A clinical study of neurological soft signs in patients with schizophrenia

Dutta, Mithun; Nath, Kamal; Baruah, Aparajeeta; Naskar, Subrata

doi:10.4103/0976-3147.181481

Cited by 5 publications

(8 citation statements)

References 27 publications

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“…In our study, 244 patients were enrolled, meeting the test power of 0.8. Eligible patients for this study had to meet the following enrollment criteria: (1) an ICD-10 diagnosis of schizophrenia [32], (2) age within the range of 18-60 years, (3) illness duration of no less than 2 years, (4) a current live-in caregiver who provides most of the care, (5) maintenance treatment with one of the following 7 antipsychotics: chlorpromazine, sulpiride, clozapine, risperidone, haloperidol, olanzapine, and aripiprazole, (6) total scores on the Positive and Negative Syndrome Scale (PANSS) of no more than 60, and (7) no formal training or regular practice of Tai-chi prior to enrollment. The 7 antipsychotics were selected because more than 90% of patients with schizophrenia in China were prescribed at least 1 of these medications [33].…”

Section: Methodsmentioning

confidence: 99%

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Kang

Wu²,

Li³

et al. 2016

Psychopathology

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Background: Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. Methods: In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. Results: Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p < 0.001) and negative symptoms (F = 44.909, p < 0.001), a lower risk for aggressive behavior (F = 12.382, p < 0.001), and a greater improvement in adherence to medication (F = 12.391, p < 0.001) after 1 year of intervention. The changes in PANSS total scores, negative scores, and social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant between the two groups (PANSS total score: t = 4.839, p < 0.001; negative symptoms: t = 8.250, p < 0.001, and quality of life-social domain: t = -2.171, p = 0.031). Multiple linear regression analysis also showed that the intervention was significantly effective for changes from baseline to 12 months on PANSS total score (B = 0.804, p < 0.001), negative score (B = 0.709, p < 0.001), and social domain of quality of life (B = -0.673, p = 0.044). Conclusions: This study suggested that the community-based integrated intervention such as social skills training plus Tai-chi should be part of a rehabilitation effort for patients with schizophrenia in order to improve clinical symptoms, quality of life, and medication adherence.

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Section: Methodsmentioning

confidence: 99%

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Kang

Wu²,

Li³

et al. 2016

Psychopathology

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“…The mean age of the participants (in years) was 33.42, with a range of 18 to 60 years, which was similar to that described in the literature. According to a study done on Schizophrenia patients, most of the participants were in the age range of 20 to 39 years (69%) with a mean age (in years) of 32.02 [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A Study of Neurological Soft Signs and Cognition in Schizophrenia

Nathani,

Faye,

Kirpekar

et al. 2023

Cureus

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Introduction: Neurological soft signs (NSS) are delicate neurological abnormalities that comprise deficits in motor coordination, problems with the sequencing of complex motor acts, and sensory integration difficulties. These are nonspecific with no specific localization in the brain. NSS are found in many patients with Schizophrenia. Cognitive dysfunctions are also present in more than two-thirds of patients with Schizophrenia. This study aims at assessing the NSS and its association with cognitive impairment in patients with Schizophrenia. Methods: A total of 100 Schizophrenia patients were included in the study. The Heidelberg scale was used for assessing the NSS. The Montreal Cognitive Assessment Scale (MoCA) for cognitive impairment, the Positive and Negative Syndrome Scale (PANSS) for Schizophrenia, and the Brief Psychiatric Rating Scale (BPRS) were used to assess the severity. Statistical analysis was performed by Pearson’s Chi-square test, Kruskal-Wallis test, Wilcoxon rank tests and Spearman rank correlation along with mean and standard deviation. Results: NSS were present in 68% (N=68) of the patients with motor coordination being maximally affected. Cognitive impairment was found in 73% (N=73) of patients with a MoCA score <26. Patients with predominant negative symptoms had higher NSS scores and lower MoCA scores. A “statistically significant” correlation was observed between cognitive impairment and NSS. Most patients with NSS and impaired cognition were in the "markedly ill" category of BPRS. Conclusion: A significant association was observed between cognitive deficits, negative symptoms, and NSS in Schizophrenia. NSS and cognitive dysfunctions are integral parts of Schizophrenia symptom domains and need to be assessed as the negative symptoms and severity of illness are associated with NSS, especially problems with motor coordination and cognitive dysfunctions.

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“…7,8 In addition, they provide the ability to perform scalable bedside assessment without costly and sophisticated equipment. 9 While NSS in illnesses were first identified in the mid-to late-1960s, 10,11 they have yet to transform the psychiatric landscape. Similar to other biomarker research, questions around reliability and validity of NSS scales have emerged as research has expanded.…”

Section: Introductionmentioning

confidence: 99%

“…NSS offer important benefits, including a direct connection between clinical presentation and neurological functioning 7,8 . In addition, they provide the ability to perform scalable bedside assessment without costly and sophisticated equipment 9 …”

Section: Introductionmentioning

confidence: 99%

Potential Role of Smartphone Technology in Advancing Work on Neurological Soft Signs with a Focus on Schizophrenia

Gray,

Buchanan,

Keshavan

et al. 2023

Harv Rev Psychiatry

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Learning Objective: After participating in this CME activity, the psychiatrist should be better able to • Outline and Identify potential benefits of using neurological soft signs (NSS) as biomarkers of schizophrenia. Abstract Since the late 1960s, NSS have been a focus of study across psychiatric illnesses, including depression, bipolar disorder, and schizophrenia in particular. Utilizing these subtle neurological impairments as biomarkers of illness has numerous benefits; NSS offer a direct connection between clinical presentation and neurological functioning, and assessments are cost-effective. However, incongruent measurement scales, confounding variables, and rating system subjectivity have hindered the advancement and scalability of NSS research and clinical implementation. This article provides a brief overview of the literature on NSS as related to schizophrenia, and proposes utilizing smartphone sensing technology to create standardized NSS assessments with objective scoring. Incorporating digital phenotyping into NSS assessment offers the potential to make measurement more scalable, accessible, and directly comparable across locations, cultures, and demographics. We conducted a narrative search in PubMed and APA PsycInfo using the following keywords: neurological soft signs, schizophrenia spectrum disorders, and psychotic illnesses. No date limitations were used. There is no other direct work on NSS and new smartphone methods like digital phenotyping; though, there is related work in neurology. Harnessing advances in smartphone technology could provide greater insight into and further our understanding of specific aspects of the NSS field. For instance, it could help us distinguish trait vs. state markers and better understand how distinct groups of signs may reflect different aspects of psychiatric illness and neurological impairment. In addition, such technology can help advance research on the capabilities of NSS as an effective diagnostic tool.

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A clinical study of neurological soft signs in patients with schizophrenia

Cited by 5 publications

References 27 publications

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study

A Study of Neurological Soft Signs and Cognition in Schizophrenia

Potential Role of Smartphone Technology in Advancing Work on Neurological Soft Signs with a Focus on Schizophrenia

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