Neurological Soft Signs and Their Relationships to Neurocognitive Functions: A Re-Visit with the Structural Equation Modeling Design

Abstract

BackgroundNeurological soft signs and neurocognitive impairments have long been considered important features of schizophrenia. Previous correlational studies have suggested that there is a significant relationship between neurological soft signs and neurocognitive functions. The purpose of the current study was to examine the underlying relationships between these two distinct constructs with structural equation modeling (SEM).Methods118 patients with schizophrenia and 160 healthy controls were recruited for the current study. The abridged version of the Cambridge Neurological Inventory (CNI) and a set of neurocognitive function tests were administered to all participants. SEM was then conducted independently in these two samples to examine the relationships between neurological soft signs and neurocognitive functions.ResultsBoth the measurement and structural models showed that the models fit well to the data in both patients and healthy controls. The structural equations also showed that there were modest to moderate associations among neurological soft signs, executive attention, verbal memory, and visual memory, while the healthy controls showed more limited associations.ConclusionsThe current findings indicate that motor coordination, sensory integration, and disinhibition contribute to the latent construct of neurological soft signs, whereas the subset of neurocognitive function tests contribute to the latent constructs of executive attention, verbal memory, and visual memory in the present sample. Greater evidence of neurological soft signs is associated with more severe impairment of executive attention and memory functions. Clinical and theoretical implications of the model findings are discussed.

Cognitive control deficit in patients with first-episode schizophrenia is associated with complex deviations of early brain development

“…13 Interactions between NSS and ACC morphology and between NSS and handedness were also detected, revealing the highest CC in patients with "typical" features (i.e., no NSS, an asymmetric ACC sulcal pattern and right-handedness) and the lowest CC in patients with "deviant" features (i.e., presence of NSS, a symmetric ACC sulcal pattern and mixed-hanedness). Our results are in line with previous findings that NSS 11,32 and mixed-handedness 12 are associated with executive impairments. These interactions between NSS, handedness and ACC morphology may explain the discrepancy observed in previous studies when only 1 factor was investigated without controlling for the other factors.…”

“…12 Finally, NSS, referred to as the minor, nonlocalizable defects in motor coordination, motor integration and sensory integration, 11 are a clinical marker of pre-and perinatal deviance; 22,35 are much more frequent in patients with schizophrenia and their siblings than in controls; 36 and are associated with cognitive deficits, including executive functions. 11,32 The intensity of NSS may vary in the course of illness with acuity of the disorder. 37 Because in our study NSS were considered a trait marker of early neurodevelopmental insult 22,35 rather than a state marker of acute cerebral changes, 38 we assessed NSS using categorical factors that were robust to possible changes in clinical state rather than a continuous variable.…”

Consortium for the Human Information and Neurocognitive Endophenotype (CHINE) in mainland China: An example from neurological soft signs for neuropsychiatric disorders

“…modeling of organism and brain imaging section below). Our database also suggests that, at the conceptual and construct levels, neurological soft signs are more or less capturing the same construct measured by traditional neurocognitive tests using the structural equation modeling approach [36]. All the neurological soft signs subscales such as motor coordination, sensory integration, and disinhibition were significantly correlated with executive function, verbal memory, and visual memory.…”

Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

“…15 Neurological soft signs and neurocognitive tests have both been found to measure brain function. 16 An increase in NSSs has been found in a variety of mental disorders. 17 Soft neurological findings have been found to have good interrater reliability.…”