Ismail B, Cantor-Graae E, McNeil T F
Department of Psychiatry, Lund University, University Hospital, Malmö, Sweden.
Am J Psychiatry. 1998 Jan;155(1):84-9. doi: 10.1176/ajp.155.1.84.
The aim of this study was to investigate the prevalence and type of neurological abnormalities in schizophrenic patients and their nonpsychotic siblings.
A comprehensive neurological assessment, including evaluation of both hard and soft signs, was performed for 60 schizophrenic patients, 21 siblings, and 75 normal comparison subjects.
None of the comparison subjects scored higher than 6 on the neurological assessment scale, but a score of 7 or higher was given to 67% of patients and 19% of siblings. Both patients and siblings scored significantly higher than comparison subjects on total neurological abnormalities, hard signs, soft signs, primitive reflexes, integrative sensory functions, and motor functions. The most conspicuous abnormalities were motor coordination problems and involuntary movements in the patients and cranial nerve deviations and mirror movements in their siblings. Levels of neurological abnormality were positively correlated within patient-sibling pairs. The total battery and hard signs best discriminated patients from comparison subjects.
High levels of neurological abnormality characterize both schizophrenic patients and their siblings. The constellation of abnormalities and absence of overt psychopathology in siblings may represent the mildest form of disturbance within the schizophrenia spectrum. Levels of neurological abnormality covary positively in patients and siblings within the same family, suggesting common genetic and/or environmental pathogenic factors. An extended assessment battery provides optimal discrimination of patients from normal subjects, and hard signs are more differentially associated with schizophrenia than are soft signs. The neurological abnormality has no consistent localizing profile, and nearly all functional domains are involved.
本研究旨在调查精神分裂症患者及其非精神病性同胞中神经功能异常的患病率及类型。
对60例精神分裂症患者、21名同胞及75名正常对照者进行了全面的神经学评估，包括硬体征和软体征的评估。
在神经学评估量表上，没有一名对照者得分高于6分，但67%的患者和19%的同胞得分在7分或更高。患者和同胞在总的神经功能异常、硬体征、软体征、原始反射、综合感觉功能及运动功能方面的得分均显著高于对照者。最明显的异常是患者的运动协调问题和不自主运动，以及其同胞的脑神经偏差和镜像运动。患者-同胞对中神经功能异常水平呈正相关。总体评估及硬体征能最好地区分患者与对照者。
神经功能高度异常是精神分裂症患者及其同胞的特征。同胞中异常表现的组合及无明显精神病理学表现可能代表精神分裂症谱系中最轻微的紊乱形式。同一家庭中患者和同胞的神经功能异常水平呈正相关，提示存在共同的遗传和/或环境致病因素。扩展的评估组合能最佳地区分患者与正常受试者，硬体征比软体征与精神分裂症的关联更具差异性。神经功能异常没有一致的定位特征，几乎所有功能领域均有涉及。
