Childhood neuromotor dysfunction in schizophrenia patients and their unaffected siblings: a prospective cohort study. Schizophr Bull 2000

Neuromotor dysfunction is a consistent finding in high-risk and archival studies of schizophrenia, but the sources of this dysfunction and its role in the devel-opmental course of the disorder remain poorly under-stood. This study examined childhood motor predic-tors of adult psychiatric outcome in a birth cohort sample (72 patients with schizophrenia or schizoaffec-tive disorder, 63 unaffected siblings, and 7,941 nonpsy-chiatric controls), evaluated prospectively with neuro-logic examinations at 8 months, 4 years, and 7 years of age. Deviance on motor coordination measures at 7 years was associated with both adult schizophrenia and unaffected sibling status, suggesting that a co-familial (and perhaps genetic) factor underlies motor coordination deficits in schizophrenia. Unusual move-ments at ages 4 and 7 predicted adult schizophrenia but not unaffected sibling status, indicating that these deficits may be specific to those who will develop the clinical phenotype. None of the motor precursors were confined to patients with an early age at first treatment contact. Fetal hypoxia predicted unusual movements at 4 but not 7 years among the preschizophrenia sub-jects, suggesting neurodevelopmental dependence of its functional effects. Neither prenatal complications nor birth weight were associated with motor dysfunc-tion in preschizophrenia subjects or their unaffected siblings at any age. Finally, preschizophrenia children did not show the expected developmental decline in unusual movements, perhaps reflecting aberrant func-tional maturation of cortical-subcortical pathways