Herold Christina J, Lässer Marc M, Seidl Ulrich Wilhelm, Hirjak Dusan, Thomann Philipp A, Schröder Johannes
Department of General Psychiatry, Section of Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany.
Center for Mental Health, Klinikum Stuttgart, Stuttgart, Germany.
Front Psychiatry. 2018 Mar 26;9:98. doi: 10.3389/fpsyt.2018.00098. eCollection 2018.
As established in a wealth of studies subtle motor and sensory neurological abnormalities or neurological soft signs (NSS) are frequently found in patients with schizophrenia at any stage of their illness. However, the potential impact of chronicity and age on NSS was scarcely investigated. Therefore, we assessed NSS in 90 patients with subchronic ( = 22) or chronic ( = 68) schizophrenia and in 60 healthy controls who were assigned to three age groups (18-29, 30-49, and +50 years). NSS were measured on the Heidelberg Scale, psychopathological symptoms including apathy were rated on established instruments. As demonstrated by analysis of variance, NSS scores in patients were significantly ( < 0.05) increased relative to healthy controls. Significant age effects arose in all NSS subscores, with older subjects scoring well above the younger ones. These age effects were more pronounced in patients than controls, indicating that NSS in chronic schizophrenia exceed age-associated changes. Moreover, the NSS scores in patients were significantly associated with duration of illness, thought disturbance, positive symptoms, and apathy. These results were confirmed after age/duration of illness and years of education were partialed out and regression analyses. Our findings conform to the hypothesis that NSS are associated with chronicity of the disorder as indicated by the correlations of NSS with both, duration of illness and apathy. The correlations between NSS and positive symptoms/thought disturbance correspond to the fluctuation of positive symptoms during the course of the disorder. The significantly more pronounced age effects on NSS in patients may either point to ongoing cerebral changes or to a greater susceptibility of patients toward physiological age effects, which may be mediated among other factors by a lower cognitive reserve.
大量研究表明，在精神分裂症患者病程的任何阶段，都经常发现细微的运动和感觉神经功能异常或神经软体征（NSS）。然而，关于慢性病程和年龄对NSS的潜在影响却鲜有研究。因此，我们评估了90例亚慢性（=22）或慢性（=68）精神分裂症患者以及60名健康对照者的NSS，这些健康对照者被分为三个年龄组（18 - 29岁、30 - 49岁和50岁以上）。使用海德堡量表测量NSS，使用既定工具对包括淡漠在内的精神病理症状进行评分。方差分析表明，患者的NSS评分相对于健康对照者显著升高（<0.05）。所有NSS子评分均出现显著的年龄效应，年龄较大的受试者得分远高于较年轻的受试者。这些年龄效应在患者中比在对照者中更为明显，表明慢性精神分裂症患者的NSS超过了与年龄相关的变化。此外，患者的NSS评分与病程、思维紊乱、阳性症状和淡漠显著相关。在控制年龄/病程和受教育年限并进行回归分析后，这些结果得到了证实。我们的研究结果符合以下假设：NSS与疾病的慢性病程相关，这一点通过NSS与病程和淡漠的相关性得以体现。NSS与阳性症状/思维紊乱之间的相关性与疾病过程中阳性症状的波动相一致。患者中NSS的年龄效应明显更显著，这可能表明大脑在持续发生变化，或者患者对生理年龄效应的易感性更高，这可能在其他因素中由较低的认知储备介导。
