Effects of Music Beat on Motor Function in Individuals at Risk for Psychotic Onset and Schizophrenia Patients

Study Overview
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Brief Summary
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The purpose of this project is to investigate whether a 3-week training program involving music beat (serving as a type of rhythmic auditory stimulation) reduces the severity of bradykinesia and dyskinesia in at-risk individuals and schizophrenia patients. It is hypothesized that the program is effective in reducing the severity of bradykinesia and dyskinesia in at-risk individuals and schizophrenia patients.

Official Title
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Effects of Music Beat on Motor Function in Individuals at Risk for Psychotic Onset and Schizophrenia Patients

Conditions
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Schizophrenia, Psychosis, Parkinsonism, Dyskinesias

Intervention / Treatment
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* Behavioral: Rhythmic auditory stimulation (RAS)
* Behavioral: no RAS


Participation Criteria
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Eligibility Criteria
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For at-risk participants: Inclusion criteria: A score of or above 9 in the Chinese version of the 16-item Prodromal Questionnaire (CPQ-16), or a score of or above 8.18 in the Chinese version of Community Assessment of Psychic Experiences with 15 items (CAPE-C15), or a score of or above 17 in Schizotypal Personality Questionnaire-Brief (SPQ-B); the age between 15-24 years; score > 60 in The Chinese version of Edinburgh Handedness Inventory (CH-EBI) to ensure right handedness; and score ≥ 22 in Montreal Cognitive Assessment Hong Kong Version (HK-MoCA) to ensure no serious cognitive deficits so that they can understand instructions. Exclusion criteria: psychiatric diagnosis by self-report; cardiovascular, neurological, muscular or orthopedic diseases that may affect hand movements; taking psychiatric medications; substance abuse; and being pregnant. For schizophrenia participants: Inclusion criteria: a diagnosis of schizophrenia without other psychiatric diseases; the age ≥ 18 years; score > 60 in CH-EBI to ensure right handedness; and score ≥ 22 in HK-MoCA to ensure no serious cognitive deficits so that they can understand instructions. Exclusion criteria: cardiovascular, neurological, muscular or orthopedic diseases that may affect hand movements; substance abuse; and being pregnant.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: at risk- RAS<br>At-risk individuals in the experimental group will undergo upper-limb movement training with the aid of music beat serving as a type of rhythmic auditory stimulation (RAS). | Behavioral: Rhythmic auditory stimulation (RAS)<br>* The song named 'Sign of The Times' is played and recorded by the research personnel beforehand. The beat of the song will serve as RAS. The computer software Audacity will be used to adjust tempi of RAS. Before intervention, the participant is required to execute the movement task without the aid of RAS as quickly as possible for 30 seconds, so that we obtain his/her baseline movement tempo. For each 40-minute training session in the first training week, three RAS tempi will be provided for the first, second, and last 10 minutes with a five-minute break in between: normal (100% of the baseline tempo), quick (105% of the baseline tempo), and fast (110% of the baseline tempo). With each training week, the three RAS tempi will be increased by 5%. Participants in the experimental groups are required to use their right hand to pick up beads from source bowls to the target bowl when listening to the song. The 3-week intervention program will include 21 40-minute daily training sessions.<br>|
| Active Comparator: at risk- no RAS<br>At-risk individuals in the control group will receive upper-limb training without the aid of RAS. | Behavioral: no RAS<br>* The training protocol will be the same as that used in the experimental group except the lack of RAS during execution of the movement task.<br>|
| Experimental: schizophrenia- RAS<br>Schizophrenia patients in the experimental group will undergo upper-limb movement training with the aid of RAS. | Behavioral: Rhythmic auditory stimulation (RAS)<br>* The song named 'Sign of The Times' is played and recorded by the research personnel beforehand. The beat of the song will serve as RAS. The computer software Audacity will be used to adjust tempi of RAS. Before intervention, the participant is required to execute the movement task without the aid of RAS as quickly as possible for 30 seconds, so that we obtain his/her baseline movement tempo. For each 40-minute training session in the first training week, three RAS tempi will be provided for the first, second, and last 10 minutes with a five-minute break in between: normal (100% of the baseline tempo), quick (105% of the baseline tempo), and fast (110% of the baseline tempo). With each training week, the three RAS tempi will be increased by 5%. Participants in the experimental groups are required to use their right hand to pick up beads from source bowls to the target bowl when listening to the song. The 3-week intervention program will include 21 40-minute daily training sessions.<br>|
| Active Comparator: schizophrenia- no RAS<br>Schizophrenia patients in the control group will receive upper-limb training without the aid of RAS. | Behavioral: no RAS<br>* The training protocol will be the same as that used in the experimental group except the lack of RAS during execution of the movement task.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motion analysis by using an eight-camera motion capture system (VICON; Oxford Metrics Group, Oxford, UK) | normalized movement time (representing severity of bradykinesia). Unit: second/mm | Within one week right before the 1st session of the intervention | 
| Motion analysis by using an eight-camera motion capture system (VICON; Oxford Metrics Group, Oxford, UK) | normalized movement time (representing severity of bradykinesia). Unit: second/mm | Within one week right after the last session of the intervention | 
| Motion analysis by using an eight-camera motion capture system (VICON; Oxford Metrics Group, Oxford, UK) | normalized number of movement units (representing severity of dyskinesia). Unit: units/mm | Within one week right before the 1st session of the intervention | 
| Motion analysis by using an eight-camera motion capture system (VICON; Oxford Metrics Group, Oxford, UK) | normalized number of movement units (representing severity of dyskinesia). Unit: units/mm | Within one week right after the last session of the intervention |