Sanders R D, Keshavan M S
Veterans Affairs Medical Center, Pittsburgh, Pennsylvania, USA.
J Neuropsychiatry Clin Neurosci. 1998 Fall;10(4):395-404. doi: 10.1176/jnp.10.4.395.
Of the proliferating approaches to neuropsychiatric assessment, a relatively neglected technique is the venerable, accessible, noninvasive, and inexpensive neurologic examination. This article organizes and synthesizes the literature on neurological findings in adult psychiatric patients. Problems in conducting and interpreting research in this area are examined, clinically pertinent empirical findings are surveyed, and directions for future investigation are outlined. Most of the "soft signs" can be reliably evaluated, and many have been validated against other techniques. Several psychiatric diagnoses are associated with impaired neurologic performance. Prognosis and treatment selection may also be informed by neurologic findings. The neurologic exam should be regarded as a collection of neurobiologic probes rather than as a single irreducible variable. Future work must better establish interrater and test-retest reliability of individual elements of the neurologic exam in psychiatric populations and focus on developing the clinical utility of individual and combined elements of the neurologic exam.
在众多神经精神评估方法中，一种相对被忽视的技术是古老、易操作、无创且廉价的神经学检查。本文整理并综合了关于成年精神病患者神经学检查结果的文献。研究了该领域开展研究及解释研究结果时存在的问题，审视了具有临床相关性的实证研究结果，并概述了未来的研究方向。大多数“软体征”能够得到可靠评估，而且许多已通过与其他技术对比得到验证。几种精神疾病诊断与神经功能受损相关。神经学检查结果也可为预后及治疗选择提供依据。神经学检查应被视为一系列神经生物学检测手段，而非单一不可简化的变量。未来的工作必须更好地确立神经学检查各单项在精神科人群中的评分者间信度和重测信度，并着重开发神经学检查单项及综合项目的临床应用价值。
