- Email: [email protected]
Asymmetrical hand force persistence and neuroleptic treatment in schizophrenia
160
asymmetry (i.e. lateralization) for language is also reduced in schizophrenia. Reduced lateralization could be the result of decreased language activity of the left hemisphere or, alternatively, increased language activity of the right. The latter could interfere with language processes of the left hemisphere. This interference may contribute to positive symptoms such as thought disorder and auditory hallucinations. Method: Language lateralization was measured with functional magnetic resonance imaging (fMRI) on a Philips 1.5 Tesla scanner, using the navigated BOLD-sensitive 3D PRESTO fMRI sequence. Twelve schizophrenic patients and 12 controls were scanned with a verb-generation- and a semantical decision task. Activity was measured bilaterally in the frontal, temporal and temporo-parietal language arreas. Clinical symptoms were rated at time of scanning. Results: Language lateralization was lower in patients (0.35 sd 0.27) than in controls (0.63 sd 0.21) (p
A.305. ASYMMETRICAL PERSISTENCE TREATMENT
HAND
FORCE
AND NEUROLEPTIC IN SCHIZOPHRENIA
N.D. W o o d w a r d , S.E. Purdon, P. F l o r - H e n r y Correspondence to: Dr. S.E. Purdon, Neuropsychology, 9 Bldg.. Alberta Hospital, Edmonton, Box 307, 17480 Fort Road, Edmonton. Alberta, Canada T5J 2J7; e-mail." spurdon@gpu, sty. ualberta, ca 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 repsonse to antipsychotic medication could assist the delineation of a cerebral mechanism for the effects of pharmacotherapy. The hand force persistence of 22 unmedicated patients with schizophrenia was compared to 22 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 second generation neuroleptic medications which may implicate an improvement in left hemisphere physiology in the cognitive advantages of the novel treatments.
A.306. MIXED
HANDEDNESS
AND NON-FAMILIAL
IN FAMILIAL
SCHIZOPHRENIA
C. M c D o n a l d , B. Wright, K , G . D . Orr, M, Taylor, A. Grech, H. W i c k h a m , T. Toulopoulou, T. Sharma, R.M. M u r r a y Department of Psychological Medicine, Institute of Psychiatry. London SE5 8AF, UK An excess of mixed handedness has been reported in schizophrenia but it is not clear whether this reflects a genetic or environmental aetiology. We sought to clarify this issue by examining mixed handedness in families likely to be enriched or depleted for schizophrenia genes. We assessed rates of mixed handedness in a group of patients with DSM-IIIR schizophrenia from multiply affected families (n=43), their unaffected first degree relatives (n=69), nonfamilial cases of schizophrenia (n =46), their first degree relatives (n = 79) and controls (n = 72). Handedness was measured using the Annett Questionnaire. Measures of developmental disturbance included the Lewis-Murray scale for obstetric complications and the Premorbid Social Adjustment scale. The data were analysed using logistic regression and controlling for gender and age. There was a significant excess of broadly defined mixed handedness (Annett class 2-7) in patients with non-familial schizophrenia compared to controls (OR 4.19, 95% CI 1.61 10.89, p=0.003). There were no significant differences in rates of mixed handedness between controls and patients with familial schizophrenia (OR 1.65, 95% CI 0.634.33, p =0.31 ), familial relatives (OR 1.23, 95% CI 0.49-3.06, p=0.66) or nonfamilial relatives (OR 1.93, 95% CI 0.71-5.24, p=0.20). There were no significant findings for narrowly defined mixed handedhess (Annett class 5-6). There was no relationship between mixed handedness and obstetric complications or poor premorbid social adjustment. Our results suggest that environmental factors may contribute to the presence of mixed handedness in schizophrenia. Such factors do not appear to be linked to obstetric complications or abnormalities of premorbid personality.
asymmetry (i.e. lateralization) for language is also reduced in schizophrenia. Reduced lateralization could be the result of decreased language activity of the left hemisphere or, alternatively, increased language activity of the right. The latter could interfere with language processes of the left hemisphere. This interference may contribute to positive symptoms such as thought disorder and auditory hallucinations. Method: Language lateralization was measured with functional magnetic resonance imaging (fMRI) on a Philips 1.5 Tesla scanner, using the navigated BOLD-sensitive 3D PRESTO fMRI sequence. Twelve schizophrenic patients and 12 controls were scanned with a verb-generation- and a semantical decision task. Activity was measured bilaterally in the frontal, temporal and temporo-parietal language arreas. Clinical symptoms were rated at time of scanning. Results: Language lateralization was lower in patients (0.35 sd 0.27) than in controls (0.63 sd 0.21) (p
A.305. ASYMMETRICAL PERSISTENCE TREATMENT
HAND
FORCE
AND NEUROLEPTIC IN SCHIZOPHRENIA
N.D. W o o d w a r d , S.E. Purdon, P. F l o r - H e n r y Correspondence to: Dr. S.E. Purdon, Neuropsychology, 9 Bldg.. Alberta Hospital, Edmonton, Box 307, 17480 Fort Road, Edmonton. Alberta, Canada T5J 2J7; e-mail." spurdon@gpu, sty. ualberta, ca 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 repsonse to antipsychotic medication could assist the delineation of a cerebral mechanism for the effects of pharmacotherapy. The hand force persistence of 22 unmedicated patients with schizophrenia was compared to 22 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 second generation neuroleptic medications which may implicate an improvement in left hemisphere physiology in the cognitive advantages of the novel treatments.
A.306. MIXED
HANDEDNESS
AND NON-FAMILIAL
IN FAMILIAL
SCHIZOPHRENIA
C. M c D o n a l d , B. Wright, K , G . D . Orr, M, Taylor, A. Grech, H. W i c k h a m , T. Toulopoulou, T. Sharma, R.M. M u r r a y Department of Psychological Medicine, Institute of Psychiatry. London SE5 8AF, UK An excess of mixed handedness has been reported in schizophrenia but it is not clear whether this reflects a genetic or environmental aetiology. We sought to clarify this issue by examining mixed handedness in families likely to be enriched or depleted for schizophrenia genes. We assessed rates of mixed handedness in a group of patients with DSM-IIIR schizophrenia from multiply affected families (n=43), their unaffected first degree relatives (n=69), nonfamilial cases of schizophrenia (n =46), their first degree relatives (n = 79) and controls (n = 72). Handedness was measured using the Annett Questionnaire. Measures of developmental disturbance included the Lewis-Murray scale for obstetric complications and the Premorbid Social Adjustment scale. The data were analysed using logistic regression and controlling for gender and age. There was a significant excess of broadly defined mixed handedness (Annett class 2-7) in patients with non-familial schizophrenia compared to controls (OR 4.19, 95% CI 1.61 10.89, p=0.003). There were no significant differences in rates of mixed handedness between controls and patients with familial schizophrenia (OR 1.65, 95% CI 0.634.33, p =0.31 ), familial relatives (OR 1.23, 95% CI 0.49-3.06, p=0.66) or nonfamilial relatives (OR 1.93, 95% CI 0.71-5.24, p=0.20). There were no significant findings for narrowly defined mixed handedhess (Annett class 5-6). There was no relationship between mixed handedness and obstetric complications or poor premorbid social adjustment. Our results suggest that environmental factors may contribute to the presence of mixed handedness in schizophrenia. Such factors do not appear to be linked to obstetric complications or abnormalities of premorbid personality.