Neurological Soft Signs, Spontaneous and Treatment Emergent Extrapyramidal Syndromes in Black Africans With First Episode Schizophrenia.

Journal: Frontiers in psychiatry

Volume: 9

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neurosciences, and Substance Abuse, University of Ibadan, Ibadan, Nigeria. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Abstract summary 

Very little is known about the relationship between spontaneous and treatment-induced motor syndromes in Africans with first episode schizophrenia. We investigated the association between spontaneous NSS and EPS, with treatment-induced EPS in a homogenous sample of Black Africans with first episode schizophrenia. We examined Xhosa (South Africa) and Yoruba (Nigeria) patients, using the Neurological Evaluation Scale and extrapyramidal symptoms scale before and at 3 months after exposure to low dose flupenthixol decanoate. Pearson's correlations and Linear regression models, controlling for duration of untreated psychosis (D.U.P) and premorbid adjustments, were used in examining associations. Among 99 participants in the baseline sample, 91 (91.8%) and 20 (20.2%) had at least one definite NSS and EPS, respectively, before exposure to antipsychotics. Treatment-induced EPS were recorded in 34 (38.6%). Spontaneous EPS was associated with treatment-emergent Akathisia in participants with a longer D.U.P ( = 0.75, β = 0.70, = 0.008). This association was specific for Parkinsonism ( = 0.75, β = 0.85, = 0.008) and dyskinesia ( = 0.75, β = 1.70, = 0.008). Similar to previous findings for tardive dyskinesia in studies implementing longer-term follow-up, spontaneous EPS may also predict short-term antipsychotic-induced EPS such as akathisia. These results may be important for early identification of patients at risk of treatment-induced Akathisia-linked psychomotor agitation in first episode schizophrenia.

Authors & Co-authors:  Ojagbemi Akin A Chiliza Bonga B Bello Toyin T Asmal Laila L Esan Oluyomi O Emsley Robin R Gureje Oye O

Study Outcome 

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Citations :  Reiter PJ. Extrapyramidal motor disturbances in Dementia Preacox. Acta Psychiatr Neurol. (1926) 1:281–310. 10.1111/j.1600-0447.1926.tb11031.x
Authors :  7
Identifiers
Doi : 172
SSN : 1664-0640
Study Population
Male,Female
Mesh Terms
Other Terms
African ancestry;locomotor control;neurodevelopmental defects;neurological examination;side effects;tardive dyskinesia
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
Switzerland