Short and long term effects of antipsychotic medication on smooth pursuit eye tracking in schizophrenia
Short and long term effects of antipsychotic medication on smooth pursuit eye tracking in schizophrenia
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DOI：
10.1007/s002130100803
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发表时间：
2001-09-01
影响因子：
3.4
通讯作者：
Joyce, EM
中科院分区：
文献类型：
--
作者：
Hutton, SB;Crawford, TJ;Joyce, EM
基本原理：在首次使用抗精神病药物的患者中观察到平滑追踪异常，表明它们是疾病的内在原因。然而，目前尚不清楚这些异常是否与在更慢性患者中观察到的异常一样严重。此外，尽管研究表明常规抗精神病药物没有短期影响，但长期抗精神病药物对平稳追踪眼球运动的影响相对未知。目的：确定抗精神病药物对首发和慢性精神分裂症患者平稳追踪表现的短期和长期影响。研究方法：我们比较了平稳的追求性能的抗精神病药物治疗和未经治疗的首发和慢性精神分裂症患者与健康对照组使用全面的性能指标。这包括速度增益，侵入性和矫正性扫视的数量，类型和大小，以及目标方向变化和眼球运动方向变化之间的平均时间，这是对受试者预测目标运动能力的测量。结果如下：慢性精神分裂症患者的速度增益显着降低，需要更长的时间来响应目标方向的变化，并作出更多的追赶扫视比首发精神分裂症患者和对照组。相对于对照组，首发患者仅在速度增益测量方面受损。未接受过抗精神病药治疗的首次发作患者与接受过治疗的首次发作患者之间无差异。无抗精神病药的慢性患者的速度增益明显低于匹配的连续治疗的慢性患者。这些结果不受年龄和症状严重程度的组间差异的影响。结论：这些结果表明：1）平滑追踪的主要指标，速度增益，在精神分裂症病程的早期受损; 2）而速度增益不受短期（数周）药物治疗的影响，但会因长期（数年）治疗而恶化; 3）平滑追踪的其他指标，追赶扫视和预测目标运动的能力，受到疾病慢性化而不是药物治疗的不利影响。
Rationale: Smooth pursuit abnormalities have been observed in antipsychotic naive first-episode patients, suggesting that they are intrinsic to the illness. However, it is not clear whether these abnormalities are as severe as those observed in more chronic patients. In addition, although research suggests that there are no short-term effects of conventional antipsychotic medication, the effects of long-term antipsychotic medication on smooth pursuit eye movements are relatively unknown. Objectives: To determine the short and long, term effects of antipsychotic medication on the smooth pursuit performance of first-episode and chronic patients with schizophrenia. Methods: We compared the smooth pursuit performance of antipsychotic-treated and untreated first-episode and chronic schizophrenic patients with healthy controls using a comprehensive range of performance measures. This included velocity gain, the number, type and size of intrusive and corrective saccades, and the average time between the change in direction of the target and the change in direction of the eye movement, a measure of subjects' ability to predict target movement. Results: Chronic schizophrenic patients had significantly reduced velocity gain, took longer to respond to the change in target direction and made more catch-up saccades than both first-episode schizophrenic patients and controls. First-episode patients were impaired relative to controls only on the measure of velocity gain. There were no differences between antipsychotic-naive and treated first-episode patients. Antipsychotic-free chronic patients were significantly less impaired on velocity gain than matched continuously treated chronic patients. These results were not influenced by group differences in age and symptom severity. Conclusions: These results show that: 1) the main index of smooth pursuit, velocity gain, is impaired early in the course of schizophrenia; 2) whereas velocity gain is unaffected by short-term (weeks) medication, it is worsened by chronic (years) treatment; 3) other indices of smooth pursuit, catch-up saccades and ability to predict target movement, are adversely influenced by illness chronicity rather than medication.