Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0090
Trends in Psychiatry and Psychotherapy
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Characterization of neurological soft signs in a Brazilian sample of stable patients with schizophrenia

Caracterização de sinais neurológicos sutis em uma amostra brasileira de pacientes estáveis com esquizofrenia

Vinicius Sousa Pietra Pedroso; Antônio Lúcio Teixeira; João Vinícius Salgado

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Abstract

Abstract Introduction: Neurological soft signs (NSS) have been considered one of the target features and a potential endophenotype for schizophrenia. The present study aimed to characterize NSS in a sample of patients with chronic schizophrenia and to compare them with healthy control individuals. Methods: In this study, we evaluated the presence of NSS in a sample of stable patients (n = 24) diagnosed with schizophrenia according to DSM-IV criteria, recruited at the Schizophrenia Outpatient Clinic of Instituto Raul Soares, Belo Horizonte, state of Minas Gerais, southeastern Brazil. Assessment was made with the Brief Motor Scale (BMS), and extrapyramidal symptoms (EPS) were evaluated with the Simpson-Angus Scale (SAS) and the Abnormal Involuntary Movement Scale (AIMS). A control group (n = 21) was also submitted to the same battery of tests. Results: We observed a significant difference in relation to BMS and SAS scores (p < 0.0001), revealing that individuals with schizophrenia present more NSS and EPS than healthy ones. BMS total scores correlated positively with SAS scores (r = 0.495, p = 0.014), but not with AIMS scores, indicating that NSS could be influenced by the intensity of EPS. Nevertheless, we observed that this relationship remained only for motor coordination tasks (r = 0.550, p = 0.005), while motor sequencing tasks were not influenced by EPS (r = 0.313, p = 0.136). Conclusion: The results suggest that NSS are more frequent in patients with schizophrenia and that motor sequencing tasks could be more specific to the syndrome.

Keywords

Neurological soft signs, schizophrenia, extrapyramidal symptoms

Resumo

Resumo Introdução: Sinais neurológicos sutis (SNS) têm sido considerados características básicas e potenciais endofenótipos na esquizofrenia. O presente estudo procurou caracterizar os SNS em uma amostra de pacientes com esquizofrenia crônica e compará-los com indivíduos controles saudáveis. Métodos: Neste estudo, avaliamos a presença de SNS em uma amostra de pacientes estáveis (n = 24) com o diagnóstico de esquizofrenia de acordo com os critérios do DSM-IV, recrutados no Ambulatório de Esquizofrenia do Instituto Raul Soares, Belo Horizonte, MG, Brasil. A avaliação foi realizada com a Escala Motora Breve (BMS) e sinais extrapiramidais (SEP) foram observados com a Escala de Simpson-Angus (SAS) e a Escala de Movimentos Involuntários Anormais (AIMS). Um grupo controle (n = 21) também foi submetido à mesma bateria de testes. Resultados: Observamos uma diferença significativa em relação aos escores da BMS e da SAS (p < 0,0001), revelando que indivíduos com esquizofrenia apresentam mais SNS e SEP que indivíduos saudáveis. Os escores da BMS se correlacionaram positivamente com os da SAS (r = 0,495, p = 0,014), mas não com os da AIMS, indicando que os SNS podem ser influenciados pela intensidade de SEP. No entanto, observamos que essa relação permaneceu somente para as tarefas de coordenação motora (r = 0,550, p = 0,005), enquanto as tarefas de sequenciamento motor não foram influenciadas pelos SEP (r = 0,313, p = 0,136). Conclusão: Os resultados sugerem que os SNS são mais frequentes em pacientes com esquizofrenia e que tarefas de sequenciamento motor podem ser mais específicas na síndrome.

Palavras-chave

Sinais neurológicos sutis, esquizofrenia, sinais extrapiramidais

References

Pedroso VSP, Salgado JV, Teixeira AL. Neurological soft signs: a review. J Bras Psiquiatr. 2010;59:233-7.

Morrens M, Docx L, Walther S. Beyond boundaries: in search of an integrative view on motor symptoms in schizophrenia. Front Psychiatry. 2014;5:145.

Bachmann S, Degen C, Geider FJ, Schröder J. Neurological soft signs in the clinical course of schizophrenia: results of a meta-analysis. Front Psychiatry. 2014;5:185.

Chan RC, Dai S, Lui SS, Ho KK, Hung KS, Wang Y. Re-visiting the nature and relationships between neurological signs and neurocognitive functions in first-episode schizophrenia: An invariance model across time. Sci Rep. 2015;5:11850.

Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261-76.

Amorim P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr. 2000;22:106-15.

Jahn T, Cohen R, Hubmann W, Mohr F, Köhler I, Schlenker R. The Brief Motor Scale (BMS) for the assessment of motor soft signs in schizophrenic psychoses and other psychiatric disorders. Psychiatry Res. 2006;142:177-89.

Simpson GM, Angus JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl. 1970;212:11-9.

Guy W. Abnormal involuntary movement scale (AIMS). ECDEU Assessment Manual for Psychopharmacology. 1976:534-7.

Dazzan P, Murray RM. Neurological soft signs in first-episode psychosis: a systematic review. Br J Psychiatry. 2002;43:s50-7.

Hui CL, Wong GH, Chiu CP, Lam MM, Chen EY. Potential endophenotype for schizophrenia: neurological soft signs. Ann Acad Med Singapore. 2009;38:408-13.

Manschreck TC, Ames D. Neurologic features and psychopathology in schizophrenic disorders. Biol Psychiatry. 1984;19:703-19.

Woods BT, Kinney DK, Yurgelun-Todd D. Neurologic abnormalities in schizophrenic patients and their families: I. Comparison of schizophrenic, bipolar, and substance abuse patients and normal controls. Arch Gen Psychiatry. 1986;43:657-63.

Hirjak D, Thomann PA, Kubera KM, Wolf ND, Sambataro F, Wolf RC. Motor dysfunction within the schizophrenia-spectrum: a dimensional step towards an underappreciated domain. Schizophr Res. 2015;169:217-33.

Chan RC, Xie W, Geng FL, Wang Y, Lui SS, Wang CY. Clinical utility and lifespan profiling of neurological soft signs in schizophrenia spectrum disorders. Schizophr Bull. 2016;42:560-70.

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