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Background: Rapid cycling (RC) is a special subtype of bipolar disorder (BD). Previous studies have rarely involved the investigation of neurological soft signs (NSS) and emotional intelligence (EI) in rapid cycling patients. Object: This study aims to compare the differences in NSS and EI between patients with RC and non‐rapid cycling (NRC) in BD. Methods: The Cambridge Neurological Inventory and The Mayer–Salovey–Caruso Emotional Intelligence Test were used to assess the NSS and EI levels of euthymic patients with BD and healthy controls (HC). Patients were divided into RC and NRC groups. Results: In terms of NSS, both the RC and NRC groups scored significantly higher than the HC group in the Motor coordination subdomain and total scores. In the Sensory integration subdomain, there was a significant trend of RC group scoring higher than the NRC group, which in turn scored higher than the HC group. In terms of EI, there was a trend of RC group scoring lower than the NRC group, which scored lower than the HC group in the understanding emotions subdomain and MSCEIT total score. In the managing emotions subdomain, the RC group scored lower than the HC group. Conclusion: Compared to the NRC group, the RC group exhibited higher NSS levels, mainly manifesting in more severe sensory integration impairment. The RC group scored lower in EI, primarily reflected in understanding and managing emotions, and the managing emotions subdomain may serve as a more sensitive indicator to distinguish between the two groups. [ABSTRACT FROM AUTHOR]

Background Treatment resistance is a major challenge in psychiatric disorders. Early detection of potential future resistance would improve prognosis by reducing the delay to appropriate treatment adjustment and recovery. Here, we sought to determine whether neurodevelopmental markers can predict therapeutic response. Methods Healthy controls (N = 236), patients with schizophrenia (N = 280) or bipolar disorder (N = 78) with a known therapeutic outcome, were retrospectively included. Age, sex, education, early developmental abnormalities (obstetric complications, height, weight, and head circumference at birth, hyperactivity, dyslexia, epilepsy, enuresis, encopresis), neurological soft signs (NSS), and ages at first subjective impairment, clinical symptoms, treatment, and hospitalization, were recorded. A supervised algorithm leveraged NSS and age at first clinical signs to classify between resistance and response in schizophrenia. Results Developmental abnormalities were more frequent in schizophrenia and bipolar disorder than in controls. NSS significantly differed between controls, responsive, and resistant participants with schizophrenia (5.5 ± 3.0, 7.0 ± 4.0, 15.0 ± 6.0 respectively, p = 3 × 10 −10) and bipolar disorder (5.5 ± 3.0, 8.3 ± 3.0, 12.5 ± 6.0 respectively, p < 1 × 10 −10). In schizophrenia, but not in bipolar disorder, age at first subjective impairment was three years lower, and age at first clinical signs two years lower, in resistant than responsive subjects (p = 2 × 10 −4 and p = 9 × 10 −3 , respectively). Age at first clinical signs and NSS accurately predicted treatment response in schizophrenia (area-under-curve: 77 ± 8%, p = 1 × 10 −14). Conclusions Neurodevelopmental features such as NSS and age of clinical onset provide a means to identify patients who may require rapid treatment adaptation. [ABSTRACT FROM AUTHOR]

Aim: Relapse rates are very high in schizophrenia. However, little is known about the predictors of the time to relapse other than treatment non‐adherence. We investigated possible risk factors for the time to relapse in patients with first‐episode schizophrenia (n = 107) who received assured treatment by way of long‐acting injectable antipsychotic over 24 months and who underwent regular clinical, cognitive, and metabolic assessments. Methods: Using Cox regression analyses we assessed selected premorbid and baseline potential predictors of time to relapse. Relapse was defined using operationally defined relapse criteria. Results: In the primary analysis only neurological soft signs total score retained significance, with higher scores predicting shorter time to relapse (HR = 1.05, 95% CI = 1.01–1.10, p =.029). In a more detailed secondary analysis poorer social relationships predicted shorter time to relapse (HR = 0.85, 95% CI = 0.76–0.95, p =.003). Conclusion: Our predominantly negative findings suggest that many of the previously implicated risk factors for the time to relapse are mediated by non‐adherence rather than having a direct effect on relapse‐proneness. Neurological soft signs, and perhaps quality of life in social relationships appear to play a role and merit further investigation. [ABSTRACT FROM AUTHOR]

There is growing evidence of disproportionate retinal thinning in schizophrenia, but doubts are still raised regarding its significance in the context of the neurobiology of the disease. Therefore, we examined whether these abnormalities are significantly associated with neurological soft signs (NSS) which are closely related to the risk of schizophrenia. This cross-sectional study analyzing linear correlations between variables involved 56 schizophrenia inpatients and 60 controls. The results confirmed such relationships, and only in the patient sample. In addition, retinal abnormalities and NSS were significantly correlated with duration of illness. These findings provide further evidence for linked neurodevelopmental and neurodegenerative aspects of schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract Neurological soft signs (NSS), discrete deficits in motor coordination and sensory integration, have shown promise as markers in autism diagnosis. While motor impairments, partly associated with core behavioral features, are frequently found in children with autism, there is limited evidence in adults. In this study, NSS were assessed in adults undergoing initial diagnosis of high-functioning autism (HFA), a subgroup difficult to diagnose due to social adaptation and psychiatric comorbidity. Adults with HFA (n = 34) and 1:1 sex-, age-, and intelligence-matched neurotypical controls were administered a structured NSS examination including motor, sensory, and visuospatial tasks. We showed that adults with HFA have significantly increased motor coordination deficits compared with controls. Using hierarchical cluster analysis within the HFA group, we also identified a subgroup that was particularly highly affected by NSS. This subgroup differed from the less affected by intelligence level, but not severity of autism behavioral features nor global psychological distress. It remains questionable whether motor impairment represents a genuinely autistic trait or is more a consequence of factors such as intelligence. Nevertheless, we conclude that examining NSS in terms of motor coordination may help diagnose adults with HFA and identify HFA individuals who might benefit from motor skills interventions.

Background: To determine the association between neurological soft signs, executive functions, and serum brain-derived neurotrophic factor (BDNF) levels in children with attention-deficit hyperactivity disorder (ADHD). Methods: Serum BDNF levels were measured in 87 drug-naive boys with ADHD, aged 7–12 years. The Revised Physical and Neurological Examination for Subtle Signs for neurological soft signs, Stroop Color-Word Test for attention functions, and Judgment of Line Orientation Test (JLOT) for visuospatial abilities were performed. Results: Age correlated negatively with dysrhythmia, total time, and total overflow in timed movements, Stroop Color-Word Time (SCWT), and serum BDNF levels. The JLOT significantly negatively correlated with Total Gaits and Stations (P1) and Total Time in Timed Movements (adjusted R2 = 0.247). In addition, SCWT maintained a significant correlation with Total Overflow in Timed Movements (adjusted R2 = 0.206). There was no correlation between serum BDNF levels and NSS. Conclusion: The association between NSS, visuospatial abilities, and selective attention may express a maturational delay in ADHD pathophysiology. Moreover, BDNF may play a role in this maturational delay. Future studies should investigate the contribution of BDNF to neuronal maturation in ADHD.

Neurological soft signs (NSS) are subtle motor control impairments that include involuntary movements and abnormalities of motor coordination, sensory integration and lateralization. They engage different brain networks, including the prefrontal networks that support the higher cognitive functions that are dysfunctional in obsessive-compulsive disorder (OCD). This study investigated the relationships between the presence of NSS and patients' severity of OCD symptoms, insight, and treatment resistance in a sample of 63 patients. Treatment-resistance was assessed considering all the treatments the patients received during the course of their disease. The four dimensions of OCD defined in the dimensional obsessive-compulsive scale were considered. Links between the patients' cognitive abilities and NSS were assessed using tests targeting specifically the core components of executive functions. As expected, OCD patients displayed more NSS than individually matched control participants. In OCD patients, high NSS scores were associated with poor insight and lower cognitive abilities. Multiple regression analysis identified worse visuospatial working memory, attentional control, and verbal fluency as predictive factors of high NSS scores among cognitive functions. Unexpectedly, the patients displaying symptoms in the contamination/washing dimension displayed less NSS than the other patients. In contrast, neither the severity of OCD symptoms nor long-range treatment resistance was significantly related to patients' NSS scores. Altogether, our findings suggest that high NSS scores may be a trait marker of a subset of OCD patients with low insight and particularly altered cognitive abilities who would not express the contamination/washing dimension of the pathology. [ABSTRACT FROM AUTHOR]

Background: To determine the association between neurological soft signs, executive functions, and serum brain-derived neurotrophic factor (BDNF) levels in children with attention-deficit hyperactivity disorder (ADHD). Methods: Serum BDNF levels were measured in 87 drug-naive boys with ADHD, aged 7--12 years. The Revised Physical and Neurological Examination for Subtle Signs for neurological soft signs, Stroop Color-Word Test for attention functions, and Judgment of Line Orientation Test (JLOT) for visuospatial abilities were performed. Results: Age correlated negatively with dysrhythmia, total time, and total overflow in timed movements, Stroop Color-Word Time (SCWT), and serum BDNF levels. The JLOT significantly negatively correlated with Total Gaits and Stations (P1) and Total Time in Timed Movements (adjusted R2 = 0.247). In addition, SCWT maintained a significant correlation with Total Overflow in Timed Movements (adjusted R2 = 0.206). There was no correlation between serum BDNF levels and NSS. Conclusion: The association between NSS, visuospatial abilities, and selective attention may express a maturational delay in ADHD pathophysiology. Moreover, BDNF may play a role in this maturational delay. Future studies should investigate the contribution of BDNF to neuronal maturation in ADHD. [ABSTRACT FROM AUTHOR]

Schizophrenia is a severe, chronic neuropsychiatric disorder characterized by symptoms that profoundly impact behavior, cognition, perception, and emotions, leading to a reduced quality of life and physical impairment. Given the complexity of schizophrenia, there is a pressing need for clinical markers and tools to predict its course, enhance disease staging, facilitate early intervention, improve differential diagnosis, and tailor individualized treatment approaches. Previous studies focused on the relationship between neurological soft signs (NSS) and factors such as age, illness duration, and symptomatology, indicating NSS as state markers improving in parallel with psychotic symptom remission or predicting treatment resistance. However, there is a lack of consensus on NSS assessment tools, hindering routine clinical monitoring despite diagnostic and prognostic potential. The present longitudinal study involved 81 psychiatric inpatients diagnosed with schizophrenia. Patients were assessed at three time points: baseline, 1 month, and 6 months. The examination included the use of scales to evaluate psychotic and neurological symptoms, as well as the identification of adverse extrapyramidal reactions caused by neuroleptic treatment. The progression of NSS was correlated to both the symptomatology and the sociodemographic data of the patients. The main findings from the present investigation revealed a statistical correlation between NSS and psychopathological symptoms, especially with negative symptoms of schizophrenia. However, it is important to note that neuroleptic side effects only had a limited impact on NSS. Therefore, instead of being linked to extrapyramidal symptoms caused by neuroleptics, NSS appears to be more frequently related with symptoms of schizophrenia. Our findings provide further support for their strong association with the course of schizophrenia, independent of treatment side effects, thus emphasizing their potential as reliable assessment tools in both research and clinical settings. [ABSTRACT FROM AUTHOR]

Neurological soft signs, considered to be an endophenotype in schizophrenia patients, have also been investigated in patients with schizophrenia as a clinical correlate of violent/aggressive behavior. We aimed to establish a homogeneous group in the context of violent behavior by including patients with schizophrenia who were admitted to a forensic psychiatry service and who were under protection. The pre-criminal employment rate for the case group was lower than that for the control group, and the history of substance abuse was significantly higher in criminal schizophrenia patients. No statistically significant difference was found between the two groups when the neurological soft symptoms, PANSS scores, Stroop test scores, and other sociodemographic factors were compared. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder's (BD) potential endophenotypes include neurological soft signs (NSS) and neurocognitive disorders (ND). Few research, meanwhile, has coupled NSS and ND as combined endophenotypes of BD. Object: This study intends to investigate NSS and ND and compare their differences in euthymic patients with bipolar disorder (EBP), their unaffected first‐degree relatives (FDR), and healthy controls (HC). Additionally, search for potential endophenotypic subprojects of NSS and ND and construct and verify a composite endophenotypic. Methods: The subjects were all Han Chinese and consisted of 86 EBP, 81 FDR, and 81HC. Cambridge Neurological Inventory and MATRICSTM Consensus Cognitive Battery tested NSS and ND independently. Results: All three groups displayed a trapezoidal distribution of NSS levels and cognitive abnormalities, with EBP having the most severe NSS levels and cognitive deficits, followed by FDR and HC. Among them, motor coordination in NSS and Information processing speed (IPS), Verbal learning (VL), and Working memory (WM) in neurocognitive function are consistent with the traits of the endophenotype of BD. The accuracy in differentiating EBP and HC or FDRs and HC was higher when these items were combined as predictor factors than in differentiating EBP and FDR. Conclusion: These results provide more evidence that motor coordination, IPS, VL, and WM may be internal characteristics of bipolar disease. When these characteristics are combined into a complex endophenotype, it may be possible to distinguish BD patients and high‐risk groups from normal populations. [ABSTRACT FROM AUTHOR]

Introduction: Evidence has shown that neurological soft signs are strongly associated with neurocognitive dysfunction. Therefore, the primary objective of this study was to assess the association between NSS and cognitive impairments in a sample of inpatients with schizophrenia. The secondary objective was to explore the association between NSS total scores and functioning. Methods: The study enrolled 95 inpatients diagnosed with schizophrenia disorders and 45 healthy controls. The neurological evaluation scale (NES) was used to assess neurological soft sign while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive functioning in patients with schizophrenia. Results: Patients with schizophrenia had significantly higher mean scores on the NES total test and subtests than the control group. Higher cognition was significantly associated with lower NES total and subtest scores. Higher functional independence was significantly associated with a lower NES total score (Beta = −.25), lower motor coordination subtest score (Beta = −.04), and lower others subtest (Beta = −.12). When taking the functional independence scale as the dependent variable, a higher NES total score was significantly associated with lower functioning (Beta = −0.03). Conclusion: NSS were associated to neurocognitive impairments in almost every domain among patients with schizophrenia. Further prospective research is still needed to confirm this role. [ABSTRACT FROM AUTHOR]

Abstract Background Bipolar disorder's (BD) potential endophenotypes include neurological soft signs (NSS) and neurocognitive disorders (ND). Few research, meanwhile, has coupled NSS and ND as combined endophenotypes of BD. Object This study intends to investigate NSS and ND and compare their differences in euthymic patients with bipolar disorder (EBP), their unaffected first‐degree relatives (FDR), and healthy controls (HC). Additionally, search for potential endophenotypic subprojects of NSS and ND and construct and verify a composite endophenotypic. Methods The subjects were all Han Chinese and consisted of 86 EBP, 81 FDR, and 81HC. Cambridge Neurological Inventory and MATRICSTM Consensus Cognitive Battery tested NSS and ND independently. Results All three groups displayed a trapezoidal distribution of NSS levels and cognitive abnormalities, with EBP having the most severe NSS levels and cognitive deficits, followed by FDR and HC. Among them, motor coordination in NSS and Information processing speed (IPS), Verbal learning (VL), and Working memory (WM) in neurocognitive function are consistent with the traits of the endophenotype of BD. The accuracy in differentiating EBP and HC or FDRs and HC was higher when these items were combined as predictor factors than in differentiating EBP and FDR. Conclusion These results provide more evidence that motor coordination, IPS, VL, and WM may be internal characteristics of bipolar disease. When these characteristics are combined into a complex endophenotype, it may be possible to distinguish BD patients and high‐risk groups from normal populations.

Despite extensive research, the etiology of negative symptoms is not well understood. Preliminary findings are linking motor disturbances to negative symptom severity. We aimed to further the understanding to what extent motor movement preparation influences negative symptom severity. In a cohort of 31 subjects with schizophrenia and 20 control subjects we recorded the readiness potential amplitude over Cz during spontaneous movements of the right and left thumb. We further assessed negative and positive symptom severity (scale for the assessment of negative and positive symptoms) as well as neurological soft signs (NSS). In subjects with schizophrenia the severity of negative symptoms was best predicted by the readiness potential amplitude and the NSS subdomain motor coordination. The correlation between deficits in motor coordination and negative symptom severity was partially mediated by the readiness potential amplitude in subjects with schizophrenia. Deficits in motor processing are linked to negative symptom severity in schizophrenia. The readiness potential may represent a biological marker of these basal deficits. In combination with the assessment of NSS, the readiness potential may be a marker of the course of negative symptom severity and help clarifying interdependencies between (pre)frontal networks for action initiation and coordination, as well as negative symptoms. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Recent research has focused on neurological soft signs (NSS) in bipolar disorder (BD), but there is still scarce evidence on their correlates with other relevant variables. The aim of this study was to explore the association between NSS and clinical demographic, neurocognitive, and functional variables. Eighty-eight euthymic BD patients were included in whom NSS were assessed using the Neurological Evaluation Scale. All subjects performed an extensive neurocognitive battery selected to assess premorbid IQ, attention, language, verbal memory, and executive functions. Psychosocial outcomes were assessed by means of the Functioning Assessment Short Test. Among the demographical variables, NSS tended to be negatively associated with years of education and increased with age. Likewise, NSS were higher in BD type I than in BD type II, but independent of age at illness onset and number of previous affective episodes. There was a negative correlation between NSS and premorbid IQ, as well as with performance in attention, language, and executive functions. Results tended to be unchanged when controlled for potential confounders. Although NSS were associated with poor psychosocial functioning in the bivariate analysis, when added to a multiple regression model including neurocognition, these neurological features did not significantly contribute to the variance of the functional outcome. Our findings contribute to a better characterization of NSS in BD; their potential clinical and theoretical implications are discussed in the manuscript. [ABSTRACT FROM AUTHOR]

INTRODUCTION: This study aimed to investigate the relationships between neurological soft signs (NSS), circadian preferences, and emotional regulation difficulties in patients with bipolar disorder (BD) and their unaffected first-degree relatives (FDRs). METHODS: A total of 105 people (35 BD patients, 35 FDRs, and 35 healthy controls) enrolled in the study. They completed a sociodemographic information form, the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), Morningness-Eveningness Questionnaire (MEQ), Difficulties in Emotion Regulation Scale (DERS), and Neurological Evaluation Scale (NES). RESULTS: NES motor coordination, complex motor movements, other subscale and total scores were significantly higher in BD and FDRs compared to the control group. The subscales of the DERS including nonacceptance, goals, impulse, strategies, accessibility, and total DERS scores were also significantly higher in patients than the relative and control groups. A statistically positive, weak, and significant relationship emerged between the patient group's other NES sub-dimension and the DERS sub-dimensions of impulse and awareness. Meanwhile, significant relationship was found in the FDRs between NSS and the NES sub-dimensions emotional integration and complex motor movements. A significant relationship was also found between the DERS sub-dimension nonacceptance and the NSS sub-dimension complex motor movements. DISCUSSION AND CONCLUSION: This study discovered that NSS are associated with negative emotional regulation strategies in patients with BD during in euthymic period and FDRs. NSS and circadian preferences may be endophenotype candidates for BD.

Abstract Background Neurological soft signs (NSS) are often reported in patients with schizophrenia and may vary with psychopathological symptoms during the course of disease. Many cross-sectional neuroimaging studies have shown that NSS are associated with disturbed network connectivity in schizophrenia. However, it remains unclear how these associations change over time during the course of disorder. Methods In present study, 20 patients with first-episode schizophrenia and 20 controls underwent baseline structural magnetic resonance imaging (MRI) scan and at one-year follow-up. Structural network characteristics of patients and controls were analyzed using graph theoretical approach based on MRI data. NSS were assessed using the Heidelberg scale. Results At baseline, patients demonstrated significant changes of the local network properties mainly involving regions of the cortical-subcortical-cerebellar circuits compared to healthy controls. For further analysis, the whole patient group was dichotomized into a NSS-persisting and NSS-decreasing subgroup. After one-year follow-up, the NSS-persisting subgroup showed decreased betweenness in right inferior opercular frontal cortex, left superior medial frontal cortex, left superior temporal cortex, right putamen and cerebellum vermis and increased betweenness in right lingual cortex. However, the NSS-decreasing subgroup exhibited only localized changes in right middle temporal cortex, right insula and right fusiform with decreased betweenness, and in left lingual cortex with increased betweenness. Conclusions These findings provide evidence for brain network reorganization subsequent to clinical disease manifestation in patients with first-episode schizophrenia, and support the hypothesis that persisting NSS refer to progressive brain network abnormalities in patients with schizophrenia. Therefore, NSS could help to establish a better prognosis in first-episode schizophrenia patients.

Background: Neurological soft signs (NSS), as subtle, nonlocalising neurological abnormalities, are considered as the potential markers of psychosis. However, comparative studies of antipsychotic-naïve patients with first-episode psychosis (FEP) and first degree relatives (FDRs) are uncommon. We compared the prevalence and pattern of NSS in FEPs, their healthy FDRs and a healthy non-relatives' control group (HC), highlighted the relationship between NSS and psychopathology and proposed cut-off scores for prevalence studies. Materials and Methods: Two hundred and two participants per group were recruited. The FEPs were consecutive attendees; FDRs were accompanying caregivers; while the HC were from hospital staff. The Brief Psychiatric Rating Scale and the Neurological Evaluation Scale were used to assess psychopathology dimensions and NSS, respectively. Results: Using an item score of two ('substantial impairment'), the prevalence of at least one NSS was: 91.5% (95% confidence interval [CI]: 86.7%–94.9%), 16.8% (95% CI: 11.8%–22.7%) and 6.5% (95% CI: 3.5%–10.9%), respectively, for FEP, FDRs and HC. FEPs were impaired in a broad range of signs. The noteworthy relationships were as follows: (i) a significant correlation between the negative symptoms' dimension versus number of NSS (r = 0.4), and NSS total score (r = 0.3), (ii) the anxiety/depression dimension correlated negatively with number of NSS (r = −0.3) and (iii) NSS cut across psychosis categories. We propose a cut-off score of ≥ 4 for the number of signs signifying probable impairment. Conclusion: The findings indicate that, subject to further studies, NSS could be regarded as a broader phenotype of neurologic dysfunction associated with psychosis proness.

Background: Neurological soft signs (NSS), as subtle, nonlocalising neurological abnormalities, are considered as the potential markers of psychosis. However, comparative studies of antipsychotic‑naïve patients with first‑episode psychosis (FEP) and first degree relatives (FDRs) are uncommon. We compared the prevalence and pattern of NSS in FEPs, their healthy FDRs and a healthy non-relatives’ control group (HC), highlighted the relationship between NSS and psychopathology and proposed cut‑off scores for prevalence studies. Materials and Methods: Two hundred and two participants per group were recruited. The FEPs were consecutive attendees; FDRs were accompanying caregivers; while the HC were from hospital staff. The Brief Psychiatric Rating Scale and the Neurological Evaluation Scale were used to assess psychopathology dimensions and NSS, respectively. Results: Using an item score of two (‘substantial impairment’), the prevalence of at least one NSS was: 91.5% (95% confidence interval [CI]: 86.7%–94.9%), 16.8% (95% CI: 11.8%–22.7%) and 6.5% (95% CI: 3.5%–10.9%), respectively, for FEP, FDRs and HC. FEPs were impaired in a broad range of signs. The noteworthy relationships were as follows: (i) a significant correlation between the negative symptoms’ dimension versus number of NSS (r = 0.4), and NSS total score (r = 0.3), (ii) the anxiety/depression dimension correlated negatively with number of NSS (r = −0.3) and (iii) NSS cut across psychosis categories. We propose a cut‑off score of ≥ 4 for the number of signs signifying probable impairment. Conclusion: The findings indicate that, subject to further studies, NSS could be regarded as a broader phenotype of neurologic dysfunction associated with psychosis proness. [ABSTRACT FROM AUTHOR]

(1) Background: Neurological Soft Signs (NSS) are subtle neurological abnormalities that are more common in schizophrenia patients than in healthy individuals and have been regularly observed in neuroleptic-naive first-episode patients, supporting the hypothesis that they are an intrinsic component of schizophrenia. (2) Methods: a review of articles published in the last ten years (from January 2013 to January 2023) was carried out on articles published in ScienceDirect and PubMed, by following the PRISMA Statement extension for scoping reviews (PRISMA-ScR), which evaluated the impact of NSS in correlation with the symptomatology, neuroleptic treatment, and the cerebral structural changes of patients with schizophrenia. (3) Results: thirty articles were included, among them twelve included MRI structural evaluation and four studies with a longitudinal design. (4) Conclusions: interest in researching NSS has increased in recent years, but questions remain about their origin and relationship to schizophrenia symptoms, thus this study aims to fill in information gaps in the hope that future research will help provide individualized treatment. It is suggested that NSS in schizophrenia might have an inherited genetic relationship pattern, thus being in line with a trait viewpoint. Most of the research revealed that schizophrenia patients had higher NSS scores than healthy controls, however, they were rather similar to their first-degree relatives, thus, also arguing in favor of a trait perspective. The greatest improvement in scores is seen in those with a remitting course, as shown by declining NSS ratings concurrent with symptomatology. [ABSTRACT FROM AUTHOR]

Schizophrenia is a severe, chronic neuropsychiatric disorder characterized by symptoms that profoundly impact behavior, cognition, perception, and emotions, leading to a reduced quality of life and physical impairment. Given the complexity of schizophrenia, there is a pressing need for clinical markers and tools to predict its course, enhance disease staging, facilitate early intervention, improve differential diagnosis, and tailor individualized treatment approaches. Previous studies focused on the relationship between neurological soft signs (NSS) and factors such as age, illness duration, and symptomatology, indicating NSS as state markers improving in parallel with psychotic symptom remission or predicting treatment resistance. However, there is a lack of consensus on NSS assessment tools, hindering routine clinical monitoring despite diagnostic and prognostic potential. The present longitudinal study involved 81 psychiatric inpatients diagnosed with schizophrenia. Patients were assessed at three time points: baseline, 1 month, and 6 months. The examination included the use of scales to evaluate psychotic and neurological symptoms, as well as the identification of adverse extrapyramidal reactions caused by neuroleptic treatment. The progression of NSS was correlated to both the symptomatology and the sociodemographic data of the patients. The main findings from the present investigation revealed a statistical correlation between NSS and psychopathological symptoms, especially with negative symptoms of schizophrenia. However, it is important to note that neuroleptic side effects only had a limited impact on NSS. Therefore, instead of being linked to extrapyramidal symptoms caused by neuroleptics, NSS appears to be more frequently related with symptoms of schizophrenia. Our findings provide further support for their strong association with the course of schizophrenia, independent of treatment side effects, thus emphasizing their potential as reliable assessment tools in both research and clinical settings.

Background: The neurological abnormalities known as neurological soft signs (NSSs), which manifest in some mentally ill individuals, are categorized as “soft” to represent a lack of precise cerebral location. They consist of inhibitory, motor, and sensory disorders. Aims: (i) To assess the NSS and compare their prevalence in patients with psychotic and non-psychotic symptoms, (ii) To determine the relationship between NSS and other sociodemographic characteristics. Materials and Methods: In this cross-sectional study, 50 patients with psychotic symptoms (schizophrenia, schizophrenia spectrum disorders, and bipolar affective disorder) and 50 patients with non-psychotic symptoms (anxiety, depressive, dissociative, and somatoform disorder) disorders were examined by a psychiatrist and diagnosed using the International Classification of Diseases 10 criteria. The patients were separated into two groups: psychotic and non-psychotic, and they were assessed using a 26-item Neurological Evaluation Scale (NES) to get their NSS score, which was then compared between the two groups. Results: In our study, the sample was dominated by females (n = 57), with a mean age of 35.38 ± 10.74 years. Patients with psychotic symptoms had a statistically higher mean NES score than patients without psychotic symptoms (20.62 ± 13.34 and 9.12 ± 4.91, respectively, p

The impact of cannabis use on neurological soft signs (NSS) in patients with schizophrenia is a topic of growing interest. This narrative review aims to provide an overview of the current understanding of this relationship. The PubMed database was used to identify relevant articles, and the initial search yielded a total of 144 publications. By using automation tools, 137 records were removed, and seven remaining studies were further reviewed in full-text. Results. The findings suggest that, although the use of cannabis decreases the global expression of NSS, heavy cannabis use is associated with higher levels of NSS in sensorimotor subdomains related to complex motor tasks. Furthermore, neuroimaging studies have revealed alterations in brain regions involved in sensorimotor execution and control in individuals with heavy cannabis use. These findings support the hypothesis that cannabis, through its effects on the sensorimotor system, can impair neurological functioning and increase the positive symptoms of schizophrenia. In conclusion, this narrative review highlights the complex relationship between cannabis use, neurological soft signs and schizophrenia. Understanding the impact of cannabis on NSS in patients with schizophrenia is crucial for developing targeted interventions and for optimizing treatment outcomes. Further research, including longitudinal studies and meta-analyses, is warranted to enhance our understanding of this important area. [ABSTRACT FROM AUTHOR]

The significance of neurological soft signs (NSS) in major depressive disorder (MDD) remains unclear and the stability of NSS in relation to antidepressant treatment has never been investigated. We hypothesized that NSS are relatively stable trait markers of MDD. We thus predicted that patients show more NSS than healthy controls, irrespective of illness duration and antidepressant treatment. To test this hypothesis, NSS were assessed in chronically depressed, medicated MDD patients before (n = 23) and after (n = 18) a series of electroconvulsive therapy (ECT). In addition, NSS were assessed once in acutely depressed, unmedicated MDD patients (n = 16) and healthy controls (n = 20). We found that both chronically depressed, medicated MDD patients and acutely depressed, unmedicated MDD patients showed more NSS than healthy controls. The degree of NSS in both patient groups did not differ. Importantly, we found no change in NSS after on average eleven sessions of ECT. Thus, the manifestation of NSS in MDD seems to be independent of illness duration and pharmacological and electroconvulsive antidepressant treatment. From a clinical perspective, our findings corroborate the neurological safety of ECT. [ABSTRACT FROM AUTHOR]

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This study aimed to compare clinical-demographic features of melancholic and nonmelancholic depressions. We included 141 depressed inpatients classified as melancholic and nonmelancholic by the Sydney Melancholia Prototype Index (SMPI) and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria. Results were controlled for confounders, including severity measures. Melancholic patients by both diagnostic systems were more severely depressed and presented more psychotic symptoms, neurological soft signs, and psychomotor disturbances. Melancholic patients classified by the SMPI were also older at illness onset and had fewer suicide attempts. After controlling for confounders, although all differences remained significant for SMPI diagnosis, the DSM-5 diagnosis of melancholia was only associated with further impaired motor sequencing. The results obtained with the SMPI support the hypothesis that melancholia has clinical features qualitatively different from those of nonmelancholic depressions. Contrarily, the DSM-5 specifier seems to reflect the severity of depressive episodes rather than core clinical features of melancholia. [ABSTRACT FROM AUTHOR]

Sensorimotor dysfunction has been previously reported in persons with cannabis dependence. Such individuals can exhibit increased levels of neurological soft signs (NSS), particularly involving motor coordination, sensorimotor integration and complex motor task performance. Abnormal NSS levels can also be detected in non‐dependent individuals with heavy cannabis use (HCU), yet very little is known about the functional correlates underlying such deficits. Here, we used resting‐state functional magnetic resonance imaging (MRI) to investigate associations between NSS and intrinsic neural activity (INA) in HCU (n = 21) and controls (n = 26). Compared with controls, individuals with HCU showed significantly higher NSS across all investigated subdomains. Three of these subdomains, that is, motor coordination, sensorimotor integration and complex motor task behaviour, were associated with specific use‐dependent variables, particularly age of onset of cannabis use and current cannabis use. Between‐group comparisons of INA revealed lower regional homogeneity (ReHo) in left precentral gyrus, left inferior occipital gyrus, right triangular pat of the inferior frontal gyrus and right precentral gyrus in HCU compared with controls. In addition, HCU showed also higher ReHo in right cerebellum and left postcentral gyrus compared with controls. Complex motor task behaviour in HCU was significantly related to INA in postcentral, inferior frontal and occipital cortices. Our findings indicate abnormal ReHo in HCU in regions associated with sensorimotor, executive control and visuomotor‐integration processes. Importantly, we show associations between ReHo, cannabis‐use behaviour and execution of complex motor tasks. Given convergent findings in manifest psychotic disorders, this study suggests an HCU endophenotype that may present with a cumulative risk for psychosis. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is a serious disorder with a lifetime prevalence of 2.7–5.9% and is thought to correlate with altered neuroplasticity. The aim of the present study is to investigate possible associations of BPD (−severity) and alterations in neurological soft signs (NSS) and olfactory function. For the monocentric observational study, 39 female subjects with a BPD diagnosis and 19 female healthy control subjects were recruited. The groups were matched by age. Olfactory functions were examined using Sniffin' Sticks. NSS were assessed by a standardized test with 50 items. BPD subjects have higher NSS scores in group comparison. By contrast, there are no alterations in the total score of olfactory function, while the BPD subjects scored higher in smell identification. Within the BPD group, the total NSS score was discovered to have a negative correlation with olfactory function. BPD subjects taking antipsychotics show more NSS than those without. We found no significant influence of posttraumatic stress disorder on the NSS or olfactory function. The BPD-severity correlates with NSS. Due to the cross-sectional design, we did not have a follow up examination. The sample size was small, and all patients had psychiatric comorbidities. Additionally, we did not perform MRI to connect our findings with possible structural abnormalities. Our study confirmed altered NSS in BPD patients, whereas no impairment in the olfactory function was found. Further research is required to establish NSS and smell tests as clinical screening tools in BPD patients and to uncover the disorder's impact on neuroplasticity. • Female borderline personality disorder (BPD) patients have higher neurological soft sign (NSS) scores compared to healthy controls. • Female BPD patients taking antipsychotics show more NSS. • Female BPD patients tend to score higher in olfactory function regarding smell identification. • The symptom severity of BPD subjects correlates with the NSS score. [ABSTRACT FROM AUTHOR]

Background: In the recent years, there were several studies concerning the neurological soft signs (NSS) in attention deficit / hyperactivity disorder (ADHD); however, there were no study addressing either the possible relationship between these signs in children with ADHD and their mothers, or in proposing possible approaches in alleviating the ADHD signs, in the country. Aims: The aim of this study was investigating the relationship between neurological soft signs and neuropsychological problems in male children with ADHD, and furthermore proposing approaches in alleviating the ADHD symptoms. Methods: This was a mixed methods research, in which, in the first phase (Quantitative) descriptive and correlational method was used, and in the second phase (Qulitative) according to the findings, the thematic network (Attride and Stirling) was utilized in designing some activities for alleviating the signs of both mothers and children. The statistical population was comprised of all of the male primary students in Isfahan city, who were referred to five therapeutic centers in 2016. From 170 referred students One hundred were randomly selected, and then both the students and their mothers were asked to complete Cambridge neuropsychological questionnaire (1995. Data analysis was performed using Pearson correlation test and multiple linear regression analysis. Results: Following the analysis of data, the results of correlation and regression calculation, showed a significant correlation between neurological soft signs in children and their mothers, (r= 0.23). Furthermore, ther found positive correlations between total score of NSS in children with motor coordination in mothers (r= 0.71); total score of NSS in mothers with motor coordination (r= 0.68) and response control (r= 0.77) in children; and finally the correlation of subtest between mothers anf children were significant as well. In the qualitative phase, the basic themes (NSS in mothers and children), integrative themes (motor coordination, sensory integration and response control) and global themes (designed activities) were specified throough using themathic network, and then therapeutic program was compiled and validated for them. Conclusion: Significant relationship of NSS and ADHD signs between mothers and children suggested that there might be a neuropsychologic substrate for the signs, and accordingly the on-time diagnosis and implementing suitable therapeutic methods are necessary for both children and mothers.

Background: Neurological soft signs (NSS) are often reported in patients with schizophrenia and may vary with psychopathological symptoms during the course of disease. Many cross-sectional neuroimaging studies have shown that NSS are associated with disturbed network connectivity in schizophrenia. However, it remains unclear how these associations change over time during the course of disorder. Methods: In present study, 20 patients with first-episode schizophrenia and 20 controls underwent baseline structural magnetic resonance imaging (MRI) scan and at one-year follow-up. Structural network characteristics of patients and controls were analyzed using graph theoretical approach based on MRI data. NSS were assessed using the Heidelberg scale. Results: At baseline, patients demonstrated significant changes of the local network properties mainly involving regions of the cortical-subcortical-cerebellar circuits compared to healthy controls. For further analysis, the whole patient group was dichotomized into a NSS-persisting and NSS-decreasing subgroup. After one-year follow-up, the NSS-persisting subgroup showed decreased betweenness in right inferior opercular frontal cortex, left superior medial frontal cortex, left superior temporal cortex, right putamen and cerebellum vermis and increased betweenness in right lingual cortex. However, the NSS-decreasing subgroup exhibited only localized changes in right middle temporal cortex, right insula and right fusiform with decreased betweenness, and in left lingual cortex with increased betweenness. Conclusions: These findings provide evidence for brain network reorganization subsequent to clinical disease manifestation in patients with first-episode schizophrenia, and support the hypothesis that persisting NSS refer to progressive brain network abnormalities in patients with schizophrenia. Therefore, NSS could help to establish a better prognosis in first-episode schizophrenia patients. [ABSTRACT FROM AUTHOR]

Introduction. Children with learning disabilities not only experience difficulties in academic performance but also exhibit neurological risks of motor and sensory processing. Evaluation of such a group might help identify their deficits even before early adolescence. The study aimed to assess sensory and motor problems in children with different types of specific learning disabilities. Methods. A cross-sectional study was performed in students of 4th, 5th, and 6th grades in governmental schools, Cairo, Egypt. Overall, 200 children with poor scholastic achievement were screened with an intelligence quotient test (Raven's Progressive Matrices). The learning disabilities were evaluated with the Fathi al-Zayyat battery. Then, the Quick Neurological Screening Test was used to indicate motor and sensory problems. Results. A total of 50 out of 772 screened children were confirmed to have learning disabilities (dyscalculia: 29, dyslexia: 11, mixed: 10), which represented 6.47% of the sample. Neurological signs were positive in all children with specific learning disabilities, while 82% of them were below average. Conclusions. The study revealed that 82% of children with specific learning disabilities at 4th, 5th, and 6th grades were below age with a moderate discrepancy in the development of sensory and motor processes. The finger-to-nose test, double simultaneous stimulation of hand and cheek test, stand-on-leg test, and tandem walk test are associated with the type of specific learning disabilities (dyscalculia, dyslexia, or mixed). [ABSTRACT FROM AUTHOR]

Background and Hypothesis: While age at onset in schizophrenia (SCZ) is usually defined by age at onset of psychosis, the illness actually occurs earlier, with a prodrome often starting in childhood or adolescence. We postulated that SCZ with early-adolescence prodromes (SCZ-eaP) presents with social cognition deficits and sensorimotor impairments more similar to autism spectrum disorders (ASD) than SCZ with late-adolescence prodromes (SCZ-laP)., Study Design: The movie for the assessment of social cognition and neurological soft signs (NSS) were compared between four groups, ASD, SCZ-eaP (<15 years), SCZ-laP (>15 years), and controls (N = 119), while accounting for age, sex, intelligence quotient, education level, and medication effect. Mediation analyses tested the effect of NSS on social cognition, across groups, and local gyrification indices were used to test whether NSS reflected deviations in early neurodevelopmental trajectories., Study Results: For social cognition and NSS, subjects with ASD were not different from SCZ-eaP, while they differed from SCZ-laP. Age at onset of prodrome correlated with NSS (r = -0.34, P = .018), and social cognition (r = 0.28, P = .048). Neurological soft signs mediated social cognition impairment across diagnoses (β = -1.24, P < 1e-6), and was explained by hypergyrification in the right fusiform gyrus, right frontal pole gyrus, and left postcentral gyrus., Conclusions: Earlier age of prodrome in SCZ is associated with impaired social cognition, mediated by neurodevelopmentally-related sensorimotor impairments along the ASD-SCZ spectrum. It suggests age of prodrome, rather than the age at psychosis onset, should be considered to define more homogeneous subgroups in SCZ., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

Introduction: Neurological soft signs (NSS) are subtle non-localizing sensorimotor abnormalities initially reported as increased in primary headache patients. The aims of this study were confirming with full power NSS increased expression in migraine and, collaterally, determining if psychiatric traits or white matter lesions at brain imaging could influence this result.Methods: Forty drug-free episodic migraine outpatients (MH) were recruited with 40 matched controls. NSS were determined by the 16-item Heidelberg scale; depression, anxiety and QoL by the HAM-D; the STAI-X1/X2; and the SF36, respectively. The Fazekas scale on brain MR studies was applied in n = 32 MH, unravelling deep white matter signal alterations (DWM). MH characteristics, including the headache disability inventory (HDI), were recorded.Results: NSS were 46% increased in MH vs. controls (p = 0.0001). HAM-D and STAI-X1/X2 were increased in MH, while SF36 was unchanged, but they all failed to influence NSS, just as MH characteristics. NSS scores were increased in MH-DWM + (n = 11, + 85%) vs. MH-DWM - (n = 21, + 27%) vs. controls (p < 0.0001). NSS increased expression in MH was influenced by DWM, while psychiatric traits and headache characteristics failed to do so.Discussion/conclusions: NSS are increased in MH and probably not influenced by the affective status, possibly marking a dysfunction within the cerebellar-thalamic-prefrontal circuit that may deserve further attention from the prognostic point of view. [ABSTRACT FROM AUTHOR]

Background: Grey matter abnormalities and neurological soft signs (NSS) have been found in schizophrenia patients and their unaffected relatives. Evidence suggested that NSS are associated with grey matter morphometrical alterations in multiple regions in schizophrenia. However, the association between NSS and structural abnormalities at network level remains largely unexplored, especially in the schizophrenia and unaffected siblings.Method: We used source-based morphometry (SBM) to examine the association of structural brain network characteristics with NSS in 62 schizophrenia patients, 25 unaffected siblings, and 60 healthy controls.Results: Two components, namely the IC-5 (superior temporal gyrus, inferior frontal gyrus and insula network) and the IC-10 (parahippocampal gyrus, fusiform, thalamus and insula network) showed significant grey matter reductions in schizophrenia patients compared to healthy controls and unaffected siblings. Further association analysis demonstrated separate NSS-related grey matter covarying patterns in schizophrenia, unaffected siblings and healthy controls. Specifically, NSS were negatively associated with IC-1 (hippocampus, caudate and thalamus network) and IC-5 in schizophrenia, but with IC-3 (caudate, superior and middle frontal cortices network) in unaffected siblings and with IC-5 in healthy controls.Conclusion: Our results confirmed the key cortical and subcortical network abnormalities and NSS-related grey matter covarying patterns in the schizophrenia and unaffected siblings. Our findings suggest that brain regions implicating genetic liability to schizophrenia are partly separated from brain regions implicating neural abnormalities. [ABSTRACT FROM AUTHOR]

Advanced parental age at delivery and neurological soft signs (NSS) constitute risk factors for schizophrenia. The aim of the current study was to develop a neurobiological diagnostic index by combining them, and without the contribution of clinical symptomatology. The study sample included 133 patients suffering from schizophrenia according to DSM-IV-TR (77 males and 56 females; aged 33.55 ± 11.22 years old) and 122 normal controls (66 males and 56 females; aged 32.89 ± 9.91 years old). The assessment included the Neurological Evaluation Scale (NES), and a number of scales assessing the clinical symptoms and adverse effects. The statistical analysis included exploratory t-test, Pearson Correlation coefficient (R) and Discriminant Function Analysis (DFA). Exploratory t-tests and Pearson's R suggested that sex, parental age and NSS constitute independent components. On the basis of DFA results, the Psychotic Neurological Index was developed. At the cut-off PNI score of 8.5, sensitivity was equal to 94.74 and specificity to 93.44. The current is probably the first study to report on an easily obtainable diagnostic neurobiological marker with identifiable properties which is absolutely independent from the clinical manifestations and could serve in distinguishing between patients with schizophrenia and healthy controls with high efficacy. [ABSTRACT FROM AUTHOR]

Objective: To explore the characteristics of neurological soft signs and the relationship between neurological soft signs and cognitive deficits in patients with chronic deficit schizophrenia. Methods: Totally 62 long-term hospitalized patients with chronic schizophrenia who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected. They were divided into deficit and non-deficit schizophrenia groups according to the Schedule for the Deficit Syndrome (SDS) . All the patients were assessed with the Cambridge Nervous Inventory (CNI) for neurological soft signs (NSS),Matrix Consensus Cognitive Battery (MCCB) for cognitive function, and Simpson-Angus Extra Pyramidal System Scale (SAS) and Abnormal Involuntary Movement Scale (AIMS) for extra pyramidal response. Results: The deficit patients had higher NSS total scores (P <0. 05) and sensory integration scale scores (P <0. 05) than non-deficit patients. There was a negative correlation between CNI total scores and MCCB total scores in patients with chronic schizophrenia (r=-0. 63,P <0. 001) . Conclusion: It suggests that the patients with deficit schizophrenia have more neurological soft signs than those with non-deficit schizophrenia, mainly in sensory integration disorder. In patients with chronic schizophrenia, the more severe the neurological soft signs, the more significant the cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Synthetic cannabinoids are one of the most used novel psychoactive substances among adolescents with eminent adverse effects affecting cognitive functions and psychomotor performances. It was previously thought that undesirable effects brought by synthetic cannabinoids are more potent than organic cannabis products in terms of duration and intensity. This study aimed to assess the effects cannabis and synthetic cannabinoids on executive functions, whether persistent use is associated with their impairments and if related with the severity of addiction. Methods: We recruited 60 male adolescents from Okasha Institute of Psychiatry, Helwan Psychiatric hospital, and El Sahel youth center being 20 synthetic cannabinoids use disorder, 20 cannabis use disorder and controls. Teens Addiction Severity index was performed, then assessment of cognitive functions by Wisconsin card sorting test, Wechsler memory scale revised, Trail making tests, Benton visual Retention test and neurological soft signs with Cambridge neurological inventory. Results: No statistical significance found regarding neurological soft signs and Benton Visual Retention test. In Wisconsin card sorting test, synthetic cannabinoids patients are statistically higher in trials administered and trials to complete 1st category while tetrahydro-cannabinoid patients are statistically higher in perservative responses and errors. Regarding trail making tests, synthetic cannabinoids patients are statistically higher. Concerning Wechsler memory scale revised, controls are statistically higher in Verbal Paired Associates I and II, Visual Paired Associates I and II, and digit span total while synthetic cannabinoids were statistically higher in memory span total. Conclusion: There is no difference in neurological soft signs, visual perception, and visual memory. Frontal lobe executive functions are affected between substance use patients; synthetic cannabinoids affected more regarding initial conceptualization ability while tetrahydro-cannabinoid patients affected more regarding cognitive flexibility. Regarding visual scanning and working memory, synthetic cannabinoid patients are more affected. Concerning different memory functions, substance use patients are more affected than controls with synthetic cannabinoid patients being more affected. [ABSTRACT FROM AUTHOR]

Patients on hemodialysis suffer from several serious complex neurological complications resulting in significant disability. Early detection of these complications during the asymptomatic phase may consent to early intervention to prevent or minimize the disability. To assess and predict neurological soft signs (NSS) in non-diabetic end-stage renal disease (ESRD) patients on hemodialysis (HD) who do not suffer any apparent neurological symptoms. An analytical, cross-sectional study was done in Hemodialysis units in the Suez Canal University Hospitals. 96 ESRD adult patients on hemodialysis are exposed to: Medical history was taken via personal interview, laboratory tests, and clinical assessment of NSS using Heidelberg scale, and brain CT was done for 50 high-risk patients (hypertensive or those on dialysis for more than 5 years) to detect the presence of any probable neuro-radiological brain abnormalities. 79.2% of our studied ESRD patients on HD had positive NSS with a mean value of total score 8.5 ± 5.9. Strong positive correlations were present between NSS and Hb levels, duration of hemodialysis, and hypertension. CT had revealed no abnormality. NSS represent a reliable, affordable tool for regular bedside assessment of ESRD patients with HD who do not suffer any neurological symptoms for early detection of asymptomatic neurological lesions, especially since the CT brain scan did not show such changes early. The duration of hemodialysis, Hb level, and hypertension were independent predictors for the occurrence of silent neurological lesions in ESRD patients. [ABSTRACT FROM AUTHOR]

Neurological soft signs (NSSs) are subtle motor and sensory deficits, and are associated with poor cognitive abilities. Although cognitive ability has been found to be a significant predictor for academic performance in children, it remains unclear whether NSSs could contribute to academic abilities such as mathematical skills, and its contribution varies according to grade level. Therefore, in this cross‐sectional study, we examined the relationships between NSSs and different mathematical skills (calculation fluency, numerical operations, and mathematical problem‐solving) in 105 Chinese children (Mean age = 7.76 years, SD age = 0.67 years; 52 from second grade, 53 from third grade; 56 boys and 49 girls) recruited from a primary public school located in Shanghai. The results of regression analyses revealed that NSSs significantly predicted calculation fluency (β = −.32, p <.050), numerical operations (β = −.38, p <.050), and mathematical problem‐solving (β = −0.40, p <.010) in second but not third grade, even controlling for cognitive processes. Our results implicate that NSSs could be a potential predictor for mathematical skills in the early years of primary school. [ABSTRACT FROM AUTHOR]

Abstract Background Borderline personality disorder (BPD) is a severe psychiatric disorder with multiple psychopathological domains; so studying the correlation of clinical or behavioral data with underlying structural and functional neurological findings in BPD is the focus of interest in recent years. The aim of our study was to compare the presence of neurological soft signs (NSS) in patients with borderline personality disorder with their presence in normal controls, and to correlate the severity of different symptoms of BPD with the presence of NSS through a case-control study which was conducted on 30 patients and 30 matching controls recruited from Al Kasr Al Ainy Hospital, Cairo University, Egypt. All subjects were assessed by the Borderline Personality Questionnaire, the Barratt Impulsivity Scale-11, the Brief Non-Suicidal Self-Injury Assessment tool, and the Cambridge Neurological Inventory. Results The BPD group had significantly higher total NSS scores, primitive reflexes subscale score, and sensory integration subscale scores. There was also a positive correlation between NSS and overall severity of borderline symptoms. Conclusions The increased rates of NSS were associated with specific clinical symptoms in BPD including suicidality, self-harm, emptiness, and quasi-psychosis. Impulsivity was found to have the highest correlation with NSS.

Introduction: Neurological soft signs (NSS) can be defined as a group of minor nonlocalizable neurological abnormalities, including simple motor coordination, complex motor sequencing, and sensory integration dysfunctions. Research has postulated complex etiopathogenesis of schizophrenia which is amalgamation of various genetic, biological, and psychosocial factors. This study provides us opportunity to endorse the neurodevelopmental hypothesis in schizophrenia. Aim: The aim of this study is to study and compare NSS in patients suffering from schizophrenia, first-degree relatives and healthy controls. Methods: A cross-sectional, observational, noninterventional, single time assessment, and hospital-based study was carried out on 60 patients, 60 first-degree relatives, and 60 healthy controls. Evaluation was done using the Positive and Negative Syndrome Scale and the Cambridge Neurological Inventory (Part 2). Results were obtained, tabulated, and analyzed. Results: We observed that patients with schizophrenia had more NSS than healthy control as well as their first-degree relatives. Similarly, first-degree relatives of patients with schizophrenia had more NSS than healthy control. The most common soft sign in patients as well as relatives was Oseretsky test. Most of the patients performed poorly on tests for motor coordination and sensory integration so did their first-degree relatives. Conclusion: NSS can be potential endophenotype for patients suffering from schizophrenia. Patients with schizophrenia had more NSS than healthy control as well as their first-degree relatives. Similarly, first-degree relatives of patients with schizophrenia had more NSS than healthy control. This suggests a role of common genetic and/or environmental factors in the pathogenesis of these abnormalities in the two groups. This is in with support neurodevelopmental hypothesis of schizophrenia.

Abnormalities in language processing, psychological distress, and subtle neurodevelopmental features called neurological soft signs (NSS) are expressed by people with dyslexia and those scoring highly on schizotypy. We investigated whether the expression of NSS, distress, and schizotypy predicted dyslexia status. Participants (N = 96, 48 dyslexic) selected to be age and sex matched, completed the Schizotypal Personality Questionnaire, General Health Questionnaire, Neurological Evaluation Scale, and the National Adult Reading Test (NART; a measure of verbal intelligence). Dyslexia status was predicted by higher total NSS and disorganized schizotypy scores in the absence of NART. However, even with the inclusion of NART, disorganized schizotypy remained a significant predictor. The findings suggest that disorganized features of schizotypy could be a significant factor for those with dyslexia. Conversely, more attention needs to be given to developmental language disorders in those who score highly on schizotypy. [ABSTRACT FROM AUTHOR]

Background: Treatment resistance is a major challenge in psychiatric disorders. Early detection of potential future resistance would improve prognosis by reducing the delay to appropriate treatment adjustment and recovery. Here, we sought to determine whether neurodevelopmental markers can predict therapeutic response., Methods: Healthy controls ( N = 236), patients with schizophrenia ( N = 280) or bipolar disorder ( N = 78) with a known therapeutic outcome, were retrospectively included. Age, sex, education, early developmental abnormalities (obstetric complications, height, weight, and head circumference at birth, hyperactivity, dyslexia, epilepsy, enuresis, encopresis), neurological soft signs (NSS), and ages at first subjective impairment, clinical symptoms, treatment, and hospitalization, were recorded. A supervised algorithm leveraged NSS and age at first clinical signs to classify between resistance and response in schizophrenia., Results: Developmental abnormalities were more frequent in schizophrenia and bipolar disorder than in controls. NSS significantly differed between controls, responsive, and resistant participants with schizophrenia (5.5 ± 3.0, 7.0 ± 4.0, 15.0 ± 6.0 respectively, p = 3 × 10 -10 ) and bipolar disorder (5.5 ± 3.0, 8.3 ± 3.0, 12.5 ± 6.0 respectively, p < 1 × 10 -10 ). In schizophrenia, but not in bipolar disorder, age at first subjective impairment was three years lower, and age at first clinical signs two years lower, in resistant than responsive subjects ( p = 2 × 10 -4 and p = 9 × 10 -3 , respectively). Age at first clinical signs and NSS accurately predicted treatment response in schizophrenia (area-under-curve: 77 ± 8%, p = 1 × 10 -14 )., Conclusions: Neurodevelopmental features such as NSS and age of clinical onset provide a means to identify patients who may require rapid treatment adaptation.

Objectives Our study aimed to investigate the fronto-cerebellar volumes in both patients and controls, as well as explore their relationship with symptomatology. Our primary objectives were to compare the frontal and cerebellar lobe volumetric measurements between patients with first-episode schizophrenia (FES) and healthy controls and to assess the relationship of these volumes with psychopathology, cognition, and neurological soft signs in FES patients. The secondary objective was to explore the association of fronto-cerebellar lobe volumes with socio-demographic factors among patients and controls, as well as the duration of untreated illness (DUI) among patients. Materials and methods This was a cross-sectional, case-control study involving 60 participants, including 30 antipsychotic-naïve FES patients and 30 healthy controls. Participants underwent MRI scanning to measure frontal and cerebellar lobe volumes using the volBrain platform. Additionally, FES patients were assessed using the Positive and Negative Syndrome Scale (PANSS), Montreal Cognitive Assessment-Basic (MoCA-B), and Brief Motor Scale (BMS). Pearson's correlation, independent sample t-tests, multivariate linear regression, and binomial logistic regression were used to analyze the relationships between brain volumes, clinical assessments, and socio-demographic factors. Results No significant differences in frontal volumes were found between the two groups, while cerebellar volumes were significantly smaller in FES patients (p=0.004), particularly in younger males (p=0.026). Frontal volumes were negatively correlated with age in both groups (p=0.012), which remained robust in patients even after controlling for their gender, education, and DUI (p=0.012, aR2=0.221). Cerebellar volume reduction was associated with a higher likelihood of being classified as a patient (p=0.029). BMS was significantly correlated with frontal lobe volumes, especially in motor sequencing (MoSe), after adjusting for age, gender, and education (p=0.009). BMS MoSe scores were also significantly positively correlated with the DUI (r=0.415, p=0.023) and PANSS-General Psychopathology (GP) (r=0.494, p=0.005). MoCA-B scores were significantly lower in females than males (p=0.016), while PANSS-GP was significantly negatively correlated with age (r=-0.432, p=0.017). Conclusion Frontal and cerebellar volumes were differentially impacted in FES, with cerebellar atrophy being a significant distinguishing feature of the disorder. Frontal atrophy was associated with motor dysfunction but did not appear to influence psychopathology or cognition significantly in the early stages. The independent effects of frontal and cerebellar volumes, as shown by the lack of correlation between them, may suggest that these brain regions undergo separate pathological processes in schizophrenia, with frontal functional changes impacting motor function and cerebellar structural changes contributing to broader psychiatric symptoms, thereby warranting further exploration involving larger sample size., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Krishna Institute of Medical Sciences "Deemed to be University" issued approval KIMSDU/IEC/07/2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mahapatra et al.)