Prevalence of antipsychotic-induced extrapyramidal symptoms and their association with neurocognition and social cognition in outpatients with schizophrenia in the “real-life”,Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Prevalence of antipsychotic-induced extrapyramidal symptoms and their association with neurocognition and social cognition in outpatients with schizophrenia in the “real-life”
Progress in Neuro-Psychopharmacology and Biological Psychiatry ( IF 5.3 ) Pub Date : 2021-01-20 , DOI: 10.1016/j.pnpbp.2021.110250
Palmiero Monteleone ₁ , Giammarco Cascino ₁ , Alessio Maria Monteleone ₁ , Paola Rocca ₂ , Alessandro Rossi ₃ , Alessandro Bertolino ₄ , Eugenio Aguglia ₅ , Mario Amore ₆ , Enrico Collantoni ₇ , Giulio Corrivetti ₁ , Alessandro Cuomo ₈ , Antonello Bellomo ₉ , Enrico D'Ambrosio ₄ , Liliana Dell'Osso ₁₀ , Marianna Frascarelli ₁₁ , Giulia Maria Giordano ₁₂ , Luigi Giuliani ₁₂ , Carlo Marchesi ₁₃ , Cristiana Montemagni ₂ , Lucio Oldani ₁₄ , Federica Pinna ₁₅ , Maurizio Pompili ₁₆ , Rita Roncone ₁₇ , Rodolfo Rossi ₃ , Alberto Siracusano ₁₈ , Antonio Vita ₁₉ , Patrizia Zeppegno ₂₀ , Silvana Galderisi ₁₂ , Mario Maj ₁₂ ,

Affiliation

Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy.
Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy.
Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy.
Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy.
Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.
Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy.
Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy.
Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy.
Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Department of Psychiatry, University of Campania "Luigi Vanvitelli" Naples, Italy.
Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy.
Department of Psychiatry, University of Milan, Milan, Italy.
Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy.
Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy.
Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy.

First generation antipsychotics (FGAs) are more likely to induce extrapyramidal side-effects (EPS) than second generation antipsychotics (SGAs), and EPS have been shown associated to cognitive deficits in schizophrenia. So far, no study has explored the relationships between EPS and social cognition (SC) in people with schizophrenia. Therefore, we assessed the prevalence of EPS in a large sample of drug-treated community-dwelling persons with schizophrenia and explored their relationships with patients' neurocognitive and SC abilities.

875 patients underwent EPS, psychopathological, neurocognitive and SC assessments by means of standardized measures. Relationships between EPS, psychopathology and neurocognitive and SC measures were investigated by correlation tests. Moreover, a partial correlation network was computed by means of a network analysis.

256 patients were treated with FGAs alone or in combination with SGA and 619 with SGAs. EPS were significantly more frequent in FGA-treated group than in the SGA-treated one. Patients with EPS disclosed a more severe psychopathology and were more impaired in neurocognitive and SC measures compared to those without EPS. Disorganization, expressive deficit, and duration of illness were significantly associated to both neurocognitive and SC measures while EPS were associated to neurocognitive measures only. The network analysis showed that parkinsonism was the sole EPS directly connected to both psychopathological and neurocognitive indices whereas no direct connection emerged between EPS and SC measures.

Present findings confirm that EPS are still present in the era of SGAs and contribute, together with other clinical variables, to the neurocognitive but not to the SC impairment of patients with schizophrenia.

中文翻译：

“现实生活”中精神分裂症门诊患者抗精神病药引起的锥体外系症状的患病率及其与神经认知和社会认知的关系

第一代抗精神病药 (FGA) 比第二代抗精神病药 (SGA) 更容易引起锥体外系副作用 (EPS)，并且 EPS 已被证明与精神分裂症的认知缺陷有关。到目前为止，还没有研究探讨过EPS与精神分裂症患者社会认知（SC）之间的关系。因此，我们在大量接受药物治疗的社区精神分裂症患者样本中评估了 EPS 的患病率，并探讨了它们与患者神经认知和 SC 能力的关系。

875 名患者通过标准化措施进行了 EPS、精神病理学、神经认知和 SC 评估。通过相关性检验研究了 EPS、精神病理学和神经认知和 SC 测量之间的关系。此外，通过网络分析计算了偏相关网络。

256 名患者单独使用 FGA 或与 SGA 联合治疗，619 名患者使用 SGA。FGA 治疗组的 EPS 明显高于 SGA 治疗组。与没有 EPS 的患者相比，有 EPS 的患者表现出更严重的精神病理学，并且在神经认知和 SC 测量方面受损更严重。紊乱、表达缺陷和病程与神经认知和 SC 测量显着相关，而 EPS 仅与神经认知测量相关。网络分析表明，帕金森症是唯一与精神病理学和神经认知指数直接相关的 EPS，而 EPS 和 SC 测量之间没有直接联系。

目前的研究结果证实，在 SGAs 时代，EPS 仍然存在，并且与其他临床变量一起，对精神分裂症患者的神经认知功能但对 SC 损伤没有贡献。

更新日期：2021-01-28

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