Browne S, Clarke M, Gervin M, Lane A, Waddington J L, Larkin C, O'Callaghan E
Stanley Foundation Research Unit, Cluain Mhuire Family Centre, Blackrock, Co. Dublin, Ireland.
Psychol Med. 2000 Nov;30(6):1433-41. doi: 10.1017/s003329179900286x.
Although it is well recognized that individuals with schizophrenia display evidence of subtle neurological impairment, its aetiopathological and clinical significance continues to be unclear.
Patients presenting with a first episode of schizophrenia or schizophreniform psychosis (DSM-IV criteria) were examined using two previously validated neurological examinations. The majority (N = 35) were examined prior to their 'first ever' dose of neuroleptic while the remaining patients (N = 21) had been medicated for less than one month. The manner in which neurological functioning is influenced by symptomatology and handedness was ascertained.
The majority of patients who were examined neuroleptic-naive displayed evidence of neurodysfunction. A combination of relative hand preference and symptomatology explained a significant proportion of the variance in neurological functioning. Mixed handedness among adults at the time of first presentation with schizophrenia was associated with more severe neurological impairment and a history of poorer scholastic attainment and pre-morbid social adjustment.
Neurological soft signs are an intrinsic part of schizophrenia rather than a direct consequence of treatment. Early developmental processes are associated with the level of subsequent neurological impairment in first episode schizophrenia. However, symptomatology appears to have an influence on the apparent severity of neurological impairment.
尽管人们普遍认识到精神分裂症患者存在轻微神经功能损害的证据，但其病因病理及临床意义仍不明确。
使用两项先前经验证有效的神经学检查对首次发作精神分裂症或精神分裂症样精神病（DSM-IV标准）的患者进行检查。大多数患者（N = 35）在首次服用抗精神病药物之前接受检查，其余患者（N = 21）用药时间少于1个月。确定神经功能受症状学和利手影响的方式。
大多数未服用过抗精神病药物的受检患者表现出神经功能障碍的证据。相对利手和症状学的组合解释了神经功能差异的很大一部分。首次出现精神分裂症时成人的混合利手与更严重的神经功能损害以及学业成绩较差和病前社会适应不良的病史相关。
神经软体征是精神分裂症的内在组成部分，而非治疗的直接后果。早期发育过程与首次发作精神分裂症后续神经功能损害的程度相关。然而，症状学似乎对神经功能损害的明显严重程度有影响。
