Extrapyramidal symptoms predict cognitive performance after first-episode psychosis

Publisher Copyright: © 2022, The Author(s).Extrapyramidal (EP) symptoms such as tremor, rigidity, and bradykinesia are common side effects of most antipsychotics, and may associate with impaired performance in neurocognitive testing. We studied EP symptoms in first-episode psychosis (FEP; n = 113). Cognitive testing and EP symptoms (three items of the Simpson-Angus Scale) were assessed at baseline and follow-up (mean follow-up time 12 months). Mild EP symptoms were present at treatment onset in 40% of the participants. EP symptoms were related with lower performance in neurocognitive testing at baseline and at follow-up, especially among those with nonaffective psychotic disorder, and especially in tasks requiring speed of processing. No associations between EP symptoms and social cognition were detected. In linear regression models, when positive and negative symptom levels and chlorpromazine equivalents were accounted for, baseline EP symptoms were associated with worse baseline global neurocognition and visuomotor performance. Baseline EP symptoms also longitudinally predicted global, verbal, and visuomotor cognition. However, there were no cross-sectional associations between EP symptoms and cognitive performance at follow-up. In sum, we found both cross-sectional and longitudinal associations between EP symptoms and neurocognitive task performance in the early course of psychosis. Those without EP symptoms at the start of treatment had higher baseline and follow-up neurocognitive performance. Even mild EP symptoms may represent early markers of long-term neurocognitive impairment.Peer reviewe

Extrapyramidal symptoms predict cognitive performance after first-episode psychosis

Extrapyramidal (EP) symptoms such as tremor, rigidity, and bradykinesia are common side effects of most antipsychotics, and may associate with impaired performance in neurocognitive testing. We studied EP symptoms in first-episode psychosis (FEP; n = 113). Cognitive testing and EP symptoms (three items of the Simpson-Angus Scale) were assessed at baseline and follow-up (mean follow-up time 12 months). Mild EP symptoms were present at treatment onset in 40% of the participants. EP symptoms were related with lower performance in neurocognitive testing at baseline and at follow-up, especially among those with nonaffective psychotic disorder, and especially in tasks requiring speed of processing. No associations between EP symptoms and social cognition were detected. In linear regression models, when positive and negative symptom levels and chlorpromazine equivalents were accounted for, baseline EP symptoms were associated with worse baseline global neurocognition and visuomotor performance. Baseline EP symptoms also longitudinally predicted global, verbal, and visuomotor cognition. However, there were no cross-sectional associations between EP symptoms and cognitive performance at follow-up. In sum, we found both cross-sectional and longitudinal associations between EP symptoms and neurocognitive task performance in the early course of psychosis. Those without EP symptoms at the start of treatment had higher baseline and follow-up neurocognitive performance. Even mild EP symptoms may represent early markers of long-term neurocognitive impairment.</p

Copy number loss in SFMBT1 is common among Finnish and Norwegian patients with iNPH

Objective To evaluate the role of the copy number loss in SFMBT1 in a Caucasian population. Methods Five hundred sixty-seven Finnish and 377 Norwegian patients with idiopathic normal pressure hydrocephalus (iNPH) were genotyped and compared with 508 Finnish elderly, neurologically healthy controls. The copy number loss in intron 2 of SFMBT1 was determined using quantitative PCR. Results The copy number loss in intron 2 of SFMBT1 was detected in 10% of Finnish (odds ratio [OR] = 1.9, p = 0.0078) and in 21% of Norwegian (OR = 4.7, p <0.0001) patients with iNPH compared with 5.4% in Finnish controls. No copy number gains in SFMBT1 were detected in patients with iNPH or healthy controls. The carrier status did not provide any prognostic value for the effect of shunt surgery in either population. Moreover, no difference was detected in the prevalence of hypertension or T2DM between SFMBT1 copy number loss carriers and noncarriers. Conclusions This is the largest and the first multinational study reporting the increased prevalence of the copy number loss in intron 2 of SFMBT1 among patients with iNPH, providing further evidence of its role in iNPH. The pathogenic role still remains unclear, requiring further study.Peer reviewe

Psykoosipotilaiden toimintakyvyn ennuste ja sitä ennustavat tekijät

TAUSTA. Tavoitteenamme oli tutkia luonnollisessa tutkimusasetelmassa psykoosin ja psykoosiriskin vuoksi ensi kertaa hoitoon tulleiden potilaiden toimintakyvyn ennustetta ja siihen vaikuttavia tekijöitä.AINEISTO JA MENETELMÄT. Tutkimusaineisto koostui 130 psykoosi- ja 107 psykoosiriskipotilaasta, joille tehtiin alkuhaastattelun jälkeen seurantahaastattelu yhdeksän ja 18 kuukauden kuluttua. Seurannan perusteella muodostettiin hyvän ja huonon ennusteen ryhmät, joita selitettiin logistisella regressioanalyysillä.TULOKSET JA PÄÄTELMÄT. Psykoosi- ja riskipotilaiden toimintakyvyn ennusteissa ei ollut eroa. Hyvä ennuste yhdistyi naissukupuoleen, lapsuuden sosiaalisuuteen, koulumenestykseen ja vähäisiin traumakokemuksiin sekä hyvään koulutustasoon ja työtilanteeseen. Oireista tunneköyhyys ja ajattelun hajanaisuus liittyvät huonoon ennusteeseen. Monimuuttuja-analyysissä naimattomuus, lapsuuden traumakokemukset ja heikko koulumenestys, huono työtilanne sekä tunneköyhyys ja ajattelun hajanaisuus ennustivat huonoa toimintakykyä. Koulutuksen ja työteon tukemiseen liittyvät kuntoutustoimenpiteet ovat keskeisiä pyrittäessä parantamaan psykoosipotilaiden ja psykoosiriskissä olevien potilaiden toimintakykyä.</p

Tapaustutkimus tasapainoharjoittelun vaikutuksesta CP-lapsen tasapainoon

Tutkimuksen tarkoituksena oli selvittää neljän viikon mittaisen kaksi kertaa viikossa toteutettavan ohjatun tasapainoharjoittelun vaikuttavuutta CP-lapsen tasapainoon. Lisäksi tutkittiin miten tasapainoharjoittelun vaikutukset säilyvät kaksi viikkoa tasapainoharjoittelun jälkeen. Tutkimukseen osallistui 10-vuotias tyttö, jolla oli diagnosoitu CP-oireyhtymä spastinen diplegia. Harjoitusmuotona käytettiin Good Balance -laitteistoa ja tasapainoharjoittelurataa, joka sisälsi kahdeksan yksinkertaista tasapainoharjoitetta. Tutkimuksessa käytettiin sekä kvantitatiivista että kvalitatiivista tutkimusmenetelmää. Mittausmenetelminä käytettiin Good Balance -järjestelmällä mitattua seisoma-asennon huojuntaa sekä visuaalisen näköpalautteen avulla suoritettavaa dynaamista harjoitetta, toiminnallista tasapainoa mittavaa kanta-varvaskävely testiä ja Bergin tasapainotestiä. Testit suoritettiin ennen interventiota ja sen loputtua, lisäksi tehtiin seurantamittaus kahden viikon kuluttua loppumittauksesta. Tasapainoharjoittelulla oli positiivisia vaikutuksia CP-lapsen toiminnalliseen tasapainoon. Toiminnallinen eli dynaaminen tasapaino parantui harjoittelun vaikutuksesta. Staattisessa tasapainossa ei havaittu positiivisia muutoksia. Tulosten perusteella testihenkilön tasapaino huonontui intervention puolivälissä alkumittauksiin nähden, mutta tulokset paranivat huomattavasti loppumittauksia kohden. Kontrollimittauksissa osa tuloksista pysyi samana tai hieman parantui ja osassa tapahtui pientä huonontumista. Neljän viikon harjoitteluinterventiolla ei saavuteta pitkäaikaisia vaikutuksia. Tämän perusteella, tutkittavan pysyvän tasapainoa parantavan vaikutuksen saamiseksi, harjoituksen tulisi mahdollisesti olla jatkuvaa.The purpose of this case study was to examine the effects of balance exercises repeated twice a week for a period of four weeks on the balance abilities of children with Cerepral Palsy. The 2-week follow up was carried out. The subject had Cerepral Palsy, spastic diplegic. She was a 10-years old girl. Training method used in this study was a Good Balance system and balance track which was built by using eight simple balance exercises. Both quantitative and qualitative methods were used in this study. As evaluation methods in our study we used postural sway measures and dynamic exercises. In addition, we used visual feedback with force plate technique based on the Good Balance System. On every practice time we also measured the time of toe-hill walking test, which measures functional balance, and performed the Berg's balance scale. Measurements were taken at the beginning, at the end and at a follow-up-test, two weeks after intervention. As a result we found out that balance exercise had positive effects to CP-children balance skills. Function (or dynamic balance) improved by the influence of training. No positive effect on static balance was found by the influence of training. According to the results, the patient's balance had decreased two weeks after the beginning of training, but got better after that. Nevertheless, no lasting results could be seen after four weeks of intervention. From the results we can conclude that to achieve long-term results, training should be continuous