Markers of basal ganglia dysfunction and conversion to psychosis: neurocognitive deficits and dyskinesias in the prodromal period.
BACKGROUND
Movement abnormalities and cognitive deficits may represent external markers of an underlying neural process linked with the early etiology of psychosis. As basal ganglia function plays a governing role in both movement and cognitive processes, an understanding of the relationship between these phenomena stands to inform etiologic conceptualizations of vulnerability and psychotic disorders.


METHODS
In this investigation, trained raters coded movement abnormalities in videotapes from structured interviews of adolescents and young adults with a prodromal risk syndrome (n = 90). The participants were administered a neuropsychological battery including measures of verbal comprehension, perceptual organization, immediate/delayed auditory memory, and an estimate of full-scale intelligence quotient. Diagnostic status was followed for a 2-year period utilizing structured clinical interviews, during which time 24 high-risk participants (26.66%) converted to an Axis I psychotic disorder.


RESULTS
Elevated dyskinetic movements in the upper-body region were correlated with deficits in domains of verbal comprehension, perceptual organization, and both immediate and delayed auditory memory. Further, discriminant function analyses indicated that baseline movement abnormalities and neurocognitive deficits significantly classified those high-risk participants who would eventually convert to a psychotic disorder (72.3%).


CONCLUSIONS
Results support a common cortico-striato-pallido-thalamic circuit irregularity, underlying both movement abnormalities and cognitive deficits in individuals at high risk for psychosis. Models incorporating external markers of progressive basal ganglia dysfunction may enhance detection and preventive intervention for those high-risk individuals most in need of treatment.
Mittal
Vijay A
VA
Department of Psychology, University of California Los Angeles, Los Angeles, California, USA. vijay.mittal@colorado.edu
Walker
Elaine F
EF
Bearden
Carrie E
CE
Walder
Deborah
D
Trottman
Hanan
H
Daley
Melita
M
Simone
Anthony
A
Cannon
Tyrone D
TD
D000293:Adolescent; D001479:Basal Ganglia / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis*; D002658:Developmental Disabilities; D018450:Disease Progression; D020820:Dyskinesias / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012307:Risk Factors; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D055815:Young Adult