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Article: First episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment

TitleFirst episode psychosis with extrapyramidal signs prior to antipsychotic drug treatment
Authors
KeywordsAntipsychotics
Basal Ganglia
Cognitive
Movement Disorder
Psychosis
Schizophrenia
Issue Date2011
PublisherScience China Press. The Journal's web site is located at http://www.springerlink.com/content/1001-6538/
Citation
Chinese Science Bulletin, 2011, v. 56 n. 32, p. 3361-3371 How to Cite?
AbstractExtrapyramidal movement disorders are common in chronic schizophrenia, and may be an intrinsic feature of the illness as well as related to antipsychotic drug treatment. Similar dysfunctions at illness onset may have implications for outcome, and for understanding the mechanisms of illness. The objectives were to examine the clinical correlates of pre-treatment movement disorders at first episode of psychosis, and determine associations with neuropsychological function and striatal structure. Never medicated subjects were recruited from consecutive admissions to Early Psychosis Programs with defined catchment areas in Hong Kong, China, and Halifax, Canada. Standardized clinical, neuropsychological and brain imaging assessments were carried out at baseline and following acute and long term treatment with typical or atypical antipsychotic drugs. At the Hong Kong site, we studied 84 subjects with first episode psychosis (n = 10 with EPS). At the Halifax site, we studied 40 subjects with first episode psychosis (n = 17 with EPS), and 23 healthy comparison subjects. Subjects with movement disorders prior to treatment (EPS+) had higher total PANSS scores at baseline (mean elevation 19.9% Hong Kong, P = 0.016; 14.7% Halifax, P = 0.049). In subjects treated with atypical antipsychotics (all Halifax), EPS+ status at baseline predicted more movement disorders at long term follow up (P = 0.0005). In both cohorts, EPS+ subjects had poorer acute symptomatic treatment response assessed with the PANSS (Hong Kong P = 0.005; Halifax P = 0.017). Neuropsychological impairment related to executive dysfunction appeared greater in a small sample of EPS+ subjects (Hong Kong, effect size 0.26-0.27, P < 0.05). Caudate volumes were 4.5% larger in EPS+ compared with EPS-subjects (Halifax P = 0.042), and correlations between striatal volumes and age were different in the EPS+ group. In conclusion, pre-treatment EPS is present in a substantial minority of subjects with first episode psychosis, appears to persist at long term follow up, and is associated with poorer response of symptoms to treatment. Selective impairment of executive function and striatal enlargement provides evidence of abnormalities of brain function and structure associated with this aspect of early psychosis. © 2011 Science China Press and Springer-Verlag Berlin Heidelberg.
Persistent Identifierhttp://hdl.handle.net/10722/171973
ISSN
2015 Impact Factor: 1.789
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHoner, WGen_US
dc.contributor.authorLang, DJen_US
dc.contributor.authorKopala, LCen_US
dc.contributor.authorMacewan, GWen_US
dc.contributor.authorSmith, GNen_US
dc.contributor.authorChen, EYHen_US
dc.contributor.authorChan, RCKen_US
dc.date.accessioned2012-10-30T06:19:03Z-
dc.date.available2012-10-30T06:19:03Z-
dc.date.issued2011en_US
dc.identifier.citationChinese Science Bulletin, 2011, v. 56 n. 32, p. 3361-3371en_US
dc.identifier.issn1001-6538en_US
dc.identifier.urihttp://hdl.handle.net/10722/171973-
dc.description.abstractExtrapyramidal movement disorders are common in chronic schizophrenia, and may be an intrinsic feature of the illness as well as related to antipsychotic drug treatment. Similar dysfunctions at illness onset may have implications for outcome, and for understanding the mechanisms of illness. The objectives were to examine the clinical correlates of pre-treatment movement disorders at first episode of psychosis, and determine associations with neuropsychological function and striatal structure. Never medicated subjects were recruited from consecutive admissions to Early Psychosis Programs with defined catchment areas in Hong Kong, China, and Halifax, Canada. Standardized clinical, neuropsychological and brain imaging assessments were carried out at baseline and following acute and long term treatment with typical or atypical antipsychotic drugs. At the Hong Kong site, we studied 84 subjects with first episode psychosis (n = 10 with EPS). At the Halifax site, we studied 40 subjects with first episode psychosis (n = 17 with EPS), and 23 healthy comparison subjects. Subjects with movement disorders prior to treatment (EPS+) had higher total PANSS scores at baseline (mean elevation 19.9% Hong Kong, P = 0.016; 14.7% Halifax, P = 0.049). In subjects treated with atypical antipsychotics (all Halifax), EPS+ status at baseline predicted more movement disorders at long term follow up (P = 0.0005). In both cohorts, EPS+ subjects had poorer acute symptomatic treatment response assessed with the PANSS (Hong Kong P = 0.005; Halifax P = 0.017). Neuropsychological impairment related to executive dysfunction appeared greater in a small sample of EPS+ subjects (Hong Kong, effect size 0.26-0.27, P < 0.05). Caudate volumes were 4.5% larger in EPS+ compared with EPS-subjects (Halifax P = 0.042), and correlations between striatal volumes and age were different in the EPS+ group. In conclusion, pre-treatment EPS is present in a substantial minority of subjects with first episode psychosis, appears to persist at long term follow up, and is associated with poorer response of symptoms to treatment. Selective impairment of executive function and striatal enlargement provides evidence of abnormalities of brain function and structure associated with this aspect of early psychosis. © 2011 Science China Press and Springer-Verlag Berlin Heidelberg.en_US
dc.languageengen_US
dc.publisherScience China Press. The Journal's web site is located at http://www.springerlink.com/content/1001-6538/en_US
dc.relation.ispartofChinese Science Bulletinen_US
dc.subjectAntipsychoticsen_US
dc.subjectBasal Gangliaen_US
dc.subjectCognitiveen_US
dc.subjectMovement Disorderen_US
dc.subjectPsychosisen_US
dc.subjectSchizophreniaen_US
dc.titleFirst episode psychosis with extrapyramidal signs prior to antipsychotic drug treatmenten_US
dc.typeArticleen_US
dc.identifier.emailChen, EYH:eyhchen@hku.hken_US
dc.identifier.authorityChen, EYH=rp00392en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s11434-011-4738-yen_US
dc.identifier.scopuseid_2-s2.0-80355147373en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80355147373&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume56en_US
dc.identifier.issue32en_US
dc.identifier.spage3361en_US
dc.identifier.epage3371en_US
dc.identifier.isiWOS:000296641800002-
dc.publisher.placeChinaen_US
dc.identifier.scopusauthoridHoner, WG=7004460814en_US
dc.identifier.scopusauthoridLang, DJ=7202377295en_US
dc.identifier.scopusauthoridKopala, LC=7005814973en_US
dc.identifier.scopusauthoridMacewan, GW=6604052646en_US
dc.identifier.scopusauthoridSmith, GN=7406737939en_US
dc.identifier.scopusauthoridChen, EYH=7402315729en_US
dc.identifier.scopusauthoridChan, RCK=35725165500en_US
dc.identifier.citeulike9821287-

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