TY - JOUR
T1 - Extrapyramidal symptoms and cognitive test performance in patients with schizophrenia
AU - Fervaha, Gagan
AU - Agid, Ofer
AU - Takeuchi, Hiroyoshi
AU - Lee, Jimmy
AU - Foussias, George
AU - Zakzanis, Konstantine K.
AU - Graff-Guerrero, Ariel
AU - Remington, Gary
N1 - Funding Information:
This work was supported, in part, by a Vanier Canada Graduate Scholarship (to G. Fervaha). This funding source had no further role in study design, statistical analysis or interpretation of findings; in writing of the manuscript; or in the decision to submit for publication.
Funding Information:
Data used in the preparation of this article were obtained from the limited access datasets (Version 1) distributed from the NIH-supported “Clinical Antipsychotic Trials of Intervention Effectiveness in Schizophrenia” (CATIE-Sz). This is a multisite, clinical trial of persons with schizophrenia comparing the effectiveness of randomly assigned medication treatment. The study was supported by NIMH Contract # N01MH90001 to the University of North Carolina at Chapel Hill. The ClinicalTrials.gov identifier is NCT00014001 . This manuscript reflects the views of the authors and may not reflect the opinions or views of the CATIE-Sz Study Investigators or the NIH.
Funding Information:
Dr. Agid has received research support from Pfizer Inc. and Janssen-Ortho , consultant fees from Janssen-Ortho, Eli Lilly Inc. US, Eli Lilly Canada, Sepreacor, Sunovion and Lundbeck, and speaker's fees from Janssen-Ortho, Eli Lilly Inc. US, Eli Lilly Canada, Novartis, Sepracor and Sunovion. Dr. Takeuchi has received fellowship grants from the Japanese Society of Clinical Neuropsychopharmacology and Astellas Foundation for Research on Metabolic Disorders ; speaker's honoraria from Dainippon Sumitomo Pharma, Eli Lilly, GlaxoSmithKlein, Janssen Pharmaceutical, Meiji Seika Pharma, and Otsuka Pharmaceutical; and manuscript fees from Dainippon Sumitomo Pharma. Dr. Lee has served a consultant honorarium from Roche. Dr. Foussias has been involved in research sponsored by Medicure Inc., and Neurocrine Bioscience, has received consultant fees from Roche, and has received speaker fees from Roche, Lundbeck and Novartis. Dr. Graff-Guerrero has received grant support from Janssen , professional services compensations from Abbott Laboratories and Gedeon Richter Plc., and speaker's fees from Eli Lilly. Dr. Remington has received research support from Novartis, Medicure and Neurocrine Bioscience, as a co-investigator he has received grant support from Pfizer Inc., consultant fees from Laboratorios Farmacéuticos ROVI, Synchroneuron, Novartis, and Roche, and speaker's fees from Novartis. The other authors have no conflicts to disclose.
Publisher Copyright:
© 2014 Elsevier B.V.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: Movement disorders are common in individuals with schizophrenia, even in those who are not exposed to antipsychotic medications. Extrapyramidal symptoms (EPS) are among the most common abnormal movements in schizophrenia, but their relationship with other features of the illness such as cognition is not well characterized. Methods: Three hundred and twenty-five individuals with schizophrenia who were not receiving any antipsychotic or anticholinergic medication and participated in the baseline visit of the Clinical Antipsychotic Treatment of Intervention Effectiveness study were included in the present study. EPSs were assessed using the Simpson-Angus Scale, while cognition was measured with a comprehensive neuropsychological test battery. The relationship between EPS and cognitive test performance was evaluated both dimensionally and categorically. Results: Greater severity of EPS was significantly associated with worse cognitive test performance evaluated using a composite score. Eighty-six patients were identified as having parkinsonism and these patients performed worse on cognitive tests than non-parkinsonian patients. These findings remained significant even after accounting for other variables such as severity of psychopathology, sedation, akathisia and dyskinesia. Conclusions: The present results demonstrate that severity of EPS is reliably linked with poorer scores on tests of cognition. While this may reflect a common pathophysiology underlying neuromotor and neurocognitive deficits, it may also be the case that parkinsonian symptoms such as rigidity and bradykinesia impede test taking ability. Regardless of mechanism, inferences regarding cognitive impairment should take into account the presence of EPS, as well as other variables that may mediate cognitive test findings.
AB - Background: Movement disorders are common in individuals with schizophrenia, even in those who are not exposed to antipsychotic medications. Extrapyramidal symptoms (EPS) are among the most common abnormal movements in schizophrenia, but their relationship with other features of the illness such as cognition is not well characterized. Methods: Three hundred and twenty-five individuals with schizophrenia who were not receiving any antipsychotic or anticholinergic medication and participated in the baseline visit of the Clinical Antipsychotic Treatment of Intervention Effectiveness study were included in the present study. EPSs were assessed using the Simpson-Angus Scale, while cognition was measured with a comprehensive neuropsychological test battery. The relationship between EPS and cognitive test performance was evaluated both dimensionally and categorically. Results: Greater severity of EPS was significantly associated with worse cognitive test performance evaluated using a composite score. Eighty-six patients were identified as having parkinsonism and these patients performed worse on cognitive tests than non-parkinsonian patients. These findings remained significant even after accounting for other variables such as severity of psychopathology, sedation, akathisia and dyskinesia. Conclusions: The present results demonstrate that severity of EPS is reliably linked with poorer scores on tests of cognition. While this may reflect a common pathophysiology underlying neuromotor and neurocognitive deficits, it may also be the case that parkinsonian symptoms such as rigidity and bradykinesia impede test taking ability. Regardless of mechanism, inferences regarding cognitive impairment should take into account the presence of EPS, as well as other variables that may mediate cognitive test findings.
KW - Motor symptoms
KW - Neurocognition
KW - Parkinsonism
KW - Psychomotor slowing
KW - Psychotic disorder
KW - Side effects
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U2 - 10.1016/j.schres.2014.11.018
DO - 10.1016/j.schres.2014.11.018
M3 - Article
C2 - 25471015
AN - SCOPUS:84921455993
VL - 161
SP - 351
EP - 356
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
IS - 2-3
ER -