Neurological soft signs discriminate schizophrenia from major depression but not bipolar disorder

Zhao, Qing; Ma, Yantao; Lui, Simon S.Y.; Liu, Wenhua; Xu, Ting; Yu, Xin; Tan, Shuping; Wang, Zhiren; Qu, Miao; Wang, Ya; Huang, Jia; Cheung, Eric F.C.; Dazzan, Paola; Chan, Raymond C.K.

doi:10.1016/j.pnpbp.2012.12.006

Cited by 70 publications

(44 citation statements)

References 40 publications

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“…Neurological soft signs were evaluated using the Cambridge Neurological Inventory in (partly medicated) patients suffering from schizophrenia, bipolar disorder, or major depression, and in healthy controls (30 participants per group) [13]. Patients with schizophrenia showed more NSS than patients with major depression and healthy controls, but neither the NSS total score nor any of the subscores allowed for a differentiation between patients with schizophrenia and bipolar disorder.…”

Section: Correlation Of Nss With the Course Of Schizophreniamentioning

confidence: 99%

Neurology Issues in Schizophrenia

Hüfner

Frajo-Apor

Hofer

2015

Curr Psychiatry Rep

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Schizophrenia ranks among the leading causes of disability worldwide. The presence of neurological signs co-occurring with the psychiatric symptoms is indicative of an organic brain pathology. In the present article, we review the current literature on neurology issues in schizophrenia. Firstly, common neurological signs found in patients with schizophrenia (neurological soft signs and smell abnormalities) and their association with imaging findings are reviewed. Secondly, the significant association of schizophrenia with epilepsy and stroke is described as well as the absent association with other organic brain diseases such as multiple sclerosis. Thirdly, we discuss the potential role of NMDA receptor antibodies in schizophrenia. Fourthly, neurological side effects of antipsychotic drugs and their treatment are reviewed; and lastly, we discuss neurocognitive deficits in patients with schizophrenia and their treatment. The focus of the review remains on articles with relevance to the clinician.

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Section: Correlation Of Nss With the Course Of Schizophreniamentioning

confidence: 99%

Neurology Issues in Schizophrenia

Hüfner

Frajo-Apor

Hofer

2015

Curr Psychiatry Rep

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“…Reading difficulties and scholastic underachievement, however, seem to be more specific to early-onset schizophrenia than early-onset bipolar I disorder. 29 Neurological signs (NS), which are neurological abnormalities in sensory and motor performance, are not specific to schizophrenia as they are also present in bipolar disorder, 30 in early-onset psychoses independently of whether the individuals later develop schizophrenia or bipolar disorder, 31 and in subjects with an at-risk mental state for psychosis. 32 NS are also more prevalent in earlyonset cases of both schizophrenia and bipolar disorder than in healthy controls.…”

Section: Cognitive Impairment During Development In Schizophrenia Andmentioning

confidence: 99%

“…30 Insight Chronic impaired insight characterizes those patients with a diagnosis of schizophrenia but not so much those with BD. 85 Environmental factors Childhood adversity seems to increase the risk for both schizophrenia and affective psychosis.…”

Section: Nsmentioning

confidence: 99%

Differential Neurodevelopmental Trajectories in Patients With Early-Onset Bipolar and Schizophrenia Disorders

Arango¹,

Fraguas

Parellada

2013

Schizophrenia Bulletin

106

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Schizophrenia and bipolar disorders share not only clinical features but also some risk factors such as genetic markers and childhood adversity, while other risk factors such as urbanicity and obstetric complications seem to be specific to schizophrenia. An intriguing question is whether the wellestablished abnormal neurodevelopment present in many children and adolescents who eventually develop schizophrenia is also present in bipolar patients. The literature on adult bipolar patients is controversial. We report data on a subgroup of patients with pediatric-onset psychotic bipolar disorder who seem to share some developmental trajectories with patients with early-onset schizophrenia. These earlyonset psychotic bipolar patients have low intelligence quotient, more neurological signs, reduced frontal gray matter at the time of their first psychotic episode, and greater brain changes than healthy controls in a pattern similar to earlyonset schizophrenia cases. However, patients with earlyonset schizophrenia seem to have more social impairment, developmental abnormalities (eg, language problems), and lower academic achievement in childhood than early-onset bipolar patients. We suggest that some of these abnormal developmental trajectories are more related to the phenotypic features (eg, early-onset psychotic symptoms) of these 2 syndromes than to categorically defined Diagnostic and Statistical Manual of Mental Disorders disorders.

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“…Nevertheless, previous studies have assessed the power of NSS to discriminate between SZ and other neuropsychiatric disorders. In particular, SZ patients have significantly higher NSS levels than individuals with OCD (6, 7), alcohol dependence (8), bipolar disorders (9, 10), depression (11), and mixed psychiatric diagnoses (12). From a neurobiological point of view, the prefix “soft” indicates that NSS refer to a non-specific or global cerebral dysfunction rather than to impairments of specific or distinct brain regions.…”

Section: Introductionmentioning

confidence: 99%

Neurological Abnormalities in Recent-Onset Schizophrenia and Asperger-Syndrome

et al. 2014

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Background: Neurological abnormalities including a variety of subtle deficits such as discrete impairments in sensory integration, motor coordination (MOCO), and sequencing of complex motor acts are frequently found in patients with schizophrenia (SZ) and commonly referred to as neurological soft signs (NSS). Asperger-syndrome (AS) is characterized by sensory-motor difficulties as well. However, the question whether the two disorders share a common or a disease-specific pattern of NSS remains unresolved.Method: A total of 78 age- and education-matched participants [26 patients with recent-onset SZ, 26 individuals with AS, and 26 healthy controls (HC)] were recruited for the study. Analyses of covariance (ANCOVAs), with age, years of education, and medication included as covariates, were used to examine group differences on total NSS and the five subscale scores. Discriminant analyses were employed to identify the NSS subscales that maximally discriminate between the three groups.Results: Significant differences among the three groups were found in NSS total score and on the five NSS subscales. The clinical groups differed significantly in the NSS subscale MOCO. The correct discriminant rate between patients with SZ and individuals with AS was 61.5%. The correct discriminant rate was 92.3% between individuals with AS and HC, and 80.8% between SZ patients and HC, respectively.Conclusion: Our findings provide new evidence for the presence of NSS in AS and lend further support to previously reported difficulties in movement control in this disorder. According to the present results, SZ and AS seem to be characterized by both quantitative and qualitative NSS expression.

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Neurological soft signs discriminate schizophrenia from major depression but not bipolar disorder

Cited by 70 publications

References 40 publications

Neurology Issues in Schizophrenia

Neurology Issues in Schizophrenia

Differential Neurodevelopmental Trajectories in Patients With Early-Onset Bipolar and Schizophrenia Disorders

Neurological Abnormalities in Recent-Onset Schizophrenia and Asperger-Syndrome

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