Trait characteristic of impaired visuomotor integration during Trail-Making Test B performance in schizophrenia

Abstract

Using concurrent recording of eye and hand movements during the performance of the Trail-Making Test B (TMT-B), Wölwer and Gaebel have recently reported impaired visuomotor integration in patients with acute schizophrenia, which mainly accounted for patients' poor test performance. In order to replicate these exploratory findings in an independent sample of patients and to further investigate their stability during different stages of the illness, the performance process during a computerized TMT-B was assessed in 22 remitted outpatients with schizophrenia, 12 unaffected first-degree relatives and 26 healthy controls. As an estimate of longitudinal stability, a partial sample of 12 patients and 19 controls was reassessed after a period of 3 months. Remitted schizophrenia patients showed exactly the same strategic problems during the performance process of TMT-B as previously found in acute patients. Compared with healthy controls, patients more often sequenced searching ('planning') and connecting targets instead of time-sparing parallel execution, and their planning periods contained more and longer planning fixations (i.e. fixations outside the cursor area), which was related to longer performance time. Unaffected relatives mostly scored between patients and healthy controls without statistically significant differences to either group. Thus, the abnormalities in the process of TMT-B performance proved to be reliable and stable trait characteristics in schizophrenia.