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Motor disorder and its relationship to frontal/executive dysfunction


Current theoretical approaches to schizophrenia invoke dysfunction in fronto-striatal circuits. The proposed study aims to provide a direct test the fronto-striatal hypothesis, by examining whether, in chronic schizophrenic patients, executive test impairm ent and task-related prefrontal cortex abnormality on functional imaging are associated with motor disorder, including both tardive dyskinesia and catatonic symptoms. In the context of working on a severe mental disorder unit over a period of 12 months, 15 0 non-elderly patients meeting criteria for chronic schizophrenia will undergo a standardised examination procedure for motor disorder. From these, three groups with relatively intact overall intellectual functioning, will then be selected: those with moto r disorder (predominantly tardive dyskinesia) (N-25), those with motor disorder (predominantly catatonia) (N=20) and those with no motor disorder (N=25). A group of 25 healthy comparison subjects will also be recruited. Executive function will be examined in order to examine the hypothesis that motor abnormality is specifically associated with executive impairment. Event related fMRI experiments will be carried out on 12 subjects from each group .using a range of tasks that activate frontal brain systems. A s well as adding to knowledge about the biological basis of schizophrenia, if frontal/executive dysfunction is shown to be a risk factor for tardive dyskinesia in schizophrenia, this could be of potential practical clinical usefulness as a screening test f or this serious side-effect of drug treatment.

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