目的:多达一半的精神分裂症患者发生精神运动减慢(PS),并与较差的预后有关。由于标准治疗未能改善PS,需要新的方法。这里,我们使用3个分析单元应用了RDoC框架,ie,行为,自我报告,和生理学测试,PS患者是否与无PS患者和对照组不同。
方法:比较了71例精神分裂症伴PS患者的运动行为,25没有PS,和42名健康对照(HC)使用5种不同的措施:(1)行为,专家评定量表:Salpétrière延迟评定量表的运动评分,(2)对于自我报告,国际身体活动问卷;以及生理学,(3)活动,这解释了粗大的运动行为,(4)步态速度,和(5)硬币旋转任务,以评估手的灵活性。
结果:比较3组的ANCOVA显示PS和HC患者在专家评分方面存在差异,自我报告,和仪器措施(所有P≤0.001)。与没有PS的患者相比,有PS的患者在专家评分中得分也更高,仪器活动水平也更低(所有P≤0.045)。仪器活动水平与PS的专家评级相关(rho=-0.51,P-fdr校正<.001),并以72%的准确率进行类似分类。
结论:PS的特征是步态较慢,较低的活动水平,与HC相比,手指运动较慢。然而,只有肌动描记术和观察者评级才能清楚地将PS与非PS患者分开。在神经影像学研究和临床试验中,活动成像可能成为PS的标准评估。
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.
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.
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.
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.