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Can a subgroup of OCD patients with motor abnormalities and poor therapeutic response be identified?

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Abstract

Rationale

In a subgroup of patients with obsessive–compulsive disorder (OCD), motor soft signs, tics and other movement disorders can be observed, indicating a special pathogenetic involvement of basal ganglia.

Objectives

The main objective of this study was to verify the hypothesis that such motor dysfunction characterises a subgroup of OCD patients with poor treatment response. For assessing even subtle motor dysfunction, a new method for kinematical analysis of hand movements has been applied.

Methods

We examined the performance of 45 in-patients who met the DSM-IV criteria for OCD before and under therapy (sertraline and behaviour therapy) using a digitising tablet and kinematical analysis of simple handwriting and drawing movements. All subjects wrote a sentence, their signature and letter sequences. Moreover, they drew circles under different conditions. Three kinematical parameters (stroke duration, variation coefficient of peak velocity, stroke length) were calculated to quantify hand-motor performance.

Results

Prior to therapy, non-responders wrote with significantly smaller amplitudes than responders. Additionally, non-responders drew significantly larger circles with the non-dominant hand at baseline, as compared to responders. Disturbances of handwriting were more frequent in non-responders than in responders.

Conclusions

Kinematical analysis of handwriting movements seems to be interesting for the prediction of poor response to treatments in OCD patients.

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Acknowledgements

This study was kindly supported by Pfizer, Germany. The evaluation of the present data was performed by Roland Mergl as part of his thesis for the acquisition of the Ph.D. degree.

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Authors and Affiliations

  1. Laboratory of Clinical Neurophysiology, Department of Psychiatry, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336, Munich, Bavaria, Germany

    Roland Mergl & Ulrich Hegerl

  2. Department of Psychiatry, Wilhelm-von-Humboldt-Universität, Charité, Schumannstr. 20–21, 10117, Berlin, Germany

    Paraskevi Mavrogiorgou & Georg Juckel

  3. Psychosomatic Hospital Windach, Schützenstr. 16, 86949, Windach, Bavaria, Germany

    Michael Zaudig

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  1. Roland Mergl
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  2. Paraskevi Mavrogiorgou
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  5. Ulrich Hegerl
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Correspondence to Roland Mergl.

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Mergl, R., Mavrogiorgou, P., Juckel, G. et al. Can a subgroup of OCD patients with motor abnormalities and poor therapeutic response be identified?. Psychopharmacology 179, 826–837 (2005). https://doi.org/10.1007/s00213-004-2115-0

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  • DOI: https://doi.org/10.1007/s00213-004-2115-0

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