Clinical Utility and Lifespan Profiling of Neurological Soft Signs in Schizophrenia Spectrum Disorders

Neurological soft signs (NSSs) bear the promise for early detection of schizophrenia spectrum disorders. Nonetheless, the sensitivity and specificity of NSSs in the psychosis continuum remains a topic of controversy. It is also unknown how NSSs reveal neurodevelopmental abnormality in schizophrenia. We investigated the effect sizes of NSSs in differentiating individuals with schizophrenia spectrum disorders from individuals with other psychiatric conditions and from covariate-matched healthy subjects. We also investigated the partitioned age-related variations of NSSs in both schizophrenia and healthy individuals. NSSs were assessed by the abridged version of the Cambridge Neurological Inventory (CNI) in 3105 participants, consisting of healthy individuals (n=1577), unaffected first-degree relatives of schizophrenia patients (n= 155), individuals with schizotypal personality disorder (n= 256), schizophrenia patients (n= 738), and other psychiatric patients (n= 379). Exact matching and propensity score matching procedures were performed to control for covariates. Multiple regression was used to partition age-related variations. Individuals along the schizophrenia continuum showed elevated levels of NSSs, with moderate effect sizes, in contrast to other psychiatric patients who had minimal NSSs, as well as matched healthy controls. Furthermore, the age-and-NSS relationship in schizophrenia patients was represented by a flat but overall elevated pattern, in contrast to a U-shaped pattern in healthy individuals. In sum, NSSs capture a moderate portion of psychosis proneness with reasonable specificity. Lifespan profiling reveals an abnormal developmental trajectory of NSSs in schizophrenia patients, which supports the endophenotype hypothesis of NSSs by associating it with the neurodevelopmental model of schizophrenia.

Brain area-related neurological soft signs in depressive patients with different types of childhood maltreatment

INTRODUCTION

This study aims to investigate the effects of childhood maltreatment on neurological soft signs (NSS) associated with certain brain area in depressive patients.

METHODS

One hundred three depressive patients were enrolled into this study, and evaluated by Childhood Trauma Questionnaire (CTQ), brain area-related neurological examination scale, 24-item Hamilton Rating scale (HAMD24), the scale for suicidal ideation (SSI) and Beck Hopelessness Scale (BHS).

RESULTS

Patients undergoing childhood maltreatment exhibited higher frontal area-related NSS scores than patients without childhood maltreatment experience. Patients experiencing childhood emotional or physical neglect displayed more frontal area-related NSS compared to their respective non-maltreatment group. Moreover, physical neglect maltreatment caused more temporal area-related NSS. Patients suffering from childhood sexual abuse had more frontal, temporal and occipital area-related NSS than patients lacking experience of childhood sexual abuse. Further correlation analysis revealed that the total score of maltreatment positively correlated with frontal and temporal area-related NSS score. There was a positive correlation between emotional abuse, emotional neglect or physical abuse and frontal area-related NSS. Physical neglect and sexual abuse were positively associated with the temporal area-related NSS score. HAMD24 score was positively correlated with all brain area-related NSS score; The SSI score correlated with three area (excluded occipital area)-related NSS score. The BHS score only positively correlated with frontal area score of NSS. Finally, no significant association was found between suicidal frequencies and brain area-related NSS score.

DISCUSSION

Childhood maltreatment adversely affects the brain of depressive patients; the different maltreatment may impair different brain areas, especially frontal and temporal areas.

Signing below the dotted line: signature position as a marker of vulnerability for visuospatial processing difficulties

Almost one-third of the participants in a neuropsychological study signed the consent form below the given line. The relationship between a signature position on or below the line and participants' cognitive function was investigated. Fifty drug-dependent individuals, 50 of their siblings, and 50 unrelated control participants completed a battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Individuals signing below, rather than on, the line performed more poorly on tests of visuospatial memory, but no differently on other cognitive tests. Signature positioning may be a soft sign for impairment of the mechanisms involved in visuospatial memory.