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Tardive Dyskinesia in Schizophrenia: Relationship to Minor Physical Anomalies, Frontal Lobe Dysfunction and Cerebral Structure on Magnetic Resonance Imaging

Published online by Cambridge University Press:  02 January 2018

John L. Waddington*
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin
Eadbhard O'Callaghan
Affiliation:
St John of God Psychiatric Service, Co. Dublin
Peter Buckley
Affiliation:
St John of God Psychiatric Service, Co. Dublin
Cathy Madigan
Affiliation:
St John of God Psychiatric Service, Co. Dublin
Oonagh Redmond
Affiliation:
Mater Hospital, Dublin
John P. Stack
Affiliation:
Mater Hospital, Dublin
Anthony Kinsella
Affiliation:
Dublin Institute of Technology
Conall Larkin
Affiliation:
St John of God Hospital, Co. Dublin
Joseph T. Ennis
Affiliation:
Mater Hospital, Dublin, Ireland
*
Professor John L. Waddington, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Republic of Ireland. Fax: (353) (1) 4780625

Extract

Background

It was hypothesised that schizophrenic patients with tardive dyskinesia show an excess of neurodevelopmental disturbance, particularly minor physical anomalies, in association with cognitive dysfunction and abnormalities of cerebral structure.

Method

Forty-seven out-patients with a DSM–III diagnosis of schizophrenia were examined for tardive dyskinesia using the Abnormal Involuntary Movement Scale; they were examined also for minor physical anomalies and neuropsychological test performance. Cortical atrophy, signal hyperintensities and lateral ventricular volume were determined on magnetic resonance imaging.

Results

Patients with and without tardive dyskinesia could not be distinguished by age, gender distribution or a number of clinical measures; however, patients with tardive dyskinesia sorted fewer categories on the Wisconsin Card Sorting Test (P = 0.04). Cerebral structure in patients with and without tardive dyskinesia could not be distinguished on magnetic resonance imaging but those with dyskinesia, all of whom showed involvement of the orofacial region, showed more evident minor physical anomalies of the head relative to those of the periphery (P = 0.02).

Conclusions

Tardive orofacial dyskinesia in schizophrenia appears to be associated particularly with poorer frontal lobe function, while predominance of craniofacial dysmorphogenesis may constitute a vulnerability factor that is related to the early origins of the disease process.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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