Neurological soft signs and cognition in the late course of chronic schizophrenia: a longitudinal study
- PDF / 540,465 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 14 Downloads / 186 Views
ORIGINAL PAPER
Neurological soft signs and cognition in the late course of chronic schizophrenia: a longitudinal study Christina J. Herold1 · Céline Z. Duval1 · Johannes Schröder1 Received: 7 November 2019 / Accepted: 4 May 2020 © The Author(s) 2020
Abstract Neurological soft signs (NSS) are minor (‘soft’) neurological abnormalities in sensory and motor performances, which are frequently reported in patients with schizophrenia at any stage of their illness. It has been demonstrated that NSS vary in the clinical course of the disorder: longitudinally NSS decrease in parallel with remission of psychopathological symptoms, an effect which mainly applies to patients with a remitting course. These findings are primarily based on patients with a first episode of the disorder, while the course of NSS in patients with chronic schizophrenia and persisting symptoms is rather unknown. Therefore, we investigated NSS twice in 21 patients with chronic schizophrenia (initial mean duration of illness: 23 ± 11 years) with a mean follow-up interval of 7 years. NSS were evaluated by the Heidelberg Scale, established instruments were used to rate neuropsychological performance and psychopathological symptoms. NSS showed significant increases on the subscales “motor coordination” and “integrative functions”, while positive and negative symptoms, including apathy, showed only minor, non-significant changes. Verbal memory, verbal fluency, and cognitive flexibility along with severity of global cognitive deficits demonstrated a significant deterioration. Regression analyses identified executive dysfunction (cognitive flexibility and verbal fluency) at baseline as significant predictors of NSS increase at follow-up. Our findings indicate that NSS deteriorate in the long-term course of chronic schizophrenia. This effect may be accounted for by a decrease of executive functions and logical memory, which can be attributed to premature brain aging. Keywords Neurological soft signs · NSS · Chronic schizophrenia · Follow-up · Neuropsychology · Psychopathology
Introduction Neurological soft signs (NSS) represent a variety of discrete abnormalities in sensory integration, motor coordination and sequencing of complex motor acts and are demonstrated in the majority of patients with schizophrenia, including neuroleptic-naïve first-episode patients and chronic cases [1–4]. Previous studies clearly show that NSS are not a static feature of schizophrenia, but instead vary in the clinical course of the disorder. This effect was confirmed in a metaanalysis based on 17 longitudinal studies, which yielded a reduction of NSS in the course of acute psychosis paralleling Communicated by Peter Falkai. * Christina J. Herold christina‑[email protected]‑heidelberg.de 1
Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Voßstr. 4, 69115 Heidelberg, Germany
the remission of psychopathological symptoms [5]. However, NSS scores did not normalize to the levels typically found in healthy controls. Recently, Bachmann an
Data Loading...
