慢性精神分裂症迟发性运动障碍患者脑电研究

目的了解TD患者是否存在脑电功率异常。方法将60名符合CCMD-3诊断标准的精神分裂症患者分成TD组与对照组,2组患者性别、年龄、总病程、服用抗精神病药物种类及剂量均匹配。所有患者均按常规进行脑电图检查(按国际标准导联10/20方式设置电极),进行脑电功率比较。结果TD组患者各频段绝大部分位点上的脑电功率低于对照组,其中α2频段F4、C4位点,β1频段FP1、F4、C4、P4位点的脑电功率差异有统计意义(P<0.05),β1频段F3、C3、P3位点脑电功率差异有高度统计意义(P<0.01)。结论TD患者存在脑电功率异常,特别是α2、β1频段,额、中央、顶区脑电功率较低。     

精神分裂症患者迟发性运动障碍临床特征分析

目的描述迟发性运动障碍（TD）患者异常不自主运动的状况和特征,分析TD发生可能的相关因素。方法共入组TD患者140例,采用阳性和阴性症状量表（PANSS）评定精神症状,采用Simpson迟发性运动障碍专用量表、异常不自主运动评定量表（AIMS）系统评估TD的严重程度及发生频率。结果在140例TD患者的8类不同部位的异常运动中,上、下肢体和舌部的舞蹈样动作发生率最高（均大于80％）,其中上肢的异常不自主运动的发生比例高达90％,脸部、颌异常运动的发生率只有30％左右。结论在TD患者中,四肢末端和舌部的异常不自主运动最为频发,典型的口-舌-颊三联征并不常见。     

慢性精神分裂症迟发性运动障碍患者6年随访

目的:了解长期服用抗精神病药的慢性精神分裂症住院患者迟发性运动障碍(TD)的预后。方法:对以往诊断为TD的54例住院患者TD症状进行6年随访。结果:42.6%患者TD症状改善,35.2%患者症状不变,22.2%患者症状恶化。服用新型非典型抗精神病药者TD症状改善较明显。患者的年龄、性别、目前药物剂量、药物剂量的改变、首次用药年龄、累计服药时间及总病程对TD症状的改善无影响。结论:长期用药患者TD症状仍可有所改善,新型非典型抗精神病药物可能改善TD症状。     

慢性精神分裂症住院病人迟发性运动障碍研究

目的　了解慢性精神分裂症住院患者迟发性运动障碍 (TD)的发生率并进行危险因素分析。方法　对4 4 3例慢性住院精神分裂症患者用自制患者情况调查表、阳性和阴性症状量表 (PANSS)、不自主运动量表 (AIMS)进行调查 ,并行二分量Logistic回归分析。结果　住院精神分裂症患者TD发生率为 2 1.7% ,其中男性为 2 0 .3% ,女性为2 7.3%。回归分析显示 ,年龄、性别、PANSS量表总分、目前抗精神病药物日剂量与TD的发生密切相关。结论　慢性精神分裂症住院患者的TD发生率很高 ,老年女性伴严重精神症状、每日药量较低时比男性更易患TD。     

氯氮平治疗过程中迟发性运动障碍的随访研究

本文对长期使用氯氮平治疗的精神分裂症病人所致的迟发性运动障碍进行了三年随访，发现ＴＤ发生与年龄，病程，疾病严重度，抗精神病药使用时间有关；部分ＴＤ病人加大氯氮平剂量后ＴＤ症状缓解，临床以口面部和上肢的运动障碍多见。     

伴迟发性运动障碍的慢性精神分裂症患者临床特征分析

目的 探讨伴迟发性运动障碍(tardive dyskinesia,TD)的慢性精神分裂症患者的临床特征.方法 采用异常不自主运动评定量表(AIMS)对126例伴TD的慢性精神分裂症患者的不自主运动进行评定,运用阳性和阴性综合征量表(PANSS)对精神症状进行评估,并与1 16例不伴TD的慢性精神分裂症患者相对照.结果 与非TD患者相比较,TD患者相对年龄更大、病程更长(P＜0.01),具有更高的PANSS总分、阴性症状评分及一般病理评分(P＜0.01或P＜0.05).TD严重程度与年龄、性别、总病程、吸烟、临床精神病理无显著相关性(P＞0.05).结论 伴TD与不伴TD的慢性精神分裂症患者有不一样的临床特征,伴TD的患者年龄更大,病程更长,具有更严重的临床精神病理.     

长期住院精神分裂症患者迟发性运动障碍调查

目的：探讨住院8年以上的男性精神分裂症患者的迟发性运动障碍(TD)的发生率及其危险因素。方法：对住院8年以上的男性精神分裂症患者193例使用异常不自主运动量表(AIMS)评定患者有无TD及其严重程度。结果：TD总的发生率为24．9％。TD组的当前服药剂量高，服用高效价药多，联用苯海索多。结论：服药剂量的高低及高效价药和苯海索的使用可能会影响到TD的发生。     

氯氮平治疗迟发性运动障碍疗效分析

目的：探讨氯氮平对迟发性运动障碍(TD)的疗效。方法：以氯氮平治疗TD患者32例，剂量为200—600mg／d，疗程24周。用不自主运动量表(AIMS)及阴性症状量表(SANS)评定。以AIMS减分率评定疗效，并随访半年。结果：痊愈7例，显著好转5例，好转9例，无效11例；显效率37．5％。无效组年龄显著高于显效组和好转组；疗前无效组AIMS评分显著高于显效组和好转组。结论：氯氯平对TD有一定疗效，随着年龄的增长及症状的加重，疗效减退。     

I型,II型精神分裂症迟发性运动障碍调查分析

对１３０例住院男性精神分裂症患者（Ｉ型５４例、Ⅱ型７６例）的迟发性运动障碍（下称ＴＤ）作了调查。采用阴性症状量表（ＳＡＮＳ）、阳性症状量表（ＳＡＰＳ）、及异常不自主运动量表（ＡＩＭＳ）进行评定，结果表明。ＴＤ的总发生率为１６．９２％（２２／１３０），Ｉ型及Ⅱ型患者ＴＤ的发生率分别为５．５６％（３／５４）和２５％（１９／７６），ＴＤ组阴性症状综合评价总分明显高于非ＴＤ组，ＴＤ的患病率随年龄的增大，服     

精神分裂症合并迟发性运动障碍患者体内过氧化物歧化酶含量的对照研究

近来国内外普遍认为神经阻滞剂治疗,可引起自由基生成增多,特别是在基底节处,从而引发ＴＤ［４,７］。ＳＯＤ是自由基清除酶,通过对ＳＯＤ进行检测,以求探讨ＴＤ病理机制。１对象与方法１１研究对象（１）符合ＩＣＤ—１０精神分裂症诊断标准的住院病人２０例。其...     

Prevalence and risk factors for tardive dyskinesia: a study in an Italian population of chronic schizophrenics

Summary The aim of this study was to evaluate tardive dyskinesia (TD) (prevalence and possible risk factors, pharmacological and clinical), in a population of schizophrenic patients after prolonged institutionalization. A total of 148 patients (80 male, 68 female) aged between 28 and 87 years (mean 55, SD 11) diagnosed according to DSM III were included in the study and assessed for the presence and severity of TD using the Abbreviated Rockland Simpson Scale for TD. Of the examined population, 32% were found to be affected by TD. Patients over 55 years had a relative risk of TD that was 2.3 times higher than in subjects under 55 (P<0.05). The most frequent movements were orofacial (60%) and in the extremities (56.4%). No significant relationship between duration of neuroleptic treatments, illness or hospitalization, anticholinergic drugs and TD prevalence was found. Severity was related to age, since there was a positive linear relationship between age and Simpson Scale scores (r=0.45,P<0.01).     

Lack of complaints in schizophrenics with tardive dyskinesia.

Eighteen of a population of 518 outpatients were found to fulfill diagnostic criteria for tardive dyskinesia. None of these patients complained to their therapists of their symptoms, and eight of them were not even aware of them. Five of the unaware patients were actively delusional or hallucinating. Since all eighteen were chronic schizophrenics on neuroleptics, these findings suggest that this group may not report their symptoms. The findings are important because early diagnosis of tardive dyskinesia allows more chance for intervention with satisfactory results.     

Vitamin B6 in treatment of tardive dyskinesia: a preliminary case series study.

Tardive dyskinesia (TD) remains a significant problem for patients and physicians. Several reports have suggested that vitamin B6 (pyridoxine) can be helpful in the treatment of some neuroleptic-induced movement disorders, including parkinsonism and TD. This report presents the results of a preliminary study of five patients with TD who underwent a four week open-label clinical trial of vitamin B6 (100 mg/d) in addition to their regular medications. The severity of the involuntary movements was assessed using the Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS) and the Simpson-Angus Scale (SAS). The patients' clinical status was assessed with the Brief Psychiatric Rating Scale (BPRS). With the addition of vitamin B6 to their treatment, four patients had clinically significant (greater than 30%) improvement on the measures of involuntary movement and, in three cases, there was also clinically significant improvement on the BPRS. None of the patients had side effects attributable to vitamin B6. The results suggest that vitamin B6 may alleviate TD, but it will need to be further tested in controlled double-blind trials.     

Meclofenoxate therapy in tardive dyskinesia: a preliminary report

Tardive dyskinesia seems to occur as a result of diminished cholinergic and enhanced dopaminergic activity in the striatum. Meclofenoxate has been shown to increase cerebral cholinergic activity. To ameliorate the tardive dyskinesia, meclofenoxate was given orally, 600-1200 mg/day, for 6-12 weeks. The effects of the drug were evaluated by scoring the degree of involuntary movement. Among 11 subjects with tardive dyskinesia or dystonia, 4 improved markedly, 1 moderately, 2 slightly, and there was no improvement in 4. One patient with subacute oral dyskinesia, induced by administration of neuroleptics for 1 month, improved markedly. The possibility that meclofenoxate may be effective in dealing with dyskinesias that are induced by neuroleptics warrants further attention.     

Choline and lecithin in the treatment of tardive dyskinesia: preliminary results from a pilot study.

Tardive dyskinesia is thought to reflect increased dopaminergic activity of the central nervous system. To compensate for this by increasing CNS cholinergic tone, the authors administered oral choline and its natural dietary source, lecithin, to 5 men with mild to severe tardive dyskinesia in a nonblind trial. Both choline and lecithin increased serum choline levels and improved abnormal movements in all patients. Lecithin had fewer adverse effects.     

褪黑素治疗迟发性运动障碍的随机对照研究

目的 观察褪黑素治疗慢性精神分裂症患者迟发性运动障碍(TD)的临床疗效和不良反应.方法 选择76例有迟发性运动障碍的精神分裂症住院患者,按照入组顺序用随机数字表将患者分为褪黑素治疗组(以下简称褪黑素组,39例)和对照组(37例).褪黑素组患者每晚服用褪黑素1次(9 mg/次),对照组患者只维持常规治疗;观察期均为12周.76例患者治疗前和治疗第4,8,12周末盲法采用异常不自主运动量表(AIMS)评定TD疗效,采用治疗中需处理的不良反应症状量表(TESS)评定不良反应.结果 治疗第4,8,12周末,对照组患者AIMS总分较治疗前的差异均无统计学意义(配对t检验,P均>0.05);褪黑素组患者AIMS总分均较治疗前显著降低,差异有统计学意义(配对t检验,P均<0.05),治疗第12周末舌部、上肢的TD症状较治疗前显著降低,差异均有统计学意义(配对t检验,P均<0.05).治疗第8,12周末两组AIMS总分差异有统计学意义(t检验,P<0.05).褪黑素组和对照组治疗各时点TESS总分与治疗前比较,褪黑素组患者治疗第4,8,12周末较治疗前均显著降低,差异均有统计学意义(配对t检验,P均<0.05);而对照组及两组间的差异均无统计学意义(t检验,P均>0.05).结论 褪黑素治疗慢性精神分裂症患者TD有效,对舌和上肢的症状效果明显,无不良反应.     

The effect of neuroleptics and tardive dyskinesia on smooth-pursuit eye movement in chronic schizophrenics

We sought to determine whether such state-related factors as neuroleptic treatment and facio-oral tardive dyskinesia (TD) influence smooth-pursuit eye movement (SPEM) in chronic schizophrenics. The design involved 100 schizophrenics, 64 of whom showed "abnormal" eye tracking. Experimentally drug-withdrawn patients, some of whom were clinically relapsed, were compared with control patients who continued taking medication in prewithdrawal and postwithdrawal SPEM tests. All groups showed a slight worsening in eye-tracking performance on two postwithdrawal tests, but significant group-by-test session "interactions" were not demonstrable. We also determined that patients with TD tend to substitute large, nontracking saccades for SPEM to a significantly greater extent than nondyskinetic patients. Our findings strengthen the supposition that impaired SPEM is a trait in many schizophrenics but suggest that patients with TD be excluded in future studies of SPEM addressed to trait issues.     

Tiapride in the treatment of tardive dyskinesia: a clinical and biochemical study

The effect of tiapride treatment was investigated in 10 patients with tardive dyskinesia. The effects of the drug on the symptoms of tardive dyskinesia, parkinsonian symptoms, and patients' mental conditions were evaluated using standardized rating scales before and weekly during the 28-day drug trial. Patients were reassessed 14 days after withdrawal of tiapride. The symptoms of tardive dyskinesia significantly improved during treatment and deteriorated after tiapride was withdrawn. Parkinsonian symptoms remained unchanged both during and after treatment. The patients' mental conditions significantly improved while they were taking tiapride, and did not appreciably deteriorate after treatment was discontinued. Plasma prolactin levels increased significantly during treatment, while plasma dopamine-beta-hydroxylase activity did not change.