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Title
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Hitting the target : exploring motor learning and performance in schizophrenia and ageing
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Author
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Abstract
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| Schizophrenia is a severe disorder that is, next to the well-known positive and negative symptoms, characterized by a cognitive and motor deterioration. Although there still is conflicting evidence whether this deterioration has a neurodegenerative etiology, it has been suggested that some motor and cognitive changes in schizophrenia resemble those observed during normal ageing51,52. In contrast to extensively demonstrated deficits in explicit learning, it remains unclear whether implicit learning is impaired in schizophrenia and normal ageing. We performed a non-interventional study, using a wide battery of motor and cognitive tests, in order to observe which motor and cognitive processes are most disrupted in schizophrenia and to test whether patients with schizophrenia would show similar patterns of cognitive and motor deficits as elderly participants. In this thesis, 30 stable schizophrenia patients were compared with 30 healthy age- and sex-matched controls and 30 elderly controls (>65 years) on six categories of motor learning: motor speed, writing, tracking, single aiming, as well as explicit and implicit adaptation and explicit and implicit sequence learning. The tasks, which were performed on 2 consecutive days and after one week, are described in detail in Chapter II and their analyses and results are depicted in the subsequent Chapters. All patients and elderly individuals showed significant learning across all tasks but even on the simplest motor tasks patients with schizophrenia showed considerable motor slowing. Our investigation revealed distinct patterns of reduced motor abilities between the two experimental groups. Specifically, the elderly performed worse on tasks requiring more complexity and fine motor control, such as tracking, writing numbers in the SDST and explicit sequence learning, probably due to a less accurate and more variable motor output system. Individuals with schizophrenia performed worse on implicit and explicit adaptation and on most of tests that require more explicit, cognitive capacities, including verbal learning. This suggests different neurobiological underpinnings between ageing and schizophrenia which challenges the notion of the accelerated ageing hypothesis of schizophrenia. The severity of positive symptoms in schizophrenia seemed to be associated with adaptation deficits. This thesis supports the notion that many specific subprocesses contribute to psychomotor slowing in schizophrenia, and that the relationship between cognitive and motor subprocesses is strongly intertwined. Considering the well-established neural foundations of sequence learning and adaptation paradigms, these were chosen as the primary domains of investigation. To capture the cognitive contributions to learning, we utilized methods to extract the explicit cognitive engagement within these domains. Our findings highlight that an explicit learning component holds significant sway within sequence and adaptation tasks, domains that have historically been perceived as primarily implicit. This underscores the need for a comprehensive reevaluation of the role of explicit cognitive processes in motor skill acquisition paradigms. Future research is urged to devise methodologies for capturing these cognitive mechanisms in rudimentary motor tasks. With a more elaborate comprehension of psychomotor slowing's underpinnings, we might pave the way for more targeted pharmaceutical interventions and refined rehabilitation strategies. This thesis conveys an optimistic message: considering the relatively well-preserved motor learning abilities, these aspects could be addressed in the development of rehabilitation programs and pharmacological treatments in order to improve everyday cognitive and motor functioning in patients with schizophrenia. |
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Language
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English
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Publication
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Antwerp
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University of Antwerp, Faculty of Medicine and Health Sciences
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2024
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ISBN
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978-94-6506-050-7
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DOI
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10.63028/10067/2062450151162165141
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Volume/pages
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200 p.
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Note
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Hulstijn, Wouter [Supervisor]
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Morrens, Manuel [Supervisor]
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Sabbe, Bernard [Supervisor]
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Full text (open access)
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