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


OBJECTIVE
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.
Mergl
Roland
R
Laboratory of Clinical Neurophysiology, Department of Psychiatry, Ludwig-Maximilians-Universität München, Nussbaumstr. 7, 80336 Munich, Bavaria, Germany. Roland.Mergl@psy.med.uni-muenchen.de
Mavrogiorgou
Paraskevi
P
Juckel
Georg
G
Zaudig
Michael
M
Hegerl
Ulrich
U
D000328:Adult; D001521:Behavior Therapy; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D006236:Handwriting; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009069:Movement Disorders / Q000150:complications*; D009422:Nervous System Diseases / Q000150:complications; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020280:Sertraline / Q000627:therapeutic use; D012815:Signal Processing, Computer-Assisted
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline