1Psychiatry Res 2000 Sep 95: 237-43
PMID10974362
TitleFactor structure of neurologic examination abnormalities in unmedicated schizophrenia.
AbstractThe heterogeneity and uncertain significance of neurologic exam abnormalities in schizophrenia prompted us to evaluate their factor structure. We administered a modified version of the Neurological Evaluation Scale (NES) to 103 unmedicated patients with schizophrenia. Data were distilled by combining right- and left-side scores, and by eliminating superfluous, rarely abnormal and unreliable items from the analysis. Exploratory principal components analysis yielded four factors: repetitive motor tasks (fist-ring, fist-edge-palm, alternating fist-palm, dysdiadochokiNESis); cognitive-perceptual tasks (memory, audiovisual integration, right-left orientation, face-hand test, rhythm tapping reproduction); balancing tasks (Romberg, tandem gait); and the palmomental reflex. Evaluation of the relationship between these factors and clinical and demographic variables revealed a robust correlation between the cognitive-perceptual factor and full-scale IQ score. This analysis is a step toward developing empirical subscales of a modified NES, which may provide insights into the nature of neurologic impairment in schizophrenia and may prove clinically useful.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
2Neuropsychiatry Neuropsychol Behav Neurol 2000 Jul 13: 184-7
PMID10910089
TitleNeurologic examination abnormalities in schizophrenia with and without a history of alcoholism.
AbstractThe current investigation examiNES the impact of a past history of alcoholism on neurologic examination abnormalities in schizophrenia (SZ).
Individuals with SZ have a high rate of comorbid alcohol use disorders (AUDs), but relatively little is known about the potential adverse consequences of alcoholism for neuropsychological and neurologic functioning in SZ. Recent evidence suggests consistent but subtle neurocognitive differences between groups, with more prominent differences in neurologic examination abnormalities.
Thirty-three male patients with SZ or SZ/AUDs were evaluated using a modified Neurologic Evaluation Scale (NES) and ratings for positive and negative symptoms.
The SZ/AUD group exhibited a greater impairment in the Cognitive-Perceptual factor of the Neurologic Evaluation Scale. Greater impairment in the tandem-Romberg factor or in motor items was not found, nor were groups different based on positive or negative symptoms.
A history of alcoholism in SZ is associated with greater overall neurologic impairment, particularly in the area of cognitive-perceptual dysfunction, an area often found to be impaired in patients with schizophrenia without alcoholism.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
3Prog. Neuropsychopharmacol. Biol. Psychiatry 2001 Feb 25: 323-35
PMID11294479
TitleThe changes of biological markers and treatment efficacy in schizophrenia.
Abstract1. In a group of schizophrenic patients, the effect and selected parameters of biological markers were evaluated during the index hospitalisation in the acute phase of schizophrenia (n = 30) and then after one year of ambulatory treatment. 2. During the acute treatment, a significant drop in symptomatology was recorded in average; an analogical tendency was observed further on, too. Apart from that, a significant change was observed in 5/41 parameters being monitored (the pair t-test): I) decrease in the total NES score, II) decrease in the sensorial integration subscale NES score, III) increase in psychomotor speed, IV) decrease in auditory reaction time, V) increase in basal cortisol. 3. In the comparison of the successfully (severity of illNESs after one year = 1, 2) and unsuccessfully (severity of illNESs after one year > or =3) treated patients in the beginning of treatment in the acute phase, the unsuccessful group had a significantly higher score of negative symptomatology, and by the end of the acute treatment, again, a significantly higher score of negative symptomatology, a higher total PANSS score and a greater severity of illNESs. 4. In the acute phase, the successful group had a significantly better score in individual items of the Contemporary Memory Scale and a significantly worse performance and goal-aimed concentration in the Bourdon test than the unsuccessfully treated one; apart from that, it had a significantly higher cortisol level after dexamethasone, which was also reflected in the lower percentage rate of dexamethasone nonsupression. 5. In the course of the year, a drop in the total NES score for the individual subscales occurred; a significant drop was observed in the sensory integration subscale. The worse concentration items improved significantly in the successful group in contrast to the unsuccessful group, where they showed a downgrade tendency. Changes in Contemporary Memory Scale were negligible and mostly below statistical significance. Apart from that, a drop in basal cortisolemia occurred in the successful group and an increase in cortisolemia after administering dexamethasone was registered in the unsuccessful group. 6. The more successful group had a significantly lower NES score, a significantly better visual reaction time and a smaller forgetting item (in percentiles) after the one-year period.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
4Prog. Neuropsychopharmacol. Biol. Psychiatry 2001 Feb 25: 323-35
PMID11294479
TitleThe changes of biological markers and treatment efficacy in schizophrenia.
Abstract1. In a group of schizophrenic patients, the effect and selected parameters of biological markers were evaluated during the index hospitalisation in the acute phase of schizophrenia (n = 30) and then after one year of ambulatory treatment. 2. During the acute treatment, a significant drop in symptomatology was recorded in average; an analogical tendency was observed further on, too. Apart from that, a significant change was observed in 5/41 parameters being monitored (the pair t-test): I) decrease in the total NES score, II) decrease in the sensorial integration subscale NES score, III) increase in psychomotor speed, IV) decrease in auditory reaction time, V) increase in basal cortisol. 3. In the comparison of the successfully (severity of illNESs after one year = 1, 2) and unsuccessfully (severity of illNESs after one year > or =3) treated patients in the beginning of treatment in the acute phase, the unsuccessful group had a significantly higher score of negative symptomatology, and by the end of the acute treatment, again, a significantly higher score of negative symptomatology, a higher total PANSS score and a greater severity of illNESs. 4. In the acute phase, the successful group had a significantly better score in individual items of the Contemporary Memory Scale and a significantly worse performance and goal-aimed concentration in the Bourdon test than the unsuccessfully treated one; apart from that, it had a significantly higher cortisol level after dexamethasone, which was also reflected in the lower percentage rate of dexamethasone nonsupression. 5. In the course of the year, a drop in the total NES score for the individual subscales occurred; a significant drop was observed in the sensory integration subscale. The worse concentration items improved significantly in the successful group in contrast to the unsuccessful group, where they showed a downgrade tendency. Changes in Contemporary Memory Scale were negligible and mostly below statistical significance. Apart from that, a drop in basal cortisolemia occurred in the successful group and an increase in cortisolemia after administering dexamethasone was registered in the unsuccessful group. 6. The more successful group had a significantly lower NES score, a significantly better visual reaction time and a smaller forgetting item (in percentiles) after the one-year period.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
5Br J Psychiatry 2001 Jun 178: 524-30
PMID11388968
TitleNeurodevelopmental indices and the development of psychotic symptoms in subjects at high risk of schizophrenia.
AbstractNeurological 'soft signs' and minor physical anomalies (MPAs) are reported to be more frequent in patients with schizophrenia than in controls.
To determine whether these disturbances are genetically mediated, and whether they are central to the geNESis of symptoms or epiphenomena.
We obtained ratings in 152 individuals who were antipsychotic drug-free and at high risk, some of whom had experienced psychotic symptoms, as well as 30 first-episode patients and 35 healthy subjects.
MPAs and Neurological Evaluation Scale (NES) 'sensory integration abnormalities' were more frequent in high-risk subjects than in healthy controls, but there were no reliable differences between high-risk subjects with and without psychotic symptoms. MPAs were most frequent in high-risk subjects with least genetic liability and NES scores showed no genetic associations.
The lack of associations with psychotic symptoms and genetic liability to schizophrenia suggests that soft signs and physical anomalies are nonspecific markers of developmental deviance that are not mediated by the gene(s) for schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
6Epilepsy Behav 2001 Dec 2: 568-573
PMID12609391
TitleEvidence That Emotional Maladjustment Is Worse in Men Than in Women with Psychogenic Nonepileptic Seizures.
AbstractThe purpose of this study is to examine the effects of gender on adjustment and cognition in patients with psychogenic nonepileptic seizures (NES) and on patients with epilepsy. We compared 57 women and 27 men, all at least 16 years old, with only NES as documented by long-term EEG-video monitor studies, to equal numbers of randomly selected women and men with only epileptic seizures. Variables examined included age, age of onset, education, scales from the MMPI, the WAIS-R, and the number of tests outside normal limits from the Neuropsychological Battery for Epilepsy. We found no significant differences in mean age, intelligence, or percentage of neuropsychological tests outside normal limits across the four groups. Women and men with NES had significantly later age of onset of attacks compared with subjects of either gender with epilepsy (26 years vs 13 years, P < 0.001) and men with NES had greater educational achievement than women with NES or patients with epilepsy (P < 0.02). However, the most important findings were seen on the MMPI. Men with NES exhibited significantly greater elevations on multiple scales (especially Hysteria, Depression, Hypochondriasis, Psychoasthenia, schizophrenia) compared with men with epilepsy or women with either epilepsy or NES. We conclude that men with NES have significantly worse patterns of emotional adjustment, as measured by the MMPI, than women with NES or subjects of either gender with epilepsy.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
7Nord J Psychiatry 2002 -1 56: 425-31
PMID12495537
TitleNeurological soft signs (NSS) in 200 treatment-na´ve cases with schizophrenia: a community-based study in a rural setting.
AbstractSeveral studies have reported neurological soft signs (NSS) to be common in individuals with schizophrenia. The majority of these studies are based on clinical samples exposed to neuroleptic treatment. The present study reports on 200 treatment-na´ve and community-identified cases of schizophrenia and 78 healthy individuals from the same area, evaluated using the Neurological Evaluation Scale (NES). The median NES score was 5.0 for cases of schizophrenia and 1.5 for healthy subjects. The impairment rate of NSS in cases with schizophrenia was 65.0% against 50.0% in healthy subjects, and the difference was statistically significant (chi2 = 5.30; df = 1; P < 0.021). NSS abnormality is as common in treatment-na´ve cases as reported in many studies in those on neuroleptic medication. There was no significant relation between the NSS impairment and duration of illNESs, remission status, positive symptoms, negative symptoms and disorganized symptoms.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
8Prog. Neuropsychopharmacol. Biol. Psychiatry 2002 Jun 26: 935-8
PMID12369269
TitleThe hypothalamic-pituitary-adrenal axis in chronic schizophrenic patients long-term treated with neuroleptics.
AbstractThe authors investigated the hypothalamic-pituitary-adrenal (HPA) axis of regularly medicated schizophrenic patients.
The subjects were 53 patients who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) criteria for schizophrenia. Each patients gave informed consent for the research. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Based on the dosages of neuroleptics (NLPs), the subjects were classified into two groups: those with lower dosages (LD) and those with higher dosages (HD).
(a) The medicated schizophrenic patients had significantly higher plasma corticotropin (ACTH) levels than the normals. (b) There was no significant difference in plasma cortisol levels between the schizophrenic patients and normals. (c) There was a significant difference in plasma ACTH levels between the HD and normal groups, but not between the LD and normal groups. (d) There was no significant difference in administration periods of NLPs, positive (POS) or negative symptoms (NES) between the HD and LD groups. (e) There was a positive correlation between the plasma ACTH and plasma cortisol levels in patients.
Our results showed that, in chronic schizophrenic patients long-term treated with NLPs, ACTH secretion was elevated.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
9Prog. Neuropsychopharmacol. Biol. Psychiatry 2002 Jun 26: 935-8
PMID12369269
TitleThe hypothalamic-pituitary-adrenal axis in chronic schizophrenic patients long-term treated with neuroleptics.
AbstractThe authors investigated the hypothalamic-pituitary-adrenal (HPA) axis of regularly medicated schizophrenic patients.
The subjects were 53 patients who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) criteria for schizophrenia. Each patients gave informed consent for the research. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Based on the dosages of neuroleptics (NLPs), the subjects were classified into two groups: those with lower dosages (LD) and those with higher dosages (HD).
(a) The medicated schizophrenic patients had significantly higher plasma corticotropin (ACTH) levels than the normals. (b) There was no significant difference in plasma cortisol levels between the schizophrenic patients and normals. (c) There was a significant difference in plasma ACTH levels between the HD and normal groups, but not between the LD and normal groups. (d) There was no significant difference in administration periods of NLPs, positive (POS) or negative symptoms (NES) between the HD and LD groups. (e) There was a positive correlation between the plasma ACTH and plasma cortisol levels in patients.
Our results showed that, in chronic schizophrenic patients long-term treated with NLPs, ACTH secretion was elevated.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
10Schizophr. Res. 2002 Dec 58: 241-6
PMID12409164
TitleNeurological soft signs in schizophrenic patients and their nonpsychotic siblings.
Abstract(a) To investigate the prevalence of neurological soft signs (NSS) in schizophrenic patients and their nonpsychotic siblings and (b) to examine the clinical correlates of NSS in the schizophrenic group.
Ninety-nine schizophrenic patients, 80 of their nonpsychotic siblings and 59 healthy controls were included in the study. NSS were assessed with the Neurological Evaluation Scale (NES). Psychiatric assessment of the patients was conducted with the Positive and Negative Syndrome Scale (PANSS). Siblings and the control group were evaluated with Schedules for Clinical Assessment in Neuropsychiatry (SCAN) to determine the presence of any past or current psychotic disorder.
schizophrenic patients had significantly higher scores overall and on each subscale of NES than the sibling and control groups. The sibling group's scores were intermediate between those of the schizophrenic patients and those of the healthy controls. All subscale scores and the total NES scores correlated positively with the negative symptoms subscale scores of PANSS. The general psychopathology subscale scores of PANSS also showed a positive correlation with all subscale scores of NES, except the 'sequencing of complex motor acts' subscale. The total NES scores of the patients as well as their scores for the 'sequencing of complex motor acts' and 'others' subscales were significantly correlated with the respective scores of their own siblings.
These results support the findings of previous studies suggesting that there might be common genetic and/or environmental factors in the pathogeNESis of neurological impairment in schizophrenic patients and their siblings. They also indicate that neurological soft signs in schizophrenic patients are associated with prominent negative symptoms.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
11Psychiatry Res 2003 Nov 121: 21-30
PMID14572621
TitleNeurological soft signs and neuropsychological performance in patients with first episode schizophrenia.
AbstractNeurological soft signs and neuropsychological (NP) impairments are prevalent in schizophrenic patients. However, the relationship of these deficits is rarely studied, and it remains controversial in what way soft signs influence NP performance. The Neurological Evaluation Scale (NES) and a comprehensive neuropsychological test battery were used to assess soft signs and cognitive functions in 61 first-episode schizophrenic patients. The NP test battery included tests such as the California Verbal Learning Test, the Continuous Performance Test, the Span of Apprehension Test, the Stroop Color-Word Test, the Trail-Making Test and the Wisconsin Card Sorting Test. The NP tests were also administered to 87 healthy controls. The first-episode schizophrenic patients were split along the median of their NES total score (SS- vs. SS+). The level of NP performance and the differences in relative performance (shape of the NP profile) on NP functions between the two groups were assessed. The two groups (SS- vs. SS+) did not differ in any demographic or clinical variable. However, they differed in the level of their NP performance (profile mean) but did not show differential deficits in NP performance (profile shape). Neurologic soft signs influence NP performance and are correlated to a generalized NP deficit rather than to any specific NP functions.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
12Psychiatry Res 2003 Nov 121: 21-30
PMID14572621
TitleNeurological soft signs and neuropsychological performance in patients with first episode schizophrenia.
AbstractNeurological soft signs and neuropsychological (NP) impairments are prevalent in schizophrenic patients. However, the relationship of these deficits is rarely studied, and it remains controversial in what way soft signs influence NP performance. The Neurological Evaluation Scale (NES) and a comprehensive neuropsychological test battery were used to assess soft signs and cognitive functions in 61 first-episode schizophrenic patients. The NP test battery included tests such as the California Verbal Learning Test, the Continuous Performance Test, the Span of Apprehension Test, the Stroop Color-Word Test, the Trail-Making Test and the Wisconsin Card Sorting Test. The NP tests were also administered to 87 healthy controls. The first-episode schizophrenic patients were split along the median of their NES total score (SS- vs. SS+). The level of NP performance and the differences in relative performance (shape of the NP profile) on NP functions between the two groups were assessed. The two groups (SS- vs. SS+) did not differ in any demographic or clinical variable. However, they differed in the level of their NP performance (profile mean) but did not show differential deficits in NP performance (profile shape). Neurologic soft signs influence NP performance and are correlated to a generalized NP deficit rather than to any specific NP functions.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
13Eur Arch Psychiatry Clin Neurosci 2003 Oct 253: 221-7
PMID14504990
TitleReexamination of the characteristics of the deficit schizophrenia patients.
AbstractThe aim of this study was to reexamine and compare the characteristics of the deficit and nondeficit schizophrenic patients. This cross-sectional study consisted of 62 in- and out-patients, 18-65 years of age, diagnosed with schizophrenia according to DSM-IV. The sociodemographic variables, premorbid adjustment, clinical course and general functioning level in the past five years were evaluated by utilizing the appropriate sections of Comprehensive Assessment of Symptoms and History (CASH). In addition, GAF, the Schedule for the Deficit Syndrome (SDS), Positive and Negative Syndrome Scale (PANSS), Montgomery Asberg Depression Scale (MADRS), the Neurological Evaluation Scale (NES) and the Simpson Angus Extrapyramidal Side Effects (EPS) Rating Scale, Trail A and B, Verbal Fluency, Stroop, Block Design and Finger Tapper tests were administered. Using the SDS, 19 patients (30.6 %) were categorized as deficit; 43 (69.4 %) were categorized as nondeficit. The deficit patients were worse on the Functioning During Past Five Years score of CASH. The PANSS and MADRS mean scores were not significantly different between the two groups, except a higher level of negative symptoms observed in the deficit group. NES scores were also significantly higher in the deficit group. However, sociodemographic and other clinical variables, neurocognitive measures and EPS symptoms did not show any significant difference between the two groups. Our findings suggest that the deficit schizophrenia is a distinct subgroup comprised of patients who have more negative symptoms, neurological impairment and poor functioning which may have a common underlying pathology.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
14Eur Arch Psychiatry Clin Neurosci 2003 Oct 253: 221-7
PMID14504990
TitleReexamination of the characteristics of the deficit schizophrenia patients.
AbstractThe aim of this study was to reexamine and compare the characteristics of the deficit and nondeficit schizophrenic patients. This cross-sectional study consisted of 62 in- and out-patients, 18-65 years of age, diagnosed with schizophrenia according to DSM-IV. The sociodemographic variables, premorbid adjustment, clinical course and general functioning level in the past five years were evaluated by utilizing the appropriate sections of Comprehensive Assessment of Symptoms and History (CASH). In addition, GAF, the Schedule for the Deficit Syndrome (SDS), Positive and Negative Syndrome Scale (PANSS), Montgomery Asberg Depression Scale (MADRS), the Neurological Evaluation Scale (NES) and the Simpson Angus Extrapyramidal Side Effects (EPS) Rating Scale, Trail A and B, Verbal Fluency, Stroop, Block Design and Finger Tapper tests were administered. Using the SDS, 19 patients (30.6 %) were categorized as deficit; 43 (69.4 %) were categorized as nondeficit. The deficit patients were worse on the Functioning During Past Five Years score of CASH. The PANSS and MADRS mean scores were not significantly different between the two groups, except a higher level of negative symptoms observed in the deficit group. NES scores were also significantly higher in the deficit group. However, sociodemographic and other clinical variables, neurocognitive measures and EPS symptoms did not show any significant difference between the two groups. Our findings suggest that the deficit schizophrenia is a distinct subgroup comprised of patients who have more negative symptoms, neurological impairment and poor functioning which may have a common underlying pathology.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
15J Affect Disord 2004 Jun 80: 221-30
PMID15207935
TitleNeurological soft signs in bipolar I disorder patients.
AbstractNeurological soft signs (NSS) have been reported to be more prevalent in patients with schizophrenia compared to other psychiatric and non-psychiatric controls. However, this issue in bipolar I disorder seems to be understudied.
The aims of the study were to examine the extent to which NSS are associated with bipolar I disorder cases compared to healthy controls, to assess the possible relationship between NSS and clinical dimensions of the disorder, and to explore the association of sociodemographic characteristics with the occurrence of NSS in cases with this disorder.
Predominantly treatment na´ve cases of bipolar I disorder from rural communities were assessed for NSS using the Neurological Evaluation Scale (NES).
This study showed that patients with bipolar I disorder performed significantly worse on two NES items from the sensory integration subscale, on one item from motor coordination and on four items from the 'others' subscale, the highest difference in performance being in items under the sequencing of complex motor acts subscale. Clinical dimensions and sociodemographic characteristics appeared to have no relationship with NES total score.
Bipolar I disorder patients seem to have more neurological dysfunction compared to healthy controls particularly in the area of sequencing of complex motor acts. In addition, the finding suggests that NSS in bipolar I disorder are stable neurological abnormalities established at its onset or may be essential characteristic features of the disorder representing stable disease process that existed long before its onset.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
16Eur Arch Psychiatry Clin Neurosci 2004 Jun 254: 165-71
PMID15205970
TitleThe deficit syndrome of the psychotic illness. A clinical and nosological study.
AbstractThe deficit syndrome is thought to be specific to and a subtype of schizophrenia; however, there are scarce or no data on the prevalence and characteristics of this syndrome in non-schizophrenic psychoses. The aim of this study was to explore the prevalence and correlates of different types of negative symptoms (NegS) in a mixed sample of psychotic disorders. Six-hundred and sixty psychotic inpatients were classified according to the presence and type of NegS into the following groups: no NegS, transitory NegS, persistent secondary NES, persistent doubtful secondary NegS, and persistent primary NegS (i. e., deficit symptoms). Furthermore, the nosological status of this symptom classification such as its clinical and etiological correlates were examined. Depending on the diagnostic criteria used for diagnosing schizophrenia, the prevalence of the deficit syndrome in schizophrenia and in non-schizophrenic psychoses ranged from 14%-32% and 2%-22%, respectively. Deficit syndromes in both schizophrenic and non-schizophrenic patients shared most of the syndrome-related clinical features. Regarding the associated clinical pattern, the transitory NegS group was closer to the group without NegS than to the groups with enduring NegS. Patient groups with enduring primary and enduring secondary NegS did not show relevant clinical or etiological differences, thus, suggesting that the primary versus secondary issue may be less relevant than previously acknowledged. The deficit syndrome may be diagnosed irrespective of the specific categories of psychotic disorders.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
17Eur Arch Psychiatry Clin Neurosci 2004 Jun 254: 165-71
PMID15205970
TitleThe deficit syndrome of the psychotic illness. A clinical and nosological study.
AbstractThe deficit syndrome is thought to be specific to and a subtype of schizophrenia; however, there are scarce or no data on the prevalence and characteristics of this syndrome in non-schizophrenic psychoses. The aim of this study was to explore the prevalence and correlates of different types of negative symptoms (NegS) in a mixed sample of psychotic disorders. Six-hundred and sixty psychotic inpatients were classified according to the presence and type of NegS into the following groups: no NegS, transitory NegS, persistent secondary NES, persistent doubtful secondary NegS, and persistent primary NegS (i. e., deficit symptoms). Furthermore, the nosological status of this symptom classification such as its clinical and etiological correlates were examined. Depending on the diagnostic criteria used for diagnosing schizophrenia, the prevalence of the deficit syndrome in schizophrenia and in non-schizophrenic psychoses ranged from 14%-32% and 2%-22%, respectively. Deficit syndromes in both schizophrenic and non-schizophrenic patients shared most of the syndrome-related clinical features. Regarding the associated clinical pattern, the transitory NegS group was closer to the group without NegS than to the groups with enduring NegS. Patient groups with enduring primary and enduring secondary NegS did not show relevant clinical or etiological differences, thus, suggesting that the primary versus secondary issue may be less relevant than previously acknowledged. The deficit syndrome may be diagnosed irrespective of the specific categories of psychotic disorders.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
18Psychiatry Clin. Neurosci. 2004 Jun 58: 274-9
PMID15149293
TitleNeurological soft signs in schizophrenic patients with obsessive-compulsive disorder.
AbstractThe purpose of this study was to examine neurological soft signs (NSS) in schizophrenic patients with obsessive-compulsive disorder (OCD). Neurological soft signs were assessed in 15 schizophrenic patients with OCD (OCD-schizophrenia), 38 schizophrenia patients without OCD (non-OCD-schizophrenia), and 24 healthy controls (HC) by means of the Neurological Evaluation Scale (NES). The OCD-schizophrenia group had significantly higher scores on total and subscales of 'sensory integration' and 'others' of NES than the HC group. Subscale scores of 'sequencing of motor acts' in-non-OCD-schizophrenia patients were significantly higher compared to OCD-schizophrenia patients. Total NES scores of both groups were significantly correlated with Scale for the Assessment of Negative Symptoms (SANS) scores. Only the subscale of 'sequencing of motor acts' was significantly correlated with SANS within the OCD-schizophrenia group. These results suggest that NSS do not significantly differ between schizophrenia patients with and without OCD, contrary to expectations. The NES scores in OCD-schizophrenic patients do not appear to be related to a more severe form of schizophrenia. Neurological signs and negative symptoms in schizophrenia patients with and without OCD may be considered as neurodevelopmental predisposing factors. Further research is required in schizophrenia patients with OCD to investigate the relationships between NSS and several neuroimaging or neuropsychological findings, constituting a subgroup within the schizophrenia spectrum.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
19Psychiatry Clin. Neurosci. 2004 Jun 58: 274-9
PMID15149293
TitleNeurological soft signs in schizophrenic patients with obsessive-compulsive disorder.
AbstractThe purpose of this study was to examine neurological soft signs (NSS) in schizophrenic patients with obsessive-compulsive disorder (OCD). Neurological soft signs were assessed in 15 schizophrenic patients with OCD (OCD-schizophrenia), 38 schizophrenia patients without OCD (non-OCD-schizophrenia), and 24 healthy controls (HC) by means of the Neurological Evaluation Scale (NES). The OCD-schizophrenia group had significantly higher scores on total and subscales of 'sensory integration' and 'others' of NES than the HC group. Subscale scores of 'sequencing of motor acts' in-non-OCD-schizophrenia patients were significantly higher compared to OCD-schizophrenia patients. Total NES scores of both groups were significantly correlated with Scale for the Assessment of Negative Symptoms (SANS) scores. Only the subscale of 'sequencing of motor acts' was significantly correlated with SANS within the OCD-schizophrenia group. These results suggest that NSS do not significantly differ between schizophrenia patients with and without OCD, contrary to expectations. The NES scores in OCD-schizophrenic patients do not appear to be related to a more severe form of schizophrenia. Neurological signs and negative symptoms in schizophrenia patients with and without OCD may be considered as neurodevelopmental predisposing factors. Further research is required in schizophrenia patients with OCD to investigate the relationships between NSS and several neuroimaging or neuropsychological findings, constituting a subgroup within the schizophrenia spectrum.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
20Psychiatry (Edgmont) 2005 Jan 2: 47-9
PMID21179643
TitleEvaluating the use of the wilbarger intervention with schizophrenic patients: a pilot study.
AbstractIndividuals with schizophrenia have difficulty processing sensory information. The authors hypothesized that the Wilbarger intervention, an occupational therapy technique successfully used to treat children with sensory integration deficits, might prove beneficial if used with schizophrenic patients. Thirty inpatients diagnosed with schizophrenia or schizoaffective disorders voluntarily participated. Each was evaluated using the sensory integration subscale of the Neurological Evaluation Scale (NES) both pre- and post-intervention. The Wilbarger was scheduled to be administered five times per day for seven days per week for four weeks. Participants averaged 19.5 days (mean) in the study (median=27.5 days) and received 80.4 (mean) (106.5 median) interventions.Those receiving 90 or more interventions improved significantly on the graphesthesia subtest (t(28)=2.498; p<0.019), the right/left confusion subtest (t(28)=2.373; p<0.025) and the post-total score (t(28)=2.184; p<0.037). Sensory subscales of the NES statistically improved after use of the Wilbarger intervention. Further studies are planned to determine the duration and clinical significance of the noted changes.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
21Psychiatry (Edgmont) 2005 Jan 2: 47-9
PMID21179643
TitleEvaluating the use of the wilbarger intervention with schizophrenic patients: a pilot study.
AbstractIndividuals with schizophrenia have difficulty processing sensory information. The authors hypothesized that the Wilbarger intervention, an occupational therapy technique successfully used to treat children with sensory integration deficits, might prove beneficial if used with schizophrenic patients. Thirty inpatients diagnosed with schizophrenia or schizoaffective disorders voluntarily participated. Each was evaluated using the sensory integration subscale of the Neurological Evaluation Scale (NES) both pre- and post-intervention. The Wilbarger was scheduled to be administered five times per day for seven days per week for four weeks. Participants averaged 19.5 days (mean) in the study (median=27.5 days) and received 80.4 (mean) (106.5 median) interventions.Those receiving 90 or more interventions improved significantly on the graphesthesia subtest (t(28)=2.498; p<0.019), the right/left confusion subtest (t(28)=2.373; p<0.025) and the post-total score (t(28)=2.184; p<0.037). Sensory subscales of the NES statistically improved after use of the Wilbarger intervention. Further studies are planned to determine the duration and clinical significance of the noted changes.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
22J Clin Psychopharmacol 2005 Aug 25: 372-5
PMID16012282
TitleNeurologic soft signs in schizophrenic patients treated with conventional and atypical antipsychotics.
AbstractNeurologic soft signs (NSS) are considered a somatic feature associated with schizophrenia (DSM-IV) that are present in neuroleptic-treated, as well as untreated or first-episode patients. The aim of this study was to determine the incidence and severity of NSS in groups of schizophrenic patients treated with either a conventional neuroleptic medication, haloperidol (n = 37), or atypical antipsychotic medications, risperidone (n = 19), clozapine (n = 34), and olanzapine (n = 18). NSS were assessed with the Neurological Evaluation Scale (NES), whereas extrapyramidal symptoms (EPS), which occur more commonly with conventional neuroleptic treatment, were evaluated using the Simpson-Angus Scale. NES scores were not significantly different between groups. Slight differences were found for 2 items only. The haloperidol group showed higher scores for the "Romberg test," whereas the clozapine group showed higher scores for "short-term memory." There were significant correlations between EPS and NES total score in the haloperidol and risperidone groups. These results demonstrate an overall overlapping of NSS among the groups, confirming their substantial independence from neurologic implications of neuroleptic treatment.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
23J Clin Psychopharmacol 2005 Aug 25: 372-5
PMID16012282
TitleNeurologic soft signs in schizophrenic patients treated with conventional and atypical antipsychotics.
AbstractNeurologic soft signs (NSS) are considered a somatic feature associated with schizophrenia (DSM-IV) that are present in neuroleptic-treated, as well as untreated or first-episode patients. The aim of this study was to determine the incidence and severity of NSS in groups of schizophrenic patients treated with either a conventional neuroleptic medication, haloperidol (n = 37), or atypical antipsychotic medications, risperidone (n = 19), clozapine (n = 34), and olanzapine (n = 18). NSS were assessed with the Neurological Evaluation Scale (NES), whereas extrapyramidal symptoms (EPS), which occur more commonly with conventional neuroleptic treatment, were evaluated using the Simpson-Angus Scale. NES scores were not significantly different between groups. Slight differences were found for 2 items only. The haloperidol group showed higher scores for the "Romberg test," whereas the clozapine group showed higher scores for "short-term memory." There were significant correlations between EPS and NES total score in the haloperidol and risperidone groups. These results demonstrate an overall overlapping of NSS among the groups, confirming their substantial independence from neurologic implications of neuroleptic treatment.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
24Schizophr. Res. 2005 Jun 75: 55-64
PMID15820324
TitleThe effects of antipsychotic medication on factor and cluster structure of neurologic examination abnormalities in schizophrenia.
AbstractThis study extends a previous study of the factor structure of the neurologic examination in unmedicated schizophrenia, utilizing cluster analysis and adding a medicated condition. We administered a modified version of the Neurologic Evaluation Scale (NES) on two occasions to 80 patients with schizophrenia or schizoaffective disorder, once while on antipsychotic medications and once while off medication. Data were distilled by combining right- and left-side scores, and by excluding rarely abnormal and unreliable items from the analysis. Principal components analysis yielded an intuitive four-factor solution in the unmedicated condition, but an inscrutable five-factor solution during medication. Cluster analysis revealed three groups: normal, cognitively impaired, and diffusely impaired. These results were also less interpretable with data from the medicated condition. Neurologic performance was better in the medicated than in the unmedicated condition. As is the case with other domains of symptoms and performance in schizophrenia, relationships among neurologic exam variables are altered by the presence of antipsychotic medication.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
25Psychiatry Res 2005 Jan 133: 65-71
PMID15698678
TitleConfirmatory factor analysis of the Neurological Evaluation Scale in unmedicated schizophrenia.
AbstractFactor structure of the Neurological Evaluation Scale (NES) was evaluated in 95 unmedicated patients with schizophrenia using confirmatory factor analysis (CFA). CFA was used to test four competing models that were based on prior empirical work examining the factor structure of the NES, as well as on theoretical considerations. A three-factor solution composed of "repetitive motor," "cognitive-perceptual," and "balance-tandem" factors best accounted for the data. These findings are consistent with prior exploratory studies that have suggested the NES is a multidimensional procedure that assesses diverse neurological domains. The current results contribute to the development of empirical subscales for neurological assessment procedures to be used in psychiatric conditions.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
26Schizophr. Res. 2005 Jun 75: 35-44
PMID15820322
TitleNeurological abnormalities in first-episode schizophrenia: temporal stability and clinical and outcome correlates.
AbstractNeurological abnormalities in subjects with schizophrenia have been regarded as diagnostically non-specific and non-localising. This study assessed the temporal stability of neurological abnormalities in subjects with first-episode schizophrenia over the course of 12 months. We also examined their relationships with psychiatric symptoms, medication effects and treatment outcome.
The sample comprised 66 largely medication-naive subjects who were treated according to a fixed protocol. We performed a factor analysis of the Neurological Evaluation Scale (NES) items, and relationships between the NES factors and various clinical and outcome measures were explored.
Five NES factors were identified, explaining 68.4% of the variance. While the NES total scores did not change significantly over time, poor performance on motor sequencing tests was related to longer duration of untreated psychosis, and showed a tendency to improve as psychiatric symptoms resolved. The most interesting finding was that high scores on the motor sequencing factor predicted the emergence of persistent dyskiNESia at 24 months (ANCOVAR F(1, 20) = 19.287, p = 0.0002).
Two NES factors (motor sequencing and attention) are reasonably replicable across samples, and have potential relevance for the further exploration of the pathogeNESis of schizophrenia, as well as possible clinical applications.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
27Int J Psychiatry Clin Pract 2005 -1 9: 238-43
PMID24930920
TitleDyskinesia and soft neurological signs in schizophrenia: a comparative study.
AbstractObjective. Several neurological abnormalities can be found at a greater frequency in patients with schizophrenia, including neurological soft signs (NSS) and signs of the "pyramidal" and "extrapyramidal" systems. We aimed to explore the frequency of movement disorders in patients with antipsychotic na´ve schizophrenia and to compare and contrast with antipsychotic-treated patients and healthy controls. Methods. Twenty-two antipsychotic naive schizophrenic patients, 22 antipsychotic treated patients and 22 healthy control subjects were assessed by Neurological Evaluation (NES), Abnormal Involuntary Movements (AIMS), and Positive and Negative Syndrome (PANSS) Scales. Results. The NES scores of the never-medicated schizophrenic group were significantly higher than those of normal controls but did not differ significantly from the medicated group. DyskiNESia rates in the both schizophrenic groups were higher than in healthy controls. Medicated and non-medicated schizophrenic patient scores did not differ in AIMS with regard to facial and oral movements, but medicated patients scored higher than non-medicated subjects with respect to extremity movements. Conclusion. Our data suggest that: soft neurological signs and abnormal involuntary movements in the facial region are more prevalent in patients with schizophrenia, whether they are medicated or antipsychotic na´ve. On the contrary, abnormal involuntary movements in the trunk and the extremities seem to be associated with medication.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
28Int J Psychiatry Clin Pract 2005 -1 9: 238-43
PMID24930920
TitleDyskinesia and soft neurological signs in schizophrenia: a comparative study.
AbstractObjective. Several neurological abnormalities can be found at a greater frequency in patients with schizophrenia, including neurological soft signs (NSS) and signs of the "pyramidal" and "extrapyramidal" systems. We aimed to explore the frequency of movement disorders in patients with antipsychotic na´ve schizophrenia and to compare and contrast with antipsychotic-treated patients and healthy controls. Methods. Twenty-two antipsychotic naive schizophrenic patients, 22 antipsychotic treated patients and 22 healthy control subjects were assessed by Neurological Evaluation (NES), Abnormal Involuntary Movements (AIMS), and Positive and Negative Syndrome (PANSS) Scales. Results. The NES scores of the never-medicated schizophrenic group were significantly higher than those of normal controls but did not differ significantly from the medicated group. DyskiNESia rates in the both schizophrenic groups were higher than in healthy controls. Medicated and non-medicated schizophrenic patient scores did not differ in AIMS with regard to facial and oral movements, but medicated patients scored higher than non-medicated subjects with respect to extremity movements. Conclusion. Our data suggest that: soft neurological signs and abnormal involuntary movements in the facial region are more prevalent in patients with schizophrenia, whether they are medicated or antipsychotic na´ve. On the contrary, abnormal involuntary movements in the trunk and the extremities seem to be associated with medication.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
29Schizophr. Res. 2006 Sep 86: 172-80
PMID16854564
TitleAre neurologic examination abnormalities heritable? A preliminary study.
AbstractNeurologic examination abnormalities (NEA) are more prevalent among patients with schizophrenia as well as their unaffected relatives when compared with healthy controls, suggesting that NEA may be endophenotypes for schizophrenia. We estimated the heritability of NEA in moderately sized pedigrees. We also evaluated correlations between NEA and cognitive performance in order to examine their construct validity.
Members of eight extended families, each consisting of two first degree relatives with schizophrenia/schizoaffective disorders, as well as available first- to fifth-degree relatives were examined (n=96 participants). A modification of the Neurological Evaluation Scale (NES) was employed, augmented with localizing signs. Where feasible, we used untransformed data such as error counts and completion time, rather than ordinal measures. Heritability was estimated using the variance component method, implemented in SOLAR.
Statistically significant heritability (h2) estimates were obtained for several measures (p<0.05, h2+/-standard error: rapid alternating movements, right-sided completion time, 0.99+/-0.19; alternating fist-palm test, completion time, 0.77+/-0.19 s, errors, 0.70+/-0.32; fist-ring test, right-sided completion time, 0.53+/-0.23 s, left-sided completion time, 0.70+/-0.21 s; go-no go task, correct responses, 0.93+/-0.33; audio-visual integration, correct responses, 0.79+/-0.54). For most items, heritability analysis was hampered by insufficient data variability (infrequent errors). Correlational analyses show some degree of divergence among types of NEA, repetitive motor tasks being associated with most domains of cognitive functioning other than executive functioning, and cognitive-perceptual tasks being associated with memory and executive functioning.
Significant familial influences on certain aspects of neurologic performance were detected. These heritable measures were also correlated with heritable neurocognitive measures.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
30Schizophr. Res. 2006 Jun 84: 365-77
PMID16630708
TitleFactor structure of the Neurological Evaluation Scale in a predominantly African American sample of patients with schizophrenia, unaffected relatives, and non-psychiatric controls.
AbstractThis study aimed to identify latent factors of the most widely used scale to measure neurological soft signs, the Neurological Evaluation Scale (NES), in a sample of schizophrenia patients, their relatives, and non-psychiatric controls.
The NES was administered following the format and instructions of the original scale [Buchanan, R.W., Heinrichs, D.W., 1989. The Neurological Evaluation Scale (NES): a structured instrument for the assessment of neurological signs in schizophrenia. Psychiatry Res. 27, 335-350]. Three factor analyses were conducted using: (1) 23 items of the scale, (2) these 23 items in a sample restricted to African American participants, and (3) 12 items previously recommended based on adequate inter-rater reliability [Sanders, R.D., Forman, S.D., Pierri, J.N., Baker, R.W., Kelley, M.E., van Kammen, D.P., Keshavan, M.S., 1998. Inter-rater reliability of the neurological examination in schizophrenia. Schizophr. Res. 29, 287-292].
Exploratory factor analysis in the overall sample (n = 110) revealed three factors of interest: a "coordination/Romberg" factor (which included the fist-edge-palm test, finger-thumb opposition, rapid alternating movements, and the Romberg test), a "sensory integration" factor (which included synkiNESis, extinction, stereognosis, and audio-visual integration), and an "eye movements/tandem walk/overflow movements" factor (which included convergence, gaze impersistence, tandem walk, and adventitious overflow). Minimal differences were apparent when comparing these results with those obtained from an analysis including only African American participants (n = 99). Restricting the analysis to only 12 items resulted in two factors (with poor discriminant validity and internal consistency), which showed few similarities with previously reported exploratory factor analysis results.
This study shows that results of empirically-derived factors of the NES vary substantially across study samples and research groups, though there appear to be at least two consistent latent variables, one related to the repetition of motor tasks and another tapping the processing of sensory stimuli. The factors demonstrated in the present study are more consistent with the original conceptually-derived subscales than prior factor analyses. Thus, until further research replicates consistent subscales of subtle neurological impairment in a variety of settings and samples, the total NES score may be more useful when comparing results across studies. Further research on latent neurological factors is needed.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
31Psychiatry Res 2006 Dec 145: 241-8
PMID17070933
TitleSchizo-obsessive and obsessive-compulsive disorder: comparison of clinical characteristics and neurological soft signs.
AbstractThe purpose of the study was to examine whether schizophrenia with obsessive-compulsive disorder (OCD) represents a severe form of OCD-spectrum disorders on the basis of neurological soft signs (NSS) and obsessive-compulsive (OC) symptoms. Sixteen patients with OCD-schizophrenia, 25 OCD patients and 23 healthy controls (HC) were studied. Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), Clinical Global Impressions Scale and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess the schizophrenic and OC symptomatology. NSS were evaluated with the Neurological Evaluation Scale (NES). OCD-schizophrenics had significantly higher scores on total NES than HC. The patients with OCD were more likely to have total Y-BOCS and subscale scores of compulsions than patients with OCD-schizophrenia. The rate of symmetry obsessions and cleaning/washing compulsions were significantly higher in patients with OCD compared to OCD-schizophrenics. We have found no correlation of OC symptoms with schizophrenic symptomatology. Our findings may suggest that OCD-schizophrenia is a distinct subtype of schizophrenia, not a more severe form of OCD-spectrum disorder.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
32Psychiatry Res 2006 Dec 145: 241-8
PMID17070933
TitleSchizo-obsessive and obsessive-compulsive disorder: comparison of clinical characteristics and neurological soft signs.
AbstractThe purpose of the study was to examine whether schizophrenia with obsessive-compulsive disorder (OCD) represents a severe form of OCD-spectrum disorders on the basis of neurological soft signs (NSS) and obsessive-compulsive (OC) symptoms. Sixteen patients with OCD-schizophrenia, 25 OCD patients and 23 healthy controls (HC) were studied. Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), Clinical Global Impressions Scale and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess the schizophrenic and OC symptomatology. NSS were evaluated with the Neurological Evaluation Scale (NES). OCD-schizophrenics had significantly higher scores on total NES than HC. The patients with OCD were more likely to have total Y-BOCS and subscale scores of compulsions than patients with OCD-schizophrenia. The rate of symmetry obsessions and cleaning/washing compulsions were significantly higher in patients with OCD compared to OCD-schizophrenics. We have found no correlation of OC symptoms with schizophrenic symptomatology. Our findings may suggest that OCD-schizophrenia is a distinct subtype of schizophrenia, not a more severe form of OCD-spectrum disorder.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
33Psychiatry Res 2006 Dec 145: 241-8
PMID17070933
TitleSchizo-obsessive and obsessive-compulsive disorder: comparison of clinical characteristics and neurological soft signs.
AbstractThe purpose of the study was to examine whether schizophrenia with obsessive-compulsive disorder (OCD) represents a severe form of OCD-spectrum disorders on the basis of neurological soft signs (NSS) and obsessive-compulsive (OC) symptoms. Sixteen patients with OCD-schizophrenia, 25 OCD patients and 23 healthy controls (HC) were studied. Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), Clinical Global Impressions Scale and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess the schizophrenic and OC symptomatology. NSS were evaluated with the Neurological Evaluation Scale (NES). OCD-schizophrenics had significantly higher scores on total NES than HC. The patients with OCD were more likely to have total Y-BOCS and subscale scores of compulsions than patients with OCD-schizophrenia. The rate of symmetry obsessions and cleaning/washing compulsions were significantly higher in patients with OCD compared to OCD-schizophrenics. We have found no correlation of OC symptoms with schizophrenic symptomatology. Our findings may suggest that OCD-schizophrenia is a distinct subtype of schizophrenia, not a more severe form of OCD-spectrum disorder.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
34Prog. Neuropsychopharmacol. Biol. Psychiatry 2006 Sep 30: 1225-30
PMID16644085
TitleAbnormal neurological signs, visual contrast sensitivity, and the deficit syndrome of schizophrenia.
AbstractThis study was designed to investigate the relationship between abnormal neurological signs, visual contrast sensitivity, and the deficit syndrome of schizophrenia. Visual contrast sensitivity for counterphase-modulated low spatial frequency gratings was measured in 32 non-deficit and 12 deficit schizophrenia patients and 20 healthy controls subjects. Abnormal neurological signs were evaluated with the Neurological Evaluation Scale (NES). Compared with the controls, patients with schizophrenia displayed impaired visual contrast sensitivity, which was associated with sensory integration deficits, as measured with the NES. The deficit syndrome was predicted by negative symptoms and sensory integration deficits. These results suggest that early-stage perceptual dysfunctions, which may reflect the abnormality of precortical magnocellular visual pathways, are related to a specific group of abnormal neurological signs.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
35Psychiatry Res 2006 Jun 147: 47-55
PMID16545554
TitleCorrelations between clinical symptoms, working memory functions and structural brain abnormalities in men with schizophrenia.
AbstractThirteen male patients with schizophrenia and thirteen male normal control subjects were compared by magnetic resonance imaging (MRI) on volumes of the straight gyrus (SG), anterior cingulate gyrus, middle frontal gyrus, hippocampus, third ventricle, cavum septi pellucidi, total brain volume and intracranial volume. In addition, neuropsychological tasks were used to measure working memory and executive functions. Healthy volunteers and schizophrenic patients showed no significant differences in mean values for volumes of regions of interests. In the case of the SG, we found a significant difference in laterality: the tendency toward left dominance in healthy volunteers changed to significant right dominance in patients. The schizophrenic patients showed lower performance in working memory tasks, and strongly significant group differences were observed in measures of neurological signs assessed by the Neurological Evaluation Scale (NES). Negative symptoms correlated with the level of spatial working memory and executive functions. Negative symptoms also correlated with the volume of the right hippocampus, while the rate of anhedonia negatively correlated with the relative volume of the left SG.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
36Psychiatry Res 2006 Jun 147: 47-55
PMID16545554
TitleCorrelations between clinical symptoms, working memory functions and structural brain abnormalities in men with schizophrenia.
AbstractThirteen male patients with schizophrenia and thirteen male normal control subjects were compared by magnetic resonance imaging (MRI) on volumes of the straight gyrus (SG), anterior cingulate gyrus, middle frontal gyrus, hippocampus, third ventricle, cavum septi pellucidi, total brain volume and intracranial volume. In addition, neuropsychological tasks were used to measure working memory and executive functions. Healthy volunteers and schizophrenic patients showed no significant differences in mean values for volumes of regions of interests. In the case of the SG, we found a significant difference in laterality: the tendency toward left dominance in healthy volunteers changed to significant right dominance in patients. The schizophrenic patients showed lower performance in working memory tasks, and strongly significant group differences were observed in measures of neurological signs assessed by the Neurological Evaluation Scale (NES). Negative symptoms correlated with the level of spatial working memory and executive functions. Negative symptoms also correlated with the volume of the right hippocampus, while the rate of anhedonia negatively correlated with the relative volume of the left SG.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
37Eur. Psychiatry 2006 Jul 21: 283-7
PMID16360308
TitleNeurological soft signs in adolescents with first episode psychosis.
AbstractThe purpose of this study is to determine the decrease of neurological soft signs (NSS) during adolescence and to compare this evolutionary process in two groups of adolescents with first episode psychosis: a) schizophrenia and b) non-schizophrenia patients. The structured neurological evaluation scale (NES) was administered to 24 adolescents with first episode psychosis. The number of NSS, the total and subscales scores were correlated with age in patients and in 39 healthy controls. Adolescents with first-episode psychosis had a higher prevalence of NSS than healthy controls; the schizophrenia patients (N=9) scored higher than non-schizophrenia patients (N=15). The number of NSS, total score and the scores on three of the four NES subscales correlated inversely with age in the healthy control group. No correlation was found for the schizophrenia group. For the non-schizophrenia group, a significant negative correlation was found only in one subscale. The decrease of NSS during adolescence in the healthy population but not in the patient groups with psychosis may be an indicator of a disturbance of brain processes that occurs during development. We did not find a clear pattern of NSS that distinguished schizophrenia from other psychoses.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
38Prog. Neuropsychopharmacol. Biol. Psychiatry 2006 Jan 30: 141-3
PMID16023278
TitleNeurological soft signs and positive treatment response to olanzapine in chronic schizophrenia.
AbstractThe goal of this study is to examine if Neurological Soft Signs (NSS) scores may improve on an 8-week olanzapine treatment in 10 patients with chronic schizophrenia. The patients were rated every 2 weeks on the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale (CGI). Baseline and endpoint NSS scores were evaluated by the Neurological Evaluation Scale (NES). The results demonstrated that baseline total PANSS and subscale scores of positive and general symptomatology, and baseline CGI scores were significantly reduced at the end of olanzapine treatment. There were no significant differences between baseline and endpoint subscale scores of negative symptomatology. We have also found no significant differences between baseline and endpoint total and subscale scores of NES. Baseline total scores of NES were significantly correlated only with negative schizophrenic symptoms at baseline. Our findings indicate that NSS may not improve in schizophrenic patients with olanzapine treatment.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
39Prog. Neuropsychopharmacol. Biol. Psychiatry 2006 Jan 30: 141-3
PMID16023278
TitleNeurological soft signs and positive treatment response to olanzapine in chronic schizophrenia.
AbstractThe goal of this study is to examine if Neurological Soft Signs (NSS) scores may improve on an 8-week olanzapine treatment in 10 patients with chronic schizophrenia. The patients were rated every 2 weeks on the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale (CGI). Baseline and endpoint NSS scores were evaluated by the Neurological Evaluation Scale (NES). The results demonstrated that baseline total PANSS and subscale scores of positive and general symptomatology, and baseline CGI scores were significantly reduced at the end of olanzapine treatment. There were no significant differences between baseline and endpoint subscale scores of negative symptomatology. We have also found no significant differences between baseline and endpoint total and subscale scores of NES. Baseline total scores of NES were significantly correlated only with negative schizophrenic symptoms at baseline. Our findings indicate that NSS may not improve in schizophrenic patients with olanzapine treatment.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
40J Neuropsychiatry Clin Neurosci 2007 -1 19: 145-50
PMID17431060
TitleNeurological soft signs in schizophrenia patients with obsessive-compulsive disorder.
AbstractObsessive-compulsive disorder is a prevalent and clinically significant phenomenon in schizophrenia patients. Both schizophrenia and obsessive-compulsive disorder (OCD) are considered to be neurodevelopmental disorders sharing dysfunctional frontal-subcortical circuitry. Using the Neurological Evaluation Scale (NES), the authors assessed neurological soft signs in 59 patients who met DSM-IV criteria for both schizophrenia and OCD. The two schizophrenia groups (with and without OCD) scored higher than the comparison group but did not significantly differ from one another on any of the NES subscales. The first-episode patients in both groups scored similarly to patients with repeated hospitalizations on all NES subscales. Notably, the OCD patients scored similarly to the two schizophrenia groups on the NES motor sequencing subscale. The author's findings support the notion that neurological soft signs are independent markers of brain dysfunction detectable early in the course of schizophrenia. However, they are of limited value as a putative endophenotype in a search for specific etiological mechanisms underlying a schizo-obsessive subgroup of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
41Eur. Psychiatry 2007 Nov 22: 499-504
PMID17614262
TitleNeurological soft signs and their relationship to 1-year outcome in first-episode schizophrenia.
AbstractTo examine the relationship between the severity of neurological soft signs at onset and at the 1-year follow-up of patients with schizophrenia, and to investigate temporal stability of neurological soft signs within 1year from the onset of the first episode schizophrenia.
The study included 92 first-episode male schizophrenic patients. Neurological soft signs were assessed on the Neurological Evaluation Scale (NES) during index hospitalization and at a 1-year follow-up. The patients were divided into remitters and non-remitters according to their psychiatric status assessed at the 1-year follow-up, using the Positive and Negative Syndrome Scale (PANSS).
A trend for a lower score for the NES item "others" in late remitters versus non-remitters at baseline was found during index hospitalization. At the 1-year follow-up, the overall severity of the neurological soft signs was statistically significantly higher in non-remitters than in remitters. Within 1year after index hospitalization, a significant reduction of neurological soft signs, with the exception of sensory integration, occurred in remitters. Within 1year after index hospitalization, the non-remitters reported a significant reduction of the overall NES score.
These findings in a population of patients with first episode schizophrenia are in accord with the findings of previous studies which found an association between neurological soft signs, treatment response and outcome. This association may characterize a subgroup of patients with a poor course of illNESs and outcome. Neurological soft signs might be regarded as one of the indicators of treatment outcome in patients suffering from their first episode of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
42Eur. Psychiatry 2007 Nov 22: 499-504
PMID17614262
TitleNeurological soft signs and their relationship to 1-year outcome in first-episode schizophrenia.
AbstractTo examine the relationship between the severity of neurological soft signs at onset and at the 1-year follow-up of patients with schizophrenia, and to investigate temporal stability of neurological soft signs within 1year from the onset of the first episode schizophrenia.
The study included 92 first-episode male schizophrenic patients. Neurological soft signs were assessed on the Neurological Evaluation Scale (NES) during index hospitalization and at a 1-year follow-up. The patients were divided into remitters and non-remitters according to their psychiatric status assessed at the 1-year follow-up, using the Positive and Negative Syndrome Scale (PANSS).
A trend for a lower score for the NES item "others" in late remitters versus non-remitters at baseline was found during index hospitalization. At the 1-year follow-up, the overall severity of the neurological soft signs was statistically significantly higher in non-remitters than in remitters. Within 1year after index hospitalization, a significant reduction of neurological soft signs, with the exception of sensory integration, occurred in remitters. Within 1year after index hospitalization, the non-remitters reported a significant reduction of the overall NES score.
These findings in a population of patients with first episode schizophrenia are in accord with the findings of previous studies which found an association between neurological soft signs, treatment response and outcome. This association may characterize a subgroup of patients with a poor course of illNESs and outcome. Neurological soft signs might be regarded as one of the indicators of treatment outcome in patients suffering from their first episode of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
43Schizophr. Res. 2007 Aug 94: 64-73
PMID17512173
TitleNeurological soft signs and minor physical anomalies in patients with schizophrenia and related disorders, their first-degree biological relatives, and non-psychiatric controls.
AbstractSubtle neurological impairments and inconsequential minor anomalies of the face and limbs are manifestations of neurodevelopmental and ontogenic abnormalities that are consistently found at higher rates in individuals with schizophrenia compared to healthy controls. Limited research has been conducted on these traits among biological relatives of patients with schizophrenia. This study hypothesized that the mean NSS score and the mean MPA score would be greater in patients than controls and that first-degree relatives would have intermediate scores. Furthermore, it was hypothesized that NSS scores and MPA scores would not be correlated. This study also explored correlations between patients' NSS and MPA scores and their relatives' respective scores and sought to replicate the finding that NSS are associated with negative and disorganized symptoms of schizophrenia, whereas MPAs are not.
Patients with schizophrenia and related psychotic disorders (n=73), first-degree relatives (n=44), and non-psychiatric controls (n=54) were assessed. Measures included the Neurological Evaluation Scale, a structured examination for MPAs, and the Positive and Negative Syndrome Scale in patients. Analyses accounted for clustering within families.
Both NSS and MPAs were greater in patients than controls, and first-degree relatives had intermediate scores. Furthermore, NSS and MPA scores were independent in all three groups. Correlations were found between patients' and their relatives' scores on one NES subscale (sensory integration) and total MPA score and several MPA regions (eyes, ears, and hands). This study replicated previous findings that in patients with schizophrenia, NSS are associated with negative, disorganized, and other domains of symptoms. Associations between MPAs and symptoms were sparse and inconsistent.
These findings suggest that NSS and MPAs represent two quite distinct markers of risk for schizophrenia that may stem from genetic factors, as well as from environmental/developmental influences. Future research on multivariable risk prediction models may benefit from the use of somewhat independent risk markers or endophenotypes.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
44Neurosci. Lett. 2007 Feb 413: 82-7
PMID17174477
TitleNeurological soft signs and cerebral measurements investigated by means of MRI in schizophrenic patients.
AbstractNeurophysiologic research has shown a Neurological Soft Sign (NSS) characteristic prevalence in schizophrenic patients, and correlations between NSS and the most frequently cerebral alterations. The aim of this study was to investigate, by means of MRI, the quantitative alterations of cortical and subcortical structures and their correlation with NSS in a sample of schizophrenic patients. Linear measures of lateral ventricular (Evans ratio), third ventricular (Third Ventricular Width), hippocampal (Interuncal Index) and cerebellar (Verm Cerebellar Atrophy) atrophy were made on magnified MR images of 33 patients with a DSM IV diagnoses of chronic schizophrenia. NSS were evaluated with the Buchanan and Heinrichs's Neurological Evaluation Scale (NES). Lateral ventricular enlargement showed to be correlated with right stereoagnosia item (p=0.001). Hippocampal atrophy, with right stereoagnosia item (p=0.023), with forefinger-right thumb opposition (p=0.004), forefinger-left thumb opposition (p=0.029 and face-hand extinction (0.26). Third ventricle enlargement showed to be correlated with forefinger-right thumb opposition (p=0.001), forefinger-left thumb opposition(p=0.021) and total sensorial integration (p=0.012). Cerebellar atrophy showed to be correlated with rhythmic drumming item (p=0.042), forefinger-right thumb opposition (p=0.007), forefinger-left thumb opposition (p=0.026), left specular movements (p=0.049), face-hand extinction (p=0.001), right-left confusion (p=0.005) and with left forefinger-nose index (p=0.032). Results obtained confirm the correlation between NSS and neuroanatomical alterations in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
45Neurosci. Lett. 2007 Feb 413: 82-7
PMID17174477
TitleNeurological soft signs and cerebral measurements investigated by means of MRI in schizophrenic patients.
AbstractNeurophysiologic research has shown a Neurological Soft Sign (NSS) characteristic prevalence in schizophrenic patients, and correlations between NSS and the most frequently cerebral alterations. The aim of this study was to investigate, by means of MRI, the quantitative alterations of cortical and subcortical structures and their correlation with NSS in a sample of schizophrenic patients. Linear measures of lateral ventricular (Evans ratio), third ventricular (Third Ventricular Width), hippocampal (Interuncal Index) and cerebellar (Verm Cerebellar Atrophy) atrophy were made on magnified MR images of 33 patients with a DSM IV diagnoses of chronic schizophrenia. NSS were evaluated with the Buchanan and Heinrichs's Neurological Evaluation Scale (NES). Lateral ventricular enlargement showed to be correlated with right stereoagnosia item (p=0.001). Hippocampal atrophy, with right stereoagnosia item (p=0.023), with forefinger-right thumb opposition (p=0.004), forefinger-left thumb opposition (p=0.029 and face-hand extinction (0.26). Third ventricle enlargement showed to be correlated with forefinger-right thumb opposition (p=0.001), forefinger-left thumb opposition(p=0.021) and total sensorial integration (p=0.012). Cerebellar atrophy showed to be correlated with rhythmic drumming item (p=0.042), forefinger-right thumb opposition (p=0.007), forefinger-left thumb opposition (p=0.026), left specular movements (p=0.049), face-hand extinction (p=0.001), right-left confusion (p=0.005) and with left forefinger-nose index (p=0.032). Results obtained confirm the correlation between NSS and neuroanatomical alterations in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
46Epilepsy Behav 2009 Mar 14: 481-3
PMID19146989
TitleA comparison of personality disorder characteristics of patients with nonepileptic psychogenic pseudoseizures with those of patients with epilepsy.
AbstractWe sought to determine the type of personality disorder cluster associated with patients with nonepileptic psychogenic seizures (NES) compared with that of patients with epileptic seizures (ES). Consecutive adult patients admitted for video/EEG monitoring found to have NES were compared with a simultaneously admitted patient with confirmed epilepsy. Personality was assessed using the Structured Clinical Interview for DSM-IV-TR Axis II Personality Disorders. Personality disorders were then divided into personality clusters described in the DSM-IV-TR: A = paranoid, schizotypal, schizoid; B = borderline, histrionic, antisocial, narcissistic; or C = avoidant, dependent, obsessive-compulsive. Thirteen of 16 patients with NES and 12 of 16 patients with ES met criteria for personality disorders. Patients with NES were more likely to meet criteria for a personality disorder in Cluster A or B, compared with patients with ES, who were more likely to have Cluster C personality disorders (chi(2) test, P=0.007). We propose that the personality traits of patients with NES contribute to the development of nonepileptic psychogenic seizures. However, the large proportion of patients with ES with Cluster C personality disorders was unexpected, and further, for the patients with epilepsy, the direction of the association of their personality traits with the development of epilepsy is unknown.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
47Psychiatr Danub 2009 Jun 21: 174-8
PMID19556945
TitleComparative analysis of soft neurological signs in positive and negative subtype of schizophrenia.
AbstractThe objective of the study was to investigate neurological deficit in schizophrenia and to compare soft neurological signs in positive and negative subtypes of schizophrenia.
66 patients with schizophrenia were evaluated with the Positive and Negative Syndrome Scale to classify the subtype of schizophrenia: positive subtype (36 patients) and negative subtype (30 patients), all of which were entering into remission. To examine the neurological soft signs we compared scores on the Neurological Evaluation Scale (NES) for positive and negative subtype.
The negative subtype of schizophrenia showed significantly higher neurological soft signs in comparison to the positive subtype, with reduced functioning in the sensory integration and motor coordination subscale as well as the other subscale.
The main finding in this study indicates that patients with schizophrenia have neurological impairment, and that the negative subtype has significantly higher neurological impairment than the positive subtype. The results further support the significance of the soft neurological signs as a possible marker of different subtypes of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
48Schizophr. Res. 2009 Feb 107: 158-64
PMID18805673
TitleFewer neurological soft signs among first episode psychosis patients with heavy cannabis use.
AbstractAlthough neurological soft signs (NSS) have been consistently associated with schizophrenia and a variety of risk factors, few studies have focused on the association between NSS and environmental factors such as cannabis use, particularly in patients with first episode psychosis.
We administered the Neurological Evaluation Scale (NES) to 92 patients during their first episode of functional psychosis. Psychopathology was assessed with the Positive And Negative Syndrome Scale (PANSS) and the family history of psychotic disorder was established on the basis of the Family Interview for Genetic Studies (FIGS). We also assessed lifetime cannabis and cocaine use utilizing that specific section of the Composite International Diagnostic Interview. The outcome variable was the presence of high NSS, defined by a score above the median split of the NES score (>21).
Most patients (80/92, 87%) presented a non-affective psychosis. The presence of high NSS showed a significant independent association with not having been a heavy cannabis user (OR=8.3; 95% CI, 2.4-33.3), family history of psychosis (OR=4.3; 95% CI, 1.2-14.9), male sex (OR=4.0; 95% CI, 1.2-14.0), lower score in verbal fluency and higher score in negative symptoms (both p<0.01).
Our cross-sectional results support the hypothesis that potentially different pathways associated with the emergence of first episode psychosis may exist, including neurological premorbid alteration and environmental cannabis abuse.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
49World J. Biol. Psychiatry 2009 -1 10: 752-62
PMID18609414
TitleMovement sequencing abilities and basal ganglia morphology in first-episode schizophrenia.
AbstractStudies of brain morphology suggest a link between movement sequencing ability and basal ganglia dysfunction. Unfortunately, relevant studies have provided inconsistent data, which may be the result of differences in the methods of brain morphology assessment, statistical analysis or heterogeneity of the populations studied.
To test the hypothesis of a link between the dysfunction of movement sequencing and basal ganglia morphology in a homogenous sample of first-episode schizophrenia patients.
Thirty-seven first-episode schizophrenia patients underwent an assessment of movement sequencing abilities using the NES scale and basal ganglia morphology from MR images. The data were compared with a group of 19 age- and sex-matched healthy controls.
The group of first-episode patients had a higher concentration of gray matter than healthy controls in the putamen and pallidum in both hemispheres. Patients with abnormal sequencing of movements had lower gray matter concentration than patients without such abnormalities in the left putamen, and no differences were found between the symptomatic group and healthy controls.
Our study suggests the involvement of the left putamen in the movement sequencing abnormalities in schizophrenia. Because of the potential confounding effect of medication, the lack of support from external evidence and the low power to perform the whole-brain analysis the results should be considered as preliminary. Further studies, especially with antipsychotic-naive first-episode schizophrenia patients are needed to solve these issues.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
50Schizophr. Res. 2010 Dec 124: 1-12
PMID20855185
TitleClinical significance of neurological soft signs in schizophrenia: factor analysis of the Neurological Evaluation Scale.
AbstractNonlocalizing neurologic deficits detectable by clinical evaluation-"soft signs"-are a robust finding in patients diagnosed with schizophrenia, but their conceptual and neuroanatomical correlates remain unclear. The purpose of this study was to evaluate the organization of these deficits and their clinical correlates using the Neurological Evaluation Scale (NES).
Ninety-three male veterans with schizophrenia and schizoaffective disorder were evaluated using a detailed clinical assessment that included the NES, the Extrapyramidal Symptom Rating Scale, the Abnormal Involuntary Movement Scale (AIMS), the BarNES Akathisia Scale, the Positive and Negative Syndrome Scale, the Wisconsin Card Sorting Test (WCST), the Schedule for the Deficit Syndrome (SDS), and the Digit Symbol Substitution Task (DSST).
Four factors explained 73% of the variance and had distinct clinical and neuropsychological correlates. Factor 1 reflected deficits involved with memory and sensory integration, and was associated with lower PANSS positive and higher AIMS scores. Factor 2 reflected impairments in motor control, and was associated with lower intelligence, more cognitive deficits, and deficit-syndrome schizophrenia. Factor 3 was related to lower intelligence and more perseverative errors on the WCST. Factor 4 was related to increasing age, more extrapyramidal symptoms, more perseverative errors, and worse scores on the DSST.
Neurologic deficits in schizophrenia have an intrinsic organization that appears to have clinical significance, highlighting the continued utility of the NES in studies of neurological deficits in schizophrenia patients. The theoretical underpinning of this organization remains unclear.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
51Neurosci. Lett. 2011 Jul 499: 170-4
PMID21645589
TitleNeurological Soft Signs and Corpus Callosum morphology in schizophrenia.
AbstractNeurological Soft Signs (NSS) have been found to be more prevalent in schizophrenic patients. A breakdown in intracortical functional connectivity, including interhemispheric communication, has been suggested in the pathogeNESis of schizophrenia. Indeed, problems with interhemispheric information transfer via the Corpus Callosum (CC) have been documented in schizophrenics. Our study goal was to relate NSS to CC morphology.
CC Magnetic Resonance Imaging (MRI) measurements were collected from 29 right-handed male schizophrenia inpatients. NSS were evaluated employing the Neurological Evaluation Scale (NES). We examined the scores obtained from the NES total and the three NES subscales: Integrative Sensory Function, Motor Coordination, and Sequencing Of Complex Motor Acts. We compared CC morphology of patients with "high" NSS with that of patients with "low" NSS. Correlation analyses were performed to further clarify the relationship between CC size, NSS, and total lifetime antipsychotic consumption.
Patients with "high" scores at the Sequencing Of Complex Motor Acts subscale showed a smaller CC rostral body, whereas patients with "high" scores at the Integrative Sensory Function subscale showed a smaller CC splenium. For both the NES total and the Sequencing Of Complex Motor Acts subscale, "high" scores were accompanied by an increase of the CC genu. Correlation analyses revealed a significant inverse correlation between the CC rostral body size and the Sequencing Of Complex Motor Acts subscale score. In addition, a significant positive correlation was shown between the CC genu size and both the NES total and the Sequencing Of Complex Motor Acts subscale scores. The presence of NSS and the accompanying CC structural abnormalities were independent on antipsychotic treatment.
Our data provide evidence for an association between NSS and CC morphology and further support the hypothesis of a disturbed interhemispheric functional connectivity in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
52Neurosci. Lett. 2011 Jul 499: 170-4
PMID21645589
TitleNeurological Soft Signs and Corpus Callosum morphology in schizophrenia.
AbstractNeurological Soft Signs (NSS) have been found to be more prevalent in schizophrenic patients. A breakdown in intracortical functional connectivity, including interhemispheric communication, has been suggested in the pathogeNESis of schizophrenia. Indeed, problems with interhemispheric information transfer via the Corpus Callosum (CC) have been documented in schizophrenics. Our study goal was to relate NSS to CC morphology.
CC Magnetic Resonance Imaging (MRI) measurements were collected from 29 right-handed male schizophrenia inpatients. NSS were evaluated employing the Neurological Evaluation Scale (NES). We examined the scores obtained from the NES total and the three NES subscales: Integrative Sensory Function, Motor Coordination, and Sequencing Of Complex Motor Acts. We compared CC morphology of patients with "high" NSS with that of patients with "low" NSS. Correlation analyses were performed to further clarify the relationship between CC size, NSS, and total lifetime antipsychotic consumption.
Patients with "high" scores at the Sequencing Of Complex Motor Acts subscale showed a smaller CC rostral body, whereas patients with "high" scores at the Integrative Sensory Function subscale showed a smaller CC splenium. For both the NES total and the Sequencing Of Complex Motor Acts subscale, "high" scores were accompanied by an increase of the CC genu. Correlation analyses revealed a significant inverse correlation between the CC rostral body size and the Sequencing Of Complex Motor Acts subscale score. In addition, a significant positive correlation was shown between the CC genu size and both the NES total and the Sequencing Of Complex Motor Acts subscale scores. The presence of NSS and the accompanying CC structural abnormalities were independent on antipsychotic treatment.
Our data provide evidence for an association between NSS and CC morphology and further support the hypothesis of a disturbed interhemispheric functional connectivity in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
53Neurosci. Lett. 2011 Jul 499: 170-4
PMID21645589
TitleNeurological Soft Signs and Corpus Callosum morphology in schizophrenia.
AbstractNeurological Soft Signs (NSS) have been found to be more prevalent in schizophrenic patients. A breakdown in intracortical functional connectivity, including interhemispheric communication, has been suggested in the pathogeNESis of schizophrenia. Indeed, problems with interhemispheric information transfer via the Corpus Callosum (CC) have been documented in schizophrenics. Our study goal was to relate NSS to CC morphology.
CC Magnetic Resonance Imaging (MRI) measurements were collected from 29 right-handed male schizophrenia inpatients. NSS were evaluated employing the Neurological Evaluation Scale (NES). We examined the scores obtained from the NES total and the three NES subscales: Integrative Sensory Function, Motor Coordination, and Sequencing Of Complex Motor Acts. We compared CC morphology of patients with "high" NSS with that of patients with "low" NSS. Correlation analyses were performed to further clarify the relationship between CC size, NSS, and total lifetime antipsychotic consumption.
Patients with "high" scores at the Sequencing Of Complex Motor Acts subscale showed a smaller CC rostral body, whereas patients with "high" scores at the Integrative Sensory Function subscale showed a smaller CC splenium. For both the NES total and the Sequencing Of Complex Motor Acts subscale, "high" scores were accompanied by an increase of the CC genu. Correlation analyses revealed a significant inverse correlation between the CC rostral body size and the Sequencing Of Complex Motor Acts subscale score. In addition, a significant positive correlation was shown between the CC genu size and both the NES total and the Sequencing Of Complex Motor Acts subscale scores. The presence of NSS and the accompanying CC structural abnormalities were independent on antipsychotic treatment.
Our data provide evidence for an association between NSS and CC morphology and further support the hypothesis of a disturbed interhemispheric functional connectivity in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
54J Neuropsychiatry Clin Neurosci 2011 -1 23: 68-73
PMID21304141
TitleSoft neurological signs in drug-free people with schizophrenia with and without obsessive-compulsive symptoms.
AbstractObsessive-compulsive (OC) symptoms are clinically important phenomena in people with schizophrenia. schizophrenia and obsessive-compulsive disorder (OCD) are considered as neurodevelopmental disorders with dysfunctional frontal subcortical circuitry. In this cross-sectional study, the authors tested the hypothesis that people with schizophrenia with OC symptoms form a subtype with a distinct neurological substrate. Using the Neurological Evaluation Scale (NES), the authors assessed 65 people with ICD-10 criteria for schizophrenia, 21 of whom had OC symptoms, and who were drug-naive or had not received any antipsychotic or anti-obsessive drugs for the previous 3 months. People with schizophrenia and OC symptoms were better educated than those without OC symptoms and differed significantly in proportion to premorbid OC symptoms, but did not differ on measures of psychopathology. Total NES scores and subgroup scores did not differ significantly between people with schizophrenia with or without OC symptoms, but the groups did differ in motor coordination test scores for the left side. Total NES scores correlated significantly with Positive and Negative Symptom Scales negative symptoms scores in those with OC symptoms but not in those without OC symptoms; this correlation was not observed with Yale-Brown Obsessive-Compulsive Scale scores. These findings, if replicated, suggest that OC symptoms in people with schizophrenia are due to differences in frontocerebellar neurological circuitry from those without OC symptoms, with possible neuro-developmental origins.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
55Psychiatry Res 2012 Jul 198: 241-7
PMID22503357
TitleNeurological soft signs and psychometrically identified schizotypy in a sample of young conscripts.
AbstractThere is growing interest in the connection between neurological soft signs (NSS) and schizophrenia spectrum disorders such as schizotypal personality disorder. The association between NSS and schizotypy was investigated in a subgroup of 169 young healthy male military conscripts included in the Athens Study of Psychosis ProneNESs and Incidence of schizophrenia. During their first 2 weeks in the National Basic Air Force Training Centre (T(1)-first assessment), subjects completed the schizotypal Personality Questionnaire (SPQ), the Symptom Checklist-90-Revised (SCL-90-R), and the Raven's Progressive Matrices (RPM). Then, 2 years later (T(2)-second assessment), at the time of military discharge, they were tested for NSS with the Neurological Evaluation Scale (NES) and reevaluated with the SPQ, the SCL-90-R and additionally the Structured Clinical Interview for Personality Disorders (SCID-II) for the Diagnostic and Statistical Manual of Mental Disorders Third Edition, Revised (DSM-III-R). NSS were more prominent in conscripts with high schizotypy; scores on Sequencing of Complex Motor Acts (SCMA) and the "Other Soft Signs" (OSS) subscales were correlated with high schizotypy at both T(1) and T(2). Increased levels of SCMA as well as the total NSS score were correlated at both T(1) and T(2) with the interpersonal SPQ factor (reflecting negative schizotypy). The findings support the proposal that negative schizotypy might be associated with subtle neurodevelopmental abnormalities.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
56Psychiatry Res 2012 Jul 198: 241-7
PMID22503357
TitleNeurological soft signs and psychometrically identified schizotypy in a sample of young conscripts.
AbstractThere is growing interest in the connection between neurological soft signs (NSS) and schizophrenia spectrum disorders such as schizotypal personality disorder. The association between NSS and schizotypy was investigated in a subgroup of 169 young healthy male military conscripts included in the Athens Study of Psychosis ProneNESs and Incidence of schizophrenia. During their first 2 weeks in the National Basic Air Force Training Centre (T(1)-first assessment), subjects completed the schizotypal Personality Questionnaire (SPQ), the Symptom Checklist-90-Revised (SCL-90-R), and the Raven's Progressive Matrices (RPM). Then, 2 years later (T(2)-second assessment), at the time of military discharge, they were tested for NSS with the Neurological Evaluation Scale (NES) and reevaluated with the SPQ, the SCL-90-R and additionally the Structured Clinical Interview for Personality Disorders (SCID-II) for the Diagnostic and Statistical Manual of Mental Disorders Third Edition, Revised (DSM-III-R). NSS were more prominent in conscripts with high schizotypy; scores on Sequencing of Complex Motor Acts (SCMA) and the "Other Soft Signs" (OSS) subscales were correlated with high schizotypy at both T(1) and T(2). Increased levels of SCMA as well as the total NSS score were correlated at both T(1) and T(2) with the interpersonal SPQ factor (reflecting negative schizotypy). The findings support the proposal that negative schizotypy might be associated with subtle neurodevelopmental abnormalities.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
57Psychiatry Res 2012 Jul 198: 241-7
PMID22503357
TitleNeurological soft signs and psychometrically identified schizotypy in a sample of young conscripts.
AbstractThere is growing interest in the connection between neurological soft signs (NSS) and schizophrenia spectrum disorders such as schizotypal personality disorder. The association between NSS and schizotypy was investigated in a subgroup of 169 young healthy male military conscripts included in the Athens Study of Psychosis ProneNESs and Incidence of schizophrenia. During their first 2 weeks in the National Basic Air Force Training Centre (T(1)-first assessment), subjects completed the schizotypal Personality Questionnaire (SPQ), the Symptom Checklist-90-Revised (SCL-90-R), and the Raven's Progressive Matrices (RPM). Then, 2 years later (T(2)-second assessment), at the time of military discharge, they were tested for NSS with the Neurological Evaluation Scale (NES) and reevaluated with the SPQ, the SCL-90-R and additionally the Structured Clinical Interview for Personality Disorders (SCID-II) for the Diagnostic and Statistical Manual of Mental Disorders Third Edition, Revised (DSM-III-R). NSS were more prominent in conscripts with high schizotypy; scores on Sequencing of Complex Motor Acts (SCMA) and the "Other Soft Signs" (OSS) subscales were correlated with high schizotypy at both T(1) and T(2). Increased levels of SCMA as well as the total NSS score were correlated at both T(1) and T(2) with the interpersonal SPQ factor (reflecting negative schizotypy). The findings support the proposal that negative schizotypy might be associated with subtle neurodevelopmental abnormalities.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
58Afr J Psychiatry (Johannesbg) 2012 Mar 15: 124-7
PMID22552727
TitleNeurological soft signs as an endophenotype in an African schizophrenia population - a pilot study.
AbstractThe use of endophenotypes, such as neurological soft signs (NSS), is advocated as one possible method to elucidate the heterogeneity of schizophrenia. Exploring the associations between NSS and specific illNESs symptoms has revealed some trends, although results have been conflicting. To date, such studies have been conducted largely on Caucasian populations and our pilot study represents the first attempt to gather such data in a homogenous African population.
Fifty-one patients, all of Xhosa ethnicity and participating in a larger schizophrenia genetic study were recruited. NSS were evaluated using a modified Neurological Evaluation Scale. Data were analysed using SPSS with the strength of the overall relationships between NES groups and SANS and SAPS components analyzed by means of canonical correlation analysis.
The canonical correlation of SANS domains (excluding asociality) with the NES conceptual groups was 0.53 (SE=0.11, p=0.024) and of the SAPS domains 0.38 (SE=0.13, p=0.943).
Our results suggest a correlation between negative symptoms of schizophrenia and the presence of NSS, supporting the recruitment of a larger sample to more comprehensively evaluate a possible role for NSS as an endophenotype in the Xhosa schizophrenia population. Taking into account that NSS evaluations allow for inexpensive, relatively easy-to-do objective evaluations, this method presents us with a valuable research tool that can be used effectively within our under-resourced environment to help inform on the neurobiological substrate of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
59Psychiatry Res 2012 Dec 200: 67-72
PMID22494706
TitleDynamics of neurological soft signs and its relationship to clinical course in patients with first-episode schizophrenia.
AbstractThe aim of the study was to assess the dynamics of neurological soft signs (NSS) over four years from the clinical onset of schizophrenia, depending on the clinical course of the disease, and to evaluate the relationship of NSS to symptomatic dimensions in patients with first-episode schizophrenia. Sixty-eight patients with first-episode schizophrenia were included in the trial. The clinical status was assessed using Positive and Negative Syndrome Scale (PANSS) at the same time as the neurological examination, at admission to the hospital for first-episode schizophrenia and at a check-up examination four years later. The assessment of NSS using the Neurological Evaluation Scale (NES) coincided with the assessment of the clinical condition of the patients. According to the Andreasen remission criterion of schizophrenia, after four years we found that 57% of patients' were remitters and 43% were non-remitters. During the monitoring period, in remitters total NES score and sensory integration/sequencing of motor acts items of the NES decreased. In non-remitters, increase in the total NES score and the 'others' item of the NES was observed. A connection between the dynamics of NSS and the clinical course of schizophrenia, over the period of four years, and a relationship between NSS and negative schizophrenia symptoms was found.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
60BMC Psychiatry 2012 -1 12: 17
PMID22409909
TitleCortico-cerebellar functional connectivity and sequencing of movements in schizophrenia.
AbstractAbnormal execution of several movements in a sequence is a frequent finding in schizophrenia. Successful performance of such motor acts requires correct integration of cortico-subcortical processes, particularly those related to cerebellar functions. Abnormal connectivity between cortical and cerebellar regions with resulting cognitive dysmetria has been proposed as the core dysfunction behind many signs and symptoms of schizophrenia. The aim of the present study was to assess if these proposed abnormalities in connectivity are a unifying feature of schizophrenia, or, rather, reflect a specific symptom domain of a heterogeneous disease. We predicted that abnormal functional connectivity between the motor cortex and cerebellum would be linked with abnormal performance of movement sequencing.
We examined 24 schizophrenia patients (SCH) and 24 age-, sex-, and handedNESs-matched healthy controls (HC) using fMRI during a modified finger-tapping task. The ability to perform movement sequencing was tested using the Neurological Evaluation Scale (NES). The subjects were categorized into two groups, with (SQ+) and without (SQ-) movement sequencing abnormalities, according to the NES-SQ score. The effects of diagnosis and movement sequencing abnormalities on the functional connectivity parameters between the motor cortex and cerebellum (MC-CRBL) and the supplementary motor cortex and cerebellum (SMA-CRBL) activated during the motor task were analyzed.
We found no effect of diagnosis on the functional connectivity measures. There was, however, a significant effect on the SQ group: SQ + patients showed a lower level of MC-CRBL connectivity than SQ- patients and healthy controls. Moreover, the level of MC-CRBL and SMA-CRBL negatively correlated with the magnitude of NES-SQ abnormalities, but with no other NES domain.
Abnormal cortico-cerebellar functional connectivity during the execution of a motor task is linked with movement sequencing abnormalities in schizophrenia, but not with the diagnosis of schizophrenia per se. It seems that specific patterns of inter-regional connectivity are linked with corresponding signs and symptoms of clinically heterogeneous conditions such as schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
61J Child Psychol Psychiatry 2012 Mar 53: 323-31
PMID22023091
TitleLongitudinal study of neurological soft signs in first-episode early-onset psychosis.
AbstractIn recent decades, the assessment of neurological soft signs (NSS) in patients with psychosis has become a subject of special interest. The study of the progression of NSS during adolescence will provide valuable information about the role of NSS as endophenotypes or biomarkers and about brain development at a stage in which brain maturation has not yet been completed.
Neurological soft signs were assessed in a sample of 110 first episodes of early-onset psychosis (EOP) and 98 healthy children and adolescents at two different times in a 2-year follow-up period.
Patients with EOP showed more NSS than controls both at baseline (p < .001) and the 2-year follow-up (p < .001). No differences were found in the number of signs among the different diagnostic subgroups (schizophrenia, bipolar disorder, and other psychoses). When we examined the changes in NSS over the follow-up, the reduction of NSS in the patients was greater than the controls for 'Motor coordination' (p = .032), 'Others' (p < .001), and 'Total score' (p < .001) of the NES.
Despite the greater reduction of NSS in patients than in controls along the follow-up, patients still have more neurological signs than healthy controls; therefore, these signs may be considered a trait marker. NSS do not seem to be specific to schizophrenia as they are present in different EOPs.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
62Compr Psychiatry 2013 Apr 54: 276-81
PMID22959340
TitlePrevalence of night eating in obese individuals with schizophrenia and schizoaffective disorder.
AbstractThe prevalence of Night Eating Syndrome (NES) in the general population is estimated to be 1.5%, however, the rates among individuals with schizophrenia and schizoaffective disorder are not yet established. This study sought to examine the frequency and correlates of NES-related behaviors in a sample of obese patients with schizophrenia. One-hundred outpatients diagnosed with schizophrenia or schizoaffective disorders completed the self-report Night Eating Questionnaire (NEQ) and were then interviewed as a follow-up for the specific assessment of NES. Based on a diagnostic interview, 12% of this sample met full criteria for NES, with an additional 10% meeting partial criteria for NES. Based on the NEQ alone, 8% met full criteria with an additional 8% meeting partial criteria. Night eating behaviors were associated with increased insomnia and depression. Our findings suggest that screening for NES among patients with serious mental illNESs may efficiently identify a subgroup with additional clinical needs.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
63Psychiatry Res 2013 Dec 210: 427-31
PMID23880482
TitleAre neurological soft signs pre-existing markers in individuals with an at-risk mental state for psychosis?
AbstractNeurological soft signs (NSS) are more common in schizophrenic psychoses and in genetically high-risk individuals than in healthy controls. But nothing is known so far regarding individuals with a clinical at-risk mental state (ARMS). The goals of our study therefore were (a) to compare the NSS frequency in ARMS individuals to that of first-episode psychosis (FEP) patients and (b) to test whether NSS could predict the transition to psychosis. Neurological soft signs were assessed using a shortened version of the Neurological Evaluation Scale (NES). Fifty-three ARMS individuals (16 with later transition to psychosis=ARMS-T, and 37 without transition=ARMS-NT) and 27 FEP patients were recruited through the Basel Early Detection Clinic FePsy. Of the FEP patients 37% showed NSS. We found no significant differences between FEP and ARMS-T patients or between ARMS-NT and ARMS-T. Our findings of NSS being present already before transition to psychosis to the same extent as after transition provide further support to the neurodevelopmental hypothesis of schizophrenic psychoses. Furthermore, our findings might indicate that ARMS-NT individuals also suffer from some sort of neurodevelopmental abnormalities.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
64J. Nerv. Ment. Dis. 2013 Aug 201: 653-8
PMID23896845
TitleSelf-esteem and relapse in schizophrenia: a 5-year follow-up study.
AbstractThis study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.This study investigated the association between an interview-based measure of self-esteem and subsequent clinical outcome in recent-onset schizophrenia. A cohort 5-year follow-up design with retrospective chart assessment of clinical outcomes was used. Relapse rates during 5 years were very high, with 92% of the sample relapsing. Self-esteem consisted of two dimensions, negative evaluation of self (NES) and positive evaluation of self (PES). Survival analysis indicated that high NES was significantly associated with shorter time to relapse; and PES, with longer survival time. The participants with high PES were three times more likely to have delayed relapse; no other covariates were significant. PES seemed to buffer the adverse effects of NES. The results indicate that social cognition in the form of self-evaluation may be implicated in clinical outcome and symptom exacerbation in schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
65Psychiatry Res 2014 Dec 220: 81-8
PMID25110310
TitleCorrelation of neurological soft signs and neurocognitive performance in first episode psychosis.
AbstractNeurological soft signs and neurocognitive impairments are commonly observed in first episode psychosis but the correlation of these factors remains controversial. Here, we evaluated 30 patients with remitted first episode psychosis and 30 healthy controls for the presence and severity of neurological soft signs (using the Neurological Evaluation Scale--NES) and for neurocognitive impairments (using seven subtests of the Cambridge Neuropsychological Test Automated Battery--CANTAB). NES score was higher in patients compared to controls. Neurocognitive impairment was evident in patients in the following domains: working memory, spatial recognition memory, attention set shifting, planning and inhibition. The NES revealed significant correlations with spatial working memory performance and Intra-Extra Dimensional Set Shifting (as a component of executive function). These correlations were observed both in patients and in controls. Planning and inhibition showed correlation with the total NES score and the sequencing of complex motor acts in both groups. In addition, spatial span and spatial recognition memory showed significant correlation with total NES score and the sequencing of complex motor acts in controls. The correlation between sequencing of complex motor acts and specific domains of neurocognitive tasks suggests that similar neuroanatomical substrates might be implicated in these processes.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
66J Psychiatr Pract 2014 Mar 20: 147-53
PMID24638050
TitleNeurological soft signs discriminate schizophrenia from bipolar disorder.
AbstractAlthough neurological soft signs have been consistently described in patients with schizophrenia, their diagnostic specificity is not well clarified.
To test the hypothesis that neurological soft signs are specifically related to schizophrenia, we examined 305 subjects (patients with schizophrenia-spectrum disorder, n=167; patients with bipolar I disorder, n=88; controls, n=50). Neurological soft signs were assessed using the Neurological Evaluation Scale (NES). Multiple logistic regression analysis was used to compute the diagnostic predictive power of neurological soft signs.
Patients in the schizophrenia-spectrum disorder group were found to have significantly greater neurological impairment (NES total score=23.9, standard deviation [SD] 11.2) than those in the bipolar disorder group (NES total score=18.2, SD 7.6; p<0.001). Neurological functioning was closely associated with psychopathology (all p<0.001). The NES total score reliably distinguished patients with schizophrenia spectrum disorders from those with bipolar disorder in 68.7% of the cases (p<0.001). Moreover, a particular set of neurological soft signs showed specificity for the schizophrenia-spectrum disorder diagnostic group.
Our findings suggest that schizophrenia and bipolar disorder can be distinguished in terms of neurological impairment. Furthermore, we recommend the utility of neurological soft signs as a useful, quantifiable, sensitive, and inexpensive tool for the diagnostic work-up of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
67Psychiatry Res 2014 Aug 218: 7-11
PMID24768250
TitleAn exploratory study of the relationship between neurological soft signs and theory of mind deficits in schizophrenia.
AbstractIndirect evidence suggests partially common pathogenetic mechanisms for Neurological Soft Signs (NSS), neurocognition, and social cognition in schizophrenia. However, the possible association between NSS and mentalizing impairments has not yet been examined. In the present study, we assessed the ability to attribute mental states to others in patients with schizophrenia and predicted that the presence of theory of mind deficits would be significantly related to NSS. Participants were 90 clinically stable patients with a DSM-IV diagnosis of schizophrenia. NSS were assessed using the Neurological Evaluation Scale (NES). Theory of mind deficits were assessed using short verbal stories designed to measure false belief understanding. The findings of the study confirmed our hypothesis. Impaired sequencing of complex motor acts was the only neurological abnormality correlated with theory of mind deficits. By contrast, sensory integration, motor coordination and the NES Others subscale had no association with patients? ability to pass first- or second-order false belief tasks. If confirmed by future studies, the current findings provide the first preliminary evidence for the claim that specific NSS and theory of mind deficits may reflect overlapping neural substrates.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
68Turk Psikiyatri Derg 2015 -1 26: 242-8
PMID26731021
Title[The Prevalence of Night Eating Syndrome among Outpatient Overweight or Obese Individuals with Serious Mental Illness].
AbstractThis study aimed to determine the prevalence of Night Eating Syndrome (NES) among overweight or obese patients with serious mental illNESs and its relationship with insomnia and quality of life.
This study included 158 overweight or obese patients diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder (according to DSM-IV criteria) that were not in the active disease period. A clinical interview and Night Eating Questionnaire (NEQ) were used to assess the prevalence of NES among those in the study group. Body mass index (BMI), sleep quality, and quality of life measures were also evaluated for each patient.
Twelve patients (7.6%) were diagnosed with NES via clinical interview while 26 (16.5%) were diagnosed by having ?25 points in the NEQ. There were no statistically significant differences between the NES and non-NES groups with respect to age, gender, education and body mass index. However, quality of life scores were lower while the severity of insomnia scores were higher in patients with NES.
The prevalence of NES is higher among overweight or obese patients with serious mental illNESs when compared to prevalence data in a general population, as demonstrated by previously published studies. Night eating behavior may be related to insomnia and poor quality of life measures. The recognition of NES among patients with severe mental disease is essential to promote prevention of obesity and insomnia as related to night eating behavior.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
69J Med Life 2015 -1 8 Spec Issue: 74-81
PMID26361516
TitleNeurological soft signs in early stage of schizophrenia associated with obsessive-compulsive disorder.
AbstractGiven that the obsessive-compulsive disorder (OCD) occurs with a much higher frequency in schizophrenia than in the general population, and, both schizophrenia and OCD are presumed to be neurodevelopmental disorders, the hypothesis of a distinct subtype of schizophrenia, the "schizo-obsessive" one, was raised.
Considering the neurological soft signs as neurobiological markers in schizophrenia, the aim of this study was to verify the hypothesis of the existence of this "schizo-obsessive" endophenotype of schizophrenia, by using the Neurological Evaluation Scale (NES) in patients with schizophrenia.
The study was conducted in a transversal manner and consisted of the assessment of 64 patients with the maximum age of 26 years, who fulfilled the DSM IV-TR criteria of schizophrenia and/ or OCD, the assessment performed both from the social-demographic view, as well as neurologic, by means of the NES scale.
Patients with schizophrenia and OCD proved to have, a significant family history from a static point of view, more loaded by affective disorders, but also by schizophrenia and OCD spectrum disorders, compared to pure schizophrenics. They also proved to have a significant higher educational level and a better occupational functioning than those schizophrenic patients without OCD, despite the similarity of the number of hospitalizations episodes or the disease duration to date. Ratings on the NES scale differentiate the group of patients with schizophrenia and OCD as having the highest scores on all subscales, scores much closer to those obtained by the group of patients with schizophrenia only, the only difference with statistical significance being recorded on the sequencing subscale of complex motor acts. The analysis of cluster through linear discriminant analysis allowed the classification of patients in the 3 groups with a probability of 89.06% and 76.56% for cross-validation.
The results regarding neurological soft signs suggest that the presence of OCD in schizophrenic patients is due to peculiarities in fronto-basal ganglia circuits with possible origins in neurodevelopmental abnormalities. We considered that the early detection of neurological soft signs and their dynamic monitoring could provide useful information on the evolution of schizophrenia. Future research should take into account larger groups of patients to investigate the relationship between neurological soft signs and brain neuroimaging data, as well as the results provided by neuropsychological investigations customed in this subgroup of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
70J Med Life 2015 -1 8 Spec Issue: 74-81
PMID26361516
TitleNeurological soft signs in early stage of schizophrenia associated with obsessive-compulsive disorder.
AbstractGiven that the obsessive-compulsive disorder (OCD) occurs with a much higher frequency in schizophrenia than in the general population, and, both schizophrenia and OCD are presumed to be neurodevelopmental disorders, the hypothesis of a distinct subtype of schizophrenia, the "schizo-obsessive" one, was raised.
Considering the neurological soft signs as neurobiological markers in schizophrenia, the aim of this study was to verify the hypothesis of the existence of this "schizo-obsessive" endophenotype of schizophrenia, by using the Neurological Evaluation Scale (NES) in patients with schizophrenia.
The study was conducted in a transversal manner and consisted of the assessment of 64 patients with the maximum age of 26 years, who fulfilled the DSM IV-TR criteria of schizophrenia and/ or OCD, the assessment performed both from the social-demographic view, as well as neurologic, by means of the NES scale.
Patients with schizophrenia and OCD proved to have, a significant family history from a static point of view, more loaded by affective disorders, but also by schizophrenia and OCD spectrum disorders, compared to pure schizophrenics. They also proved to have a significant higher educational level and a better occupational functioning than those schizophrenic patients without OCD, despite the similarity of the number of hospitalizations episodes or the disease duration to date. Ratings on the NES scale differentiate the group of patients with schizophrenia and OCD as having the highest scores on all subscales, scores much closer to those obtained by the group of patients with schizophrenia only, the only difference with statistical significance being recorded on the sequencing subscale of complex motor acts. The analysis of cluster through linear discriminant analysis allowed the classification of patients in the 3 groups with a probability of 89.06% and 76.56% for cross-validation.
The results regarding neurological soft signs suggest that the presence of OCD in schizophrenic patients is due to peculiarities in fronto-basal ganglia circuits with possible origins in neurodevelopmental abnormalities. We considered that the early detection of neurological soft signs and their dynamic monitoring could provide useful information on the evolution of schizophrenia. Future research should take into account larger groups of patients to investigate the relationship between neurological soft signs and brain neuroimaging data, as well as the results provided by neuropsychological investigations customed in this subgroup of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
71J Med Life 2015 -1 8 Spec Issue: 74-81
PMID26361516
TitleNeurological soft signs in early stage of schizophrenia associated with obsessive-compulsive disorder.
AbstractGiven that the obsessive-compulsive disorder (OCD) occurs with a much higher frequency in schizophrenia than in the general population, and, both schizophrenia and OCD are presumed to be neurodevelopmental disorders, the hypothesis of a distinct subtype of schizophrenia, the "schizo-obsessive" one, was raised.
Considering the neurological soft signs as neurobiological markers in schizophrenia, the aim of this study was to verify the hypothesis of the existence of this "schizo-obsessive" endophenotype of schizophrenia, by using the Neurological Evaluation Scale (NES) in patients with schizophrenia.
The study was conducted in a transversal manner and consisted of the assessment of 64 patients with the maximum age of 26 years, who fulfilled the DSM IV-TR criteria of schizophrenia and/ or OCD, the assessment performed both from the social-demographic view, as well as neurologic, by means of the NES scale.
Patients with schizophrenia and OCD proved to have, a significant family history from a static point of view, more loaded by affective disorders, but also by schizophrenia and OCD spectrum disorders, compared to pure schizophrenics. They also proved to have a significant higher educational level and a better occupational functioning than those schizophrenic patients without OCD, despite the similarity of the number of hospitalizations episodes or the disease duration to date. Ratings on the NES scale differentiate the group of patients with schizophrenia and OCD as having the highest scores on all subscales, scores much closer to those obtained by the group of patients with schizophrenia only, the only difference with statistical significance being recorded on the sequencing subscale of complex motor acts. The analysis of cluster through linear discriminant analysis allowed the classification of patients in the 3 groups with a probability of 89.06% and 76.56% for cross-validation.
The results regarding neurological soft signs suggest that the presence of OCD in schizophrenic patients is due to peculiarities in fronto-basal ganglia circuits with possible origins in neurodevelopmental abnormalities. We considered that the early detection of neurological soft signs and their dynamic monitoring could provide useful information on the evolution of schizophrenia. Future research should take into account larger groups of patients to investigate the relationship between neurological soft signs and brain neuroimaging data, as well as the results provided by neuropsychological investigations customed in this subgroup of schizophrenia.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal
72Prog. Neuropsychopharmacol. Biol. Psychiatry 2016 Jan 64: 96-101
PMID26241859
TitleNeurological and cerebellar soft signs do not discriminate schizophrenia from bipolar disorder patients.
AbstractPatients with schizophrenia (SZ) and bipolar disorder (BD) share subtle motor abnormalities called the neurological soft signs (NSS). Since in both diseases there is evidence for alterations in cerebellar functions, structure and connectivity, we expected that the cerebellar soft signs (CSS), analogue of NSS focusing strictly on cerebellar symptoms, would be also a common trait in SZ and BD. We examined 30 patients with BD, 30 patients with SZ and 28 control subjects using the Neurological Evaluation Scale (NES, for NSS) and International Cooperative Ataxia Rating Scale (ICARS, for CSS). SZ and BD did not differ in total and subscales' scores in both NES and ICARS. Subscale analysis revealed that SZ performed significantly worse than controls in all the subscales of both NES and ICARS. BD patients scored significantly worse than controls in all NES subscales and in oculomotor and kinetic subscales of the ICARS, while other ICARS subscales did not differentiate those two groups. To our knowledge this is the first study to show that CSS constitute common symptoms in BD and SZ. We recommend a special focus on those diseases in further research regarding structural and functional changes of cerebellum and their clinical outcome.
SCZ Keywordsschizophrenia, schizophrenic, schizophrenics, schizotypy, schizotypal