Psychiatry 2023; 31:226-233. [PMID: 37699066 DOI: 10.1097/hrp.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
LEARNING OBJECTIVE AFTER PARTICIPATING IN THIS CME ACTIVITY, THE PSYCHIATRIST SHOULD BE BETTER ABLE TO • Outline and Identify potential benefits of using neurological soft signs (NSS) as biomarkers of schizophrenia. ABSTRACT Since the late 1960s, NSS have been a focus of study across psychiatric illnesses, including depression, bipolar disorder, and schizophrenia in particular. Utilizing these subtle neurological impairments as biomarkers of illness has numerous benefits; NSS offer a direct connection between clinical presentation and neurological functioning, and assessments are cost-effective. However, incongruent measurement scales, confounding variables, and rating system subjectivity have hindered the advancement and scalability of NSS research and clinical implementation. This article provides a brief overview of the literature on NSS as related to schizophrenia, and proposes utilizing smartphone sensing technology to create standardized NSS assessments with objective scoring. Incorporating digital phenotyping into NSS assessment offers the potential to make measurement more scalable, accessible, and directly comparable across locations, cultures, and demographics. We conducted a narrative search in PubMed and APA PsycInfo using the following keywords: neurological soft signs, schizophrenia spectrum disorders, and psychotic illnesses. No date limitations were used. There is no other direct work on NSS and new smartphone methods like digital phenotyping; though, there is related work in neurology. Harnessing advances in smartphone technology could provide greater insight into and further our understanding of specific aspects of the NSS field. For instance, it could help us distinguish trait vs. state markers and better understand how distinct groups of signs may reflect different aspects of psychiatric illness and neurological impairment. In addition, such technology can help advance research on the capabilities of NSS as an effective diagnostic tool.
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Affiliation(s)
- Lucy E Gray
- From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Ms. Gray, and Drs. Keshavan and Torous); Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD (Dr. Buchanan); Massachusetts Mental Health Center, Boston, MA (Drs. Keshavan and Torous)
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Petrescu C, Petrescu DM, Marian G, Focseneanu BE, Iliuta FP, Ciobanu CA, Papacocea S, Ciobanu AM. Neurological Soft Signs in Schizophrenia, a Picture of the Knowledge in the Last Decade: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11101471. [PMID: 37239757 DOI: 10.3390/healthcare11101471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Neurological Soft Signs (NSS) are subtle neurological abnormalities that are more common in schizophrenia patients than in healthy individuals and have been regularly observed in neuroleptic-naive first-episode patients, supporting the hypothesis that they are an intrinsic component of schizophrenia. (2) Methods: a review of articles published in the last ten years (from January 2013 to January 2023) was carried out on articles published in ScienceDirect and PubMed, by following the PRISMA Statement extension for scoping reviews (PRISMA-ScR), which evaluated the impact of NSS in correlation with the symptomatology, neuroleptic treatment, and the cerebral structural changes of patients with schizophrenia. (3) Results: thirty articles were included, among them twelve included MRI structural evaluation and four studies with a longitudinal design. (4) Conclusions: interest in researching NSS has increased in recent years, but questions remain about their origin and relationship to schizophrenia symptoms, thus this study aims to fill in information gaps in the hope that future research will help provide individualized treatment. It is suggested that NSS in schizophrenia might have an inherited genetic relationship pattern, thus being in line with a trait viewpoint. Most of the research revealed that schizophrenia patients had higher NSS scores than healthy controls, however, they were rather similar to their first-degree relatives, thus, also arguing in favor of a trait perspective. The greatest improvement in scores is seen in those with a remitting course, as shown by declining NSS ratings concurrent with symptomatology.
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Affiliation(s)
- Cristian Petrescu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Diana M Petrescu
- Neurology Clinic Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Gabriela Marian
- Academy of Romanian Scientists, 050045 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Brindusa E Focseneanu
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Department of Psychiatry and Psychology, Titu Maiorescu University of Medicine, 040441 Bucharest, Romania
| | - Floris Petru Iliuta
- Department of Psychiatry and Psychology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Serban Papacocea
- Department of Neurosurgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adela M Ciobanu
- Department of Psychiatry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
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4
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Nadesalingam N, Lefebvre S, Alexaki D, Baumann Gama D, Wüthrich F, Kyrou A, Kerkeni H, Kalla R, Walther S. The Behavioral Mapping of Psychomotor Slowing in Psychosis Demonstrates Heterogeneity Among Patients Suggesting Distinct Pathobiology. Schizophr Bull 2023; 49:507-517. [PMID: 36413085 PMCID: PMC10016403 DOI: 10.1093/schbul/sbac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Psychomotor slowing (PS) occurs in up to half of schizophrenia patients and is linked to poorer outcomes. As standard treatment fails to improve PS, novel approaches are needed. Here, we applied the RDoC framework using 3 units of analysis, ie, behavior, self-report, and physiology to test, whether patients with PS are different from patients without PS and controls. METHODS Motor behavior was compared between 71 schizophrenia patients with PS, 25 without PS, and 42 healthy controls (HC) using 5 different measures: (1) for behavior, an expert rating scale: Motor score of the Salpêtrière Retardation Rating Scale, (2) for self-report, the International Physical Activity Questionnaire; and for physiology, (3) Actigraphy, which accounts for gross motor behavior, (4) Gait velocity, and (5) coin rotation task to assess manual dexterity. RESULTS The ANCOVAs comparing the 3 groups revealed differences between patients with PS and HC in expert ratings, self-report, and instrumental measures (all P ≤ .001). Patients with PS also scored higher in expert ratings and had lower instrumental activity levels compared to patients without PS (all P ≤ .045). Instrumental activity levels correlated with an expert rating of PS (rho = -0.51, P-fdr corrected <.001) and classified similarly at 72% accuracy. CONCLUSIONS PS is characterized by slower gait, lower activity levels, and slower finger movements compared to HC. However, only actigraphy and observer ratings enable to clearly disentangle PS from non-PS patients. Actigraphy may become the standard assessment of PS in neuroimaging studies and clinical trials.
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Affiliation(s)
- Niluja Nadesalingam
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stéphanie Lefebvre
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Danai Alexaki
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Klinik Sonnenhalde AG Psychiatrie und Psychotherapie, Basel, Switzerland
| | - Daniel Baumann Gama
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Alexandra Kyrou
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Hassen Kerkeni
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Roger Kalla
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Walther S, Mittal VA. Motor Behavior is Relevant for Understanding Mechanism, Bolstering Prediction, And Improving Treatment: A Transdiagnostic Perspective. Schizophr Bull 2022; 48:741-748. [PMID: 35137227 PMCID: PMC9212099 DOI: 10.1093/schbul/sbac003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Sebastian Walther
- To whom the correspondence should be addressed; Murtenstrasse 21, 3008 Bern, Switzerland; tel: +41 31 632 8979, fax: +41 31 632 8950, e-mail:
| | - Vijay A Mittal
- Departments of Psychology, Psychiatry, and Medical Social Sciences, Institute for Policy Research and Institute for Innovations in Developmental Sciences, Northwestern University, Evanston and Chicago, IL,USA
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Viher PV, Stegmayer K, Bracht T, Federspiel A, Bohlhalter S, Strik W, Wiest R, Walther S. Neurological Soft Signs Are Associated With Altered White Matter in Patients With Schizophrenia. Schizophr Bull 2021; 48:220-230. [PMID: 34355246 PMCID: PMC8781326 DOI: 10.1093/schbul/sbab089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Neurological soft signs (NSS) are related to grey matter and functional brain abnormalities in schizophrenia. Studies in healthy subjects suggest, that NSS are also linked to white matter. However, the association between NSS and white matter abnormalities in schizophrenia remains to be elucidated. The present study investigated, if NSS are related to white matter alterations in patients with schizophrenia. The total sample included 42 healthy controls and 41 patients with schizophrenia. We used the Neurological Evaluation Scale (NES), and we acquired diffusion weighted magnetic resonance imaging to assess white matter on a voxel-wise between subject statistic. In patients with schizophrenia, linear associations between NES with fractional anisotropy (FA), radial, axial, and mean diffusivity were analyzed with tract-based spatial statistics while controlling for age, medication dose, the severity of the disease, and motion. The main pattern of results in patients showed a positive association of NES with all diffusion measures except FA in important motor pathways: the corticospinal tract, internal capsule, superior longitudinal fascicle, thalamocortical radiations and corpus callosum. In addition, exploratory tractography analysis revealed an association of the right aslant with NES in patients. These results suggest that specific white matter alterations, that is, increased diffusivity might contribute to NSS in patients with schizophrenia.
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Affiliation(s)
- Petra Verena Viher
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland,To whom correspondence should be addressed; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; tel: +41-31-930-97-57, fax: +41-31-930-94-04, e-mail:
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Tobias Bracht
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stephan Bohlhalter
- Department of Clinical Research, University Hospital, Inselspital, Bern, Switzerland,Neurocenter, Luzerner Kantonsspital, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Neuroradiology, University of Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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Morozova A, Zorkina Y, Pavlov K, Pavlova O, Abramova O, Ushakova V, Mudrak AV, Zozulya S, Otman I, Sarmanova Z, Klyushnik T, Reznik A, Kostyuk G, Chekhonin V. Associations of Genetic Polymorphisms and Neuroimmune Markers With Some Parameters of Frontal Lobe Dysfunction in Schizophrenia. Front Psychiatry 2021; 12:655178. [PMID: 34025476 PMCID: PMC8138937 DOI: 10.3389/fpsyt.2021.655178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
We investigated the associations of DRD3 rs6280, HTR1A rs6295, BDNF rs6265, SCL6A4 rs16965628, and 5HT2A rs7322347 with schizophrenia in a case-control study, and associations of these genetic variants with several clinical features. We also investigated markers of inflammatory response (C-reactive protein, IL-2, IL-6, IL-10), the activity of leukocytic elastase (LE) and α1-proteinase inhibitor (a1-PI), antibodies to S100B and myelin basic protein (MBP) in schizophrenia. Clinical symptoms were assessed on three scales: Positive and Negative Syndrome Scale, The Bush - Francis Catatonia Rating Scale and Frontal Assessment Battery. All SNPs were typed using predesigned TaqMan SNP genotyping assays. The biomarkers related to the immune system were routinely tested using ELISA kits. The association with schizophrenia was found for DRD3 rs6280 (p = 0.05) and HTR2A rs7322347 (p = 0.0013). We found differences between groups by parameters of LE and a1-PI and LE/a1-PI (p < 0.001). And IL-6 was evaluated in the schizophrenia group (p < 0.001). We showed that patients with the TT allele (BDNF rs6265) had more severe impairments in frontal lobe function. a1-PI can serve as a marker for assessing the severity of frontal lobe damage in patients with frontal dementia. We found some biological parameters reflecting the severity of frontal dysfunction in schizophrenia.
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Affiliation(s)
- Anna Morozova
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Yana Zorkina
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Konstantine Pavlov
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Olga Pavlova
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Olga Abramova
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Valeria Ushakova
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
- Department of Biology, Lomonosov Moscow State University, Moscow, Russia
| | - Alexander V. Mudrak
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | | | - Irina Otman
- Mental Health Research Center, Moscow, Russia
| | | | | | - Alexander Reznik
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
- Institute of Medical and Social Technologies, Moscow, Russia
| | - Georgiy Kostyuk
- Mental-Health Clinic No. 1 Named After N. A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Vladimir Chekhonin
- Department Basic and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
- Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University, Moscow, Russia
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Comprehensive characterization of motor and coordination functions in three adolescent wild-type mouse strains. Sci Rep 2021; 11:6497. [PMID: 33753800 PMCID: PMC7985312 DOI: 10.1038/s41598-021-85858-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022] Open
Abstract
Neuropsychiatric disorders are often associated with motor and coordination abnormalities that have important implications on the etiology, pathophysiology, and management of these disorders. Although the onset of many neuropsychiatric disorders including autism spectrum disorder, schizophrenia, and attention-deficit hyperactivity disorder emerges mainly during infancy and adolescence, most of the behavioral studies in mice modeling neuropsychiatric phenotypes are performed in adult animals, possibly missing valuable phenotypic information related to the effect of synaptic maturation during development. Here, we examined which behavioral tests assessing both motor and coordination functions can be performed in mice at two different adolescent stages. As strain and sex affect mouse behavior, our experiments covered both male and female mice of three inbred wild-type strains, C57BL/6N, DBA/2, and FVB/N. Adolescent mice of both postnatal days (P)22-30 and P32-40 developmental stages were capable of mastering common motor and coordination tests. However, results differed significantly between strains and sexes. Moreover, the 10-day interval between the two tested cohorts uncovered a strong difference in the behavioral results, confirming the significant impact of maturation on behavioral patterns. Interestingly, the results of distinct behavioral experiments were directly correlated with the weight of mice, which may explain the lack of reproducibility of some behavioral results in genetically-modified mice. Our study paves the way for better reproducibility of behavioral tests by addressing the effect of the developmental stage, strain, sex, and weight of mice on achieving the face validity of neuropsychiatric disorder-associated motor dysfunctions.
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Postural sway in first-degree relatives of individuals with schizophrenia. Schizophr Res 2021; 228:319-321. [PMID: 33497906 DOI: 10.1016/j.schres.2020.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 11/29/2020] [Accepted: 12/31/2020] [Indexed: 11/20/2022]
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Wüthrich F, Pavlidou A, Stegmayer K, Eisenhardt S, Moor J, Schäppi L, Vanbellingen T, Bohlhalter S, Walther S. Nonverbal communication remains untouched: No beneficial effect of symptomatic improvement on poor gesture performance in schizophrenia. Schizophr Res 2020; 223:258-264. [PMID: 32883557 PMCID: PMC7952214 DOI: 10.1016/j.schres.2020.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/06/2020] [Accepted: 08/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gestures are an important part of communication. Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Unaffected, first-degree relatives of schizophrenia patients share some subclinical motor and cognitive abnormalities. We aimed to investigate, whether gesture performance changes with symptomatic improvement in patients, and to test the longitudinal performance in unaffected, first-degree relatives. METHODS In this study, we measured gesture performance using a validated test in 33 patients, 29 first-degree relatives and 38 healthy controls. Measurements were completed shortly after admission and before discharge in patients. Performance was rated blindly by experts using video recordings of the gesture task. Additionally, we evaluated cognitive function and psychotic symptoms at both visits. RESULTS Gesture performance was poorer in relatives compared to controls and poorer in patients compared to both relatives and controls. Patients showed an improvement in psychopathology but a significant decrease in gesture performance at follow-up, while performance in the other groups remained stable. Proportional change of gesture performance correlated with change of cognitive function in patients, whereas there were no correlations with change of cognitive function in the other groups. CONCLUSION While symptom severity was reduced, the gesture deficit further deteriorated in schizophrenia. The finding argues for distinct processes contributing to poor nonverbal communication skills in patients, requiring novel alternative treatment efforts.
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Affiliation(s)
- Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
| | - Anastasia Pavlidou
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Sarah Eisenhardt
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jeanne Moor
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland,Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland
| | - Lea Schäppi
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Tim Vanbellingen
- ARTORG Center for Biomedical Engineering Research, Gerontechnology and Rehabilitation Group, University of Bern, Switzerland,Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
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Osborne KJ, Walther S, Shankman SA, Mittal VA. Psychomotor Slowing in Schizophrenia: Implications for Endophenotype and Biomarker Development. Biomark Neuropsychiatry 2020; 2:100016. [PMID: 33738459 PMCID: PMC7963400 DOI: 10.1016/j.bionps.2020.100016] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Motor abnormalities (e.g., dyskinesia, psychomotor slowing, neurological soft signs) are core features of schizophrenia that occur independent of drug treatment and are associated with the genetic vulnerability and pathophysiology for the illness. Among this list, psychomotor slowing in particular is one of the most consistently observed and robust findings in the field. Critically, psychomotor slowing may serve as a uniquely promising endophenotype and/or biomarker for schizophrenia considering it is frequently observed in those with genetic vulnerability for the illness, predicts transition in subjects at high-risk for the disorder, and is associated with symptoms and recovery in patients. The purpose of the present review is to provide an overview of the history of psychomotor slowing in psychosis, discuss its possible neural underpinnings, and review the current literature supporting slowing as a putative endophenotype and/or biomarker for the illness. This review summarizes substantial evidence from a diverse array of methodologies and research designs that supports the notion that psychomotor slowing not only reflects genetic vulnerability, but is also sensitive to disease processes and the pathophysiology of the illness. Furthermore, there are unique deficits across the cognitive (prefix "psycho") and motor execution (root word "motor") aspects of slowing, with cognitive processes such as planning and response selection being particularly affected. These findings suggest that psychomotor slowing may serve as a promising endophenotype and biomarker for schizophrenia that may prove useful for identifying individuals at greatest risk and tracking the course of the illness and recovery.
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Affiliation(s)
- K. Juston Osborne
- Northwestern University, Department of Psychology, Evanston, IL, USA
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Translational Research Center, Bern, Switzerland
| | - Stewart A. Shankman
- Northwestern University, Department of Psychology, Evanston, IL, USA
- Northwestern University, Department of Psychiatry, Chicago, IL, USA
| | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Evanston, IL, USA
- Northwestern University, Department of Psychiatry, Chicago, IL, USA
- Northwestern University, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
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