精神分裂症神经系统软体征初探

对７５例男性精神分裂症病人进行神经系统软体征检查，并与临床作比较分析。神经系统软体征发生率为６８％，与文化程度、起病急缓及病期长短无关，而家族史阳性、偏执型精神分裂症及病情较重（ＢＰＲＳ＞５０分）的病人神经系统软体征发生率显著增高。随着抗精神病治疗、病情改善，软体征出现的平均项数也显著减少。对其可能原因进行了讨论。     

精神分裂症患者神经系统软体征随访观察

目的:探讨缺陷型、非缺陷型精神分裂症患者神经系统软体征(NSS)的长期随访特点.方法:对1997年9月曾进行NSS评定、持续住院的缺陷型和非缺陷型精神分裂症患者分别23例和30例于4年后再次进行评定,同时采用简明精神病评定量表(BPRS)、阳性症状评定量表(SAPS)、阴性症状评定量表(SANS)评定其精神症状.结果:4年后精神分裂症患者NSS总分及顶叶、额叶、枕叶因子分均明显增加;非缺陷型患者仅顶叶、额叶因子分显著增加.NSS评分均与同期的SANS评分呈正相关,而与SAPS评分无显著相关性.结论:缺陷型精神分裂症患者NSS随病程进展呈加重趋势,其严重程度与阴性症状密切相关.     

缺陷型精神分裂症神经系统软体征及其相关因素研究

目的 探讨缺陷型精神分裂症神经系统软体征及其相关因素。方法 将175例精神分裂症病人采用Carpenter提出的关于缺陷综合征的诊断标准划分为缺陷型（47例）、非缺陷型（128例）,对其神经系统软体征进行评定,同时应用阴性症状评定量表（SANS）、阳性症状评定量表（SAPS）、简明智能评定量表（BIRS）、住院精神病人社会功能评定量表（SSSI）分别进行评定并进行相关分析。结果 缺陷型精神分裂症神经系统软体征与SANS、SSSI呈显著正相关,与智能百分比呈显著负相关。结论 缺陷型精神分裂症神经系统软体征与多种因素有关。     

精神分裂症患者未患病一级亲属的认知功能研究

目的 探讨精神分裂症未患病的一级亲属认知功能的特点。方法 对110例精神分裂症患者未患病一级亲属（亲属组）及50例正常对照（对照组）进行认知功能测验,包括持续注意力测试（CPT）、威斯康星卡片分类测试（WCST）、修订版韦氏记忆量表（WMS-RC）的逻辑记忆和词语流畅性测试。结果 精神分裂症患者一级亲属在WMS-RC逻辑记忆中的即刻逻辑记忆、延迟逻辑记忆,词语流畅性测试中的词语总数、词语正确数,CPT中的视觉漏报、视觉平均反映时间1和2、听觉漏报数、听觉平均反应时间1和2的成绩均差于对照组（P〈0.05）。结论 精神分裂症未患病的一级亲属存在一定程度的认知功能损害,提示认知损害可能是精神分裂症的内表型指标之一。     

精神分裂症患者及其一级亲属性格特征的对照研究

目的探讨精神分裂症患者及其一级亲属的性格特征。方法选取住我院治疗处于缓解期的精神分裂症患者48例和一级亲属与正常组各79人，进行MMPI测查分析。结果精神分裂症患者及其一级亲属Hs、D、Hy、Pd、Pa、Pt、Sc量表分高于正常人，而患者和一级亲属间各量表分接近。结论精神分裂症患者及一级亲属具有明显的分裂性人格，两者的性格特征可能有着共同的遗传学基础。     

精神分裂症神经系统软体征与临床变量的关系

精神分裂症神经系统软体征与临床变量的关系甘景梨为探讨精神分裂症神经系统软体征（ＳＳ）与临床变量的关系，我们对有与无ＳＳ的精神分裂症病人进行了治疗前后的对照研究。１．对象与方法：对象为我院连续入院病人，共１５６例，其中男性１０８例，女性４８例；年龄１７...     

情感性精神障碍与精神分裂症患者神经系统软体征对照分析

目的 为探讨精神分裂症及情感性精神障碍患者神经系统软体征的发生频率及其所具有的病理意义。方法:参照Bartko·G等人选定的神经系统软体征条目,检查符合CCMD-2-R诊断标准的115例情感性精神障碍、120例精神分裂症患者和100名正常对照者的神经系统软体征的发生频率。结果:115例情感性精神障碍患者的神经系统软体征阳性频率为55％,与精神分裂症患者59％的比率无统计学差异(X~2=0.63,P>0.05),非常显著地高于正常对照资料(X~2=82.95,df=2,P<0.01)。结论:情感性精神障碍患者与精神分裂症患者一样存在脑结构异常。     

精神分裂症神经系统软体征及其相关因素的研究

目的 搪塞精神分裂症神经系统软体征的发生率及其与临床关系。方法 入院时对符合入组标准的精神分裂症患者进行ＢＰＲＳ评分及了２项软件体征检查。于疗后１月、２月时各进行一镒ＢＰＲＳ评分及国欠体征检查。结果 精神分裂症神经系统软体征发生率为６８％;与文化程度、起病急缓、病期主分型无关,而家族史阳性及病情较重者神经系统软体征发生率显著增高。软体征出现平均项数,随主病情改善也显著减少。结论神经系统软体征的研究     

精神分裂症一级亲属糖代谢研究

目的研究精神分裂症患者一级亲属的糖代谢情况。方法检测精神分裂症患者一级亲属85例(患者亲属组)和普通人群对照99人(对照组)的空腹血糖、胰岛素、C肽、身高、体重,并计算体质量指数(BMI)及胰岛素抵抗指数(IRI)。结果①一级亲属组糖尿病/糖耐量减低发生率(5.9%/15.3%)均稍高于对照组(4.0%/13.1%),差异无统计学意义(P>0.05);②亲属组的空腹血糖、胰岛素及IRI均稍高于对照组,但差异均无统计学意义(P>0.05)。结论未发现精神分裂症患者一级亲属存在显著的糖代谢异常。     

Reduced cerebellar volume and neurological soft signs in first-episode schizophrenia

Recent studies indicate that morphological and functional abnormalities of the cerebellum are associated with schizophrenia. Since the cerebellum is crucial for motor coordination, one may ask whether the respective changes are associated with motor dysfunction in the disease. To test these hypotheses in a clinical study, we investigated cerebellar volumes derived from volumetric magnetic resonance imaging of 37 first-episode patients with schizophrenia, schizophreniform or schizoaffective disorder and 18 healthy controls matched for age, gender and handedness. To control for potential interindividual differences in head size, intracranial volume was entered as a covariate. Neurological soft signs (NSS) were examined after remission of acute symptoms. Compared with the controls, patients had significantly smaller cerebellar volumes for both hemispheres. Furthermore, NSS in patients were inversely correlated with tissue volume of the right cerebellar hemisphere partialling for intracranial volume. No associations were detected between cerebellar volumes and psychopathological measures obtained at hospital admission when patients were in the acute psychotic state or after remission, treatment duration until remission, treatment response or prognostic factors, respectively. These findings support the hypothesis of cerebellar involvement in schizophrenia and indicate that the respective changes are associated with NSS.     

Dyskinesia and soft neurological signs in schizophrenia: a comparative study

Objective. Several neurological abnormalities can be found at a greater frequency in patients with schizophrenia, including neurological soft signs (NSS) and signs of the “pyramidal” and “extrapyramidal” systems. We aimed to explore the frequency of movement disorders in patients with antipsychotic naïve schizophrenia and to compare and contrast with antipsychotic-treated patients and healthy controls. Methods. Twenty-two antipsychotic naive schizophrenic patients, 22 antipsychotic treated patients and 22 healthy control subjects were assessed by Neurological Evaluation (NES), Abnormal Involuntary Movements (AIMS), and Positive and Negative Syndrome (PANSS) Scales. Results. The NES scores of the never-medicated schizophrenic group were significantly higher than those of normal controls but did not differ significantly from the medicated group. Dyskinesia rates in the both schizophrenic groups were higher than in healthy controls. Medicated and non-medicated schizophrenic patient scores did not differ in AIMS with regard to facial and oral movements, but medicated patients scored higher than non-medicated subjects with respect to extremity movements. Conclusion. Our data suggest that: soft neurological signs and abnormal involuntary movements in the facial region are more prevalent in patients with schizophrenia, whether they are medicated or antipsychotic naïve. On the contrary, abnormal involuntary movements in the trunk and the extremities seem to be associated with medication.     

Neurological soft signs in schizophrenia: Assessment and correlates

A German version of the Neurological Evaluation Scale (NES) was administered to 143 schizophrenic patients, 45 of them being severly chronic and disabled. Seventy-eight alcohol-dependent inpatients and 57 healthy volunteers were tested as control groups. Neurological soft signs (NSS) were rated with convincing agreement. Schizophrenic patients are more impaired on all scales than healthy controls. The chronic, severly disabled schizophrenic patients are more impaired compared with the main group of schizophrenic patients and both control groups. A significant patients and alcohol-dependent patients was only found for the subscale Motor Coordination. Compared with healthy controls the alcohol-dependent patients show a higher NES total score. The NES total score was related to the relative width of the third ventricle. Total score and subscales were correlated consistently with the level of cognitive functioning as measured by the Raven Standard Progressive Matrices and various neuropsychological tests presumably sensitive to dysfunctions of the prefrontal cortex. The NSS were related to positive as well as to negative symptoms, the correlations with negative symptoms being confined to items of Cognitive Disorganization. This close association of psychomotor and cognitive dysfunctions may be seen as related to the frequently discussed dysfunctions of the prefrontal cortex or the neurointegrative deficit postulated by Meehl.     

精神分裂症神经系统软体征与认知功能相关性研究进展

既往众多研究发现,健康人群及包含精神分裂症、情感障碍、强迫障碍、注意多动障碍在内的多种精神疾病患者都伴有认知功能的损害及神经系统软体征（NeurologicalSoftSigns,NSS）。两者常同时在精神疾患的临床表现中可见,现对两者之间是否存在关联及关联为何进行综述。     

Emotion processing and theory of mind in schizophrenia patients and their unaffected first-degree relatives

Previous studies have suggested that social cognition is affected in individuals with schizophrenia. The purpose of this study was to explore to what extent social cognition deficits are shared by unaffected first-degree relatives, and the nature of the relationship between performance in different paradigms of social cognition. 20 Schizophrenia patients (7 females, 31 ± 10 years), 20 healthy age- and gender-matched individuals, 20 unaffected first-degree relatives of the schizophrenia patients (11 females, 50 ± 20 years), and 20 healthy individuals matched for age and gender were recruited. Patients showed deficits in the detection of social Faux Pas (0.80 ± 0.17 vs. controls: 0.94 ± 0.09, p = 0.025) and the correct identification of Theory of Mind stories (0.71 ± 0.13 vs. controls: 0.82 ± 0.12, p = 0.038). Relatives performed poorly in the Faces Test (0.83 ± 0.14 vs. controls: 0.9 ± 0.08, p = 0.048), the Reading the Mind in the Eyes Test (0.59 ± 0.17 vs. controls: 0.71 ± 0.14, p = 0.046) and the detection of social Faux Pas (0.8 ± 0.2 vs. controls: 0.93 ± 0.09, p = 0.024). Abnormalities were independent of age, years of education, and general cognitive performance in patients and their relatives. Performance in an Emotion Processing task (Faces Test) was correlated with performance in theory of mind tests in healthy individuals and relatives of patients with schizophrenia only. These results suggest that schizophrenia patients and their unaffected first-degree relatives display similar but nonidentical patterns of social cognition processing.     

Comparative study of neurological soft signs in schizophrenia with onset in childhood, adolescence and adulthood

OBJECTIVE: To compare neurological soft signs (NSS) in patients of schizophrenia with onset in childhood (COS), adolescence (AdOS) and adulthood (AOS). METHOD: Assessment of NSS in 15 patients of COS and 20 patients each of AdOS and AOS was made using condensed neuropsychiatric examination for NSS. RESULTS: NSS were significantly more frequent in COS (100%) and AdOS (90%) when compared with AOS (55%) patients. COS patients showed significantly higher scores on temporal and frontal lobe NSS, of which differences between the three groups in temporal lobe NSS disappeared on ancova. Parietal lobe dependent NSS were seen in a few COS patients. The NSS were more in those with lesser IQ, lower education and higher Positive and Negative Syndrome Scale scores. CONCLUSION: Findings indicate that earlier onset types may be more strongly associated with a generalized disruption of brain function. Non-suppression of primitive reflexes with cortical maturation in COS point towards disordered neurodevelopment. Preponderance of fronto-temporal and a relative lack of parietal lobe NSS point towards differential lobar involvement. Neurodevelopmental abnormalities leading to NSS also lead to lower IQ and lower educational level.     

精神分裂症及其一级亲属性格特征的对比分析

本研究对缓解期精神分裂症患者６８例及其一级亲属和正常人各１１２人进行ＭＭＰＩ测查。结果提示：精神分裂症患者及其一级亲属Ｈｓ、Ｄ、Ｈｙ、Ｐｄ、Ｐａ、Ｐｔ、Ｓｃ等量表分高于正常人，其中Ｐｄ、Ｐａ、Ｓｃ增幅最大；而患者和一级亲属之间各量表分比较接近。精神分裂症患者和一级亲属具有明显的分裂性人格，两者的性格特征可能有着共同的遗传学基础。