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Genuine motorische Phänomene bei schizophrenen Psychosen

Neuronale Korrelate und Pathomechanismen

Genuine motor phenomena in schizophrenia

Neuronal correlates and pathomechanisms

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Zusammenfassung

Ungeachtet der zunehmenden Anzahl neurobiologischer Studien zur motorischen Dysfunktion bei schizophrenen Psychosen sind die neuronalen Korrelate und Pathomechanismen genuiner motorischer Auffälligkeiten (GMA) nicht vollständig aufgeklärt. Zudem ist die klinische Relevanz eines potenziellen „motorischen intermediär Phänotyps“ gegenwärtig umstritten. Diese systematische Übersichtsarbeit leistet einen Beitrag zur Charakterisierung eines „motorischen intermediär Phänotyps“ bei schizophrenen Psychosen. Darüber hinaus hat diese Übersichtsarbeit das Ziel, vor dem Hintergrund aktueller Neuroimagingbefunde GMA-assoziierte neuronale Korrelate als Biomarker psychotischer Störungen zu diskutieren. Die detaillierte Erfassung von GMA im Kontext multimodaler Bildgebung könnte zukünftig die Früherkennung psychotischer Störungen und die Einleitung störungsorientierter und individualisierter Therapien fördern. In der Gesamtbetrachtung der Daten gibt es erste Hinweise darauf, dass die motorische Dysfunktion bei schizophrenen Psychosen dimensional betrachtet werden muss. Der prädiktive Wert neurobiologischer Befunde im Hinblick auf die Transition in eine lebensbedrohliche Katatonie oder auf die Entwicklung chronischer Dyskinesien kann gegenwärtig noch nicht abschließend beurteilt werden.

Abstract

Despite a growing body of evidence on motor dysfunction in schizophrenia spectrum disorders, the neuronal correlates of genuine motor abnormalities (GMA) are not fully elucidated at present. Moreover, the clinical relevance of a potential “motor intermediate phenotype” remains controversial. This systematic review aims at characterizing a “motor intermediate phenotype” in schizophrenia spectrum disorders. The second goal of this systematic review is to discuss GMA-associated brain alterations as potential biomarkers of psychosis risk syndrome and manifest motor symptoms against the background of current neuroimaging evidence. The detailed clinical assessment of GMA in the context of multimodal imaging could, in the future promote the early recognition of psychotic disorders and the initiation of disorder-oriented and individualized treatment. Taken as a whole the data provide initial evidence that motor dysfunction in schizophrenic spectrum disorders must be considered dimensionally. The predictive value of neurobiological results with respect to the transition to a life-threatening catatonia or the development of chronic dyskinesia, cannot currently be conclusively assessed.

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Authors and Affiliations

  1. Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland

    D. Hirjak

  2. Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Kanada

    G. Northoff

  3. Zentrum für Seelische Gesundheit, Gesundheitszentrum Odenwaldkreis, Erbach, Deutschland

    P. A. Thomann

  4. Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universität Heidelberg, Heidelberg, Deutschland

    P. A. Thomann, K. M. Kubera & R. C. Wolf

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  1. D. Hirjak
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  2. G. Northoff
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  3. P. A. Thomann
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  4. K. M. Kubera
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Correspondence to D. Hirjak.

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D. Hirjak, G. Northoff, P.A. Thomann, K.M. Kubera und R.C. Wolf geben an, dass kein Interessenkonflikt besteht.

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Abschnitte dieser Arbeit sind der kumulativen Habilitationsschrift des Erstautors entnommen, die im September 2016 von der Habilitationskommission des Fachbereichs Medizin der Universität Heidelberg angenommen wurde.

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Hirjak, D., Northoff, G., Thomann, P.A. et al. Genuine motorische Phänomene bei schizophrenen Psychosen. Nervenarzt 89, 27–43 (2018). https://doi.org/10.1007/s00115-017-0434-8

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