Study data published in Schizophrenia Research support the efficacy of a multimodal speech-gesture (MSG) training program for patients with schizophrenia. After 8 sessions of MSG training, patients displayed improvements in speech-gesture processing and reported better quality of life. Further, pre- and posttraining magnetic resonance imaging (MRI) data showed neural activation changes in the middle temporal gyrus, providing insight into the neurological underpinnings of speech-gesture communication.
Difficulty with social communication is a core symptom of schizophrenia spectrum disorder (SSD). To assess the impact of MSG training on patients’ communication abilities, investigators conducted a randomized waiting list-controlled pilot trial at a university in Marburg, Germany. Patients with SSD were randomized to receive either treatment as usual (TAU) or 8 sessions of MSG.
After completing their initial treatment options, patients were switched to the other condition. Outcomes included quality of life and changes in abstract speech-gesture processing, which were captured using a standardized psychological assessment.
Imaging data were collected using a full-body MRI system while patients were exposed to video clips of an actor speaking abstract and concrete sentences. A group of healthy controls were recruited and underwent the same psychological and imaging assessments. Results were compared between patients and controls and between treatment conditions.
This trial enrolled 30 patients with schizophrenia spectrum disorder (SSD), among whom 20 received TAU followed by MSG (TAU-first) and 10 received MSG followed by TAU (MSG-first). Mean age was 35.5±11.1 years; mean disease duration was 12.2±9.1 years; 22 (75.9%) were men; and 7 (24.1%) were women.
A total of 17 healthy controls were recruited. Demographic characteristics were comparable between patients and control participants.
Compared to controls, patients with SSD has significantly lower baseline scores on the Satisfaction With Life Scale (P =.020). However, patients’ quality of life improved significantly at the posttraining assessment (P <.0001). This improvement was correlated with neural changes in the processing of abstract speech-gesture videos. Specifically, neural activation in the middle temporal gyrus was significantly different in the pre- and post-MSG assessments and was independently correlated with improvements in quality of life.
On post-training questionnaires, 94% of patients indicated that they found MSG training useful. Among surveyed relatives of patients, 53% reported an increase in the patients’ social contacts and 66% reported improvements in patients’ expressive communication skills.
These results provide the basis for further study of speech-gesture training in SSD. Study limitations include the small cohort; research in a larger patient group is necessary.
“[W]e provide [the] first promising results of a novel multimodal speech-gesture training for patients with schizophrenia,” the investigators wrote. “We could link training induced changes in speech-gesture processing to changes in quality of life, demonstrating the relevance of intact communication skills and gesture processing for well-being.”
Riedl L, Nagels A, Sammer G, et al. Multimodal speech-gesture training in patients with schizophrenia spectrum disorder: effects on quality of life and neural processing. Schizophr Res. Published online June 24, 2022. doi: 10.1016/j.schres.2022.06.009