Asymmetrical hand force persistence and neuroleptic treatment in schizophrenia

The recent development of an isometric instrument for the precise quantification of hand force persistence has created a novel opportunity for the evaluation of potential motor asymmetries in schizophrenia and their response to treatment. A study of asymmetries in the unmedicated state may provide insight into the pathogenesis of schizophrenia, whereas alterations of asymmetries in response to antipsychotic medication could assist the delineation of a cerebral mechanism for the effects of pharmacotherapy. The hand force persistence of 21 unmedicated patients with schizophrenia was compared to 21 age, gender, and handedness matched normal controls. The effect of neuroleptic treatment on hand force persistence was then evaluated on a subset of 10 patients after at least 30 days of treatment. The anticipated asymmetry was evident in the unmedicated sample that showed impaired right hand force persistence compared to the normal control sample. The prospective comparison showed an alleviation of the asymmetry resulting from an improvement of right hand force persistence with treatment. In addition to providing further support to a primary left hemisphere cerebral involvement in schizophrenia, the present results suggest that prior investigations of motor asymmetry may have been compromised by the study of medicated patients. The apparently paradoxical improvement of motor skill may relate to the substantial number of patients treated with 2nd generation neuroleptic medications which may implicate an improvement in left hemisphere physiology in the cognitive advantages of the novel treatments. (JINS, 2001, 7, 606–614.)

一种用于精确量化手部力量持久性的等长仪器的近期研发，为评估精神分裂症中潜在的运动不对称及其对治疗的反应创造了新的契机。对未用药状态下不对称性的研究可能会深入了解精神分裂症的发病机制，而抗精神病药物治疗后不对称性的改变有助于描绘药物治疗效果的大脑机制。将21名未用药的精神分裂症患者的手部力量持久性与21名年龄、性别和利手匹配的正常对照者进行了比较。然后在10名患者接受至少30天治疗后，评估了抗精神病药物治疗对手部力量持久性的影响。在未用药的样本中，预期的不对称性很明显，与正常对照样本相比，其右手力量持久性受损。前瞻性比较显示，随着治疗右手力量持久性得到改善，不对称性有所减轻。除了进一步支持精神分裂症主要涉及左半球大脑这一观点外，目前的研究结果还表明，先前对运动不对称的研究可能因研究用药患者而存在偏差。运动技能看似矛盾的改善可能与大量使用第二代抗精神病药物治疗的患者有关，这可能意味着新型治疗在认知优势方面改善了左半球的生理机能。（《国际神经心理学协会杂志》，2001年，7卷，606 - 614页）