Gesture Performance in First- and Multiple-Episode Patients with Schizophrenia Spectrum Disorders

Abstract

Background/Aim: Gesturing plays an important role in social behavior and social learning. Deficits are frequent in schizophrenia and may contribute to impaired social functioning. Information about deficits during the course of the disease and presence of severity and patterns of impairment in first-episode patients is missing. Hence, we aimed to investigate gesturing in first- compared to multiple-episode schizophrenia patients and healthy controls. Methods: In 14 first-episode patients, 14 multiple-episode patients and 16 healthy controls matched for age, gender and education, gesturing was assessed by the comprehensive Test of Upper Limb Apraxia. Performance in two domains of gesturing - imitation and pantomime - was recorded on video. Raters of gesture performance were blinded. Results: Patients with multiple episodes had severe gestural deficits. For almost all gesture categories, performance was worse in multiple- than in first-episode patients. First-episode patients demonstrated subtle deficits with a comparable pattern. Conclusions: Subjects with multiple psychotic episodes have severe deficits in gesturing, while only mild impairments were found in first-episode patients independent of age, gender, education and negative symptoms. The results indicate that gesturing is impaired at the onset of disease and likely to further deteriorate during its course.

Gesture Performance in Schizophrenia Predicts Functional Outcome After 6 Months

“… 27 Gesture deficits are more frequently observed in patients with multiple episodes of the disorder. 37 Still, the Group × Time interactions for negative symptoms and social functioning ( figure 1 and supplementary table S2 ) in the repeated measures ANCOVAs remained significant even when controlling for age and duration of illness. Furthermore, the dimensional assessment of gesture performance yielded similar results as the categorical one in the hierarchical regression analyses.…”

“…In addition, patients with gesture deficits are older, are chronic, and have more impaired frontal lobe function and more motor symptoms. 27 , 37 …”

The cortical signature of impaired gesturing: Findings from schizophrenia

“…A high correlation between both tasks argues further for a generalized gesture deficit ( Walther et al, 2015 ). Gesture impairments are present at disease onset ( Stegmayer et al, 2016b ), are related to reduced social competence ( Park et al, 2008 ), and gesture production and recognition predict functional outcome and negative symptoms after 6 months ( Walther et al, 2016 ).…”

Dysbalanced Resting-State Functional Connectivity Within the Praxis Network Is Linked to Gesture Deficits in Schizophrenia

“…Our group reported poorer gesture performance in schizophrenia in 3 independent samples, whereby pantomime is generally more compromised than imitation. 2 , 3 , 8 , 10 , 12 , 20 , 21 , 24 There was no significant effect of side nor of its interactions with category, domain, or group. This fits to observations in healthy subjects, in whom gesture performance did not differ between left and right hand.…”

“… 8 Gesture deficits may occur in first episode or chronic patients. 10 Gesture performance is associated with key schizophrenia symptoms, including motor abnormalities, impaired frontal lobe functioning, positive symptoms, poor working memory, and conceptual disorganization. 3 , 8 , 11 Notably, gesture deficit predicts unfavorable functional outcome and negative symptoms after 6 months.…”