Neurological Soft Signs as Early Psychosis Predictors

Neurological Soft Signs Neurological Soft Signs as Early Psychosis as Early Psychosis PredictorsPredictors

Alison CarrAlison Carr

NeuropsychologyNeuropsychology

Spring 2007Spring 2007

Neurological Soft Neurological Soft SignsSigns ““[…]non-normative performance on a […]non-normative performance on a

motor or sensory test; […] the individual motor or sensory test; […] the individual shows abnormalities, but none of the shows abnormalities, but none of the features of a fixed localizable features of a fixed localizable neurological disorder.neurological disorder.

Bender, Fink, and Green (1947)Bender, Fink, and Green (1947)

Physiological Reasons Physiological Reasons for NSSfor NSS

Dazzan Dazzan et al.et al. (2004) (2004)

Measuring NSSMeasuring NSS

Neurological Evaluation Scale (NES) Neurological Evaluation Scale (NES) (Buchanan and Hendrichs, March 1989)(Buchanan and Hendrichs, March 1989)

NSS*NSS*

Right-Left confusion

GraspExtinction

SnoutOszeretski testFinger-thumb opposition

Agraphaestesia

PalmomentalFist-edge-palm testRhythm tappingStereognosis

GazeFist-ring testTandem walkAudio-visual integration

Primitive Reflexes

Motor Sequencing

Motor Coordination

Sensory Integration

* Dazzan and Murray (2002)

MRI in NSS patientsMRI in NSS patients

Dazzaan Dazzaan et al.et al., 2004, 2004

MRI in NSS patientsMRI in NSS patients

Dazzaan Dazzaan et al.et al., 2004, 2004

MRI in NSS patientsMRI in NSS patients

Dazzaan Dazzaan et al.et al., 2004, 2004

NSS in the Normative NSS in the Normative PopulationPopulation

Kinney Kinney et al.et al., 1986, 1986

Ardilla and Roselli, 1996Ardilla and Roselli, 1996

Cause or Effect?Cause or Effect?

If NSS are a cause…If NSS are a cause…

If NSS are an effect…If NSS are an effect…

Why Schizophrenia?Why Schizophrenia?

NSS = CauseNSS = Cause

Studies looking at NSS in first-episode Studies looking at NSS in first-episode psychosis patientspsychosis patients Scottish Schizophrenia Research Group, Scottish Schizophrenia Research Group,

19871987 Browne Browne et alet al, 2000, 2000

NSS = Result NSS = Result

Gupta Gupta et al.,et al., 1995 1995

King King et alet al., 1991., 1991

Smith Smith et al.et al., 1999, 1999

NSS in Patients with NSS in Patients with Mental DisorderMental Disorder Flyckt Flyckt et alet al. (1999). (1999)

Rochford Rochford et al.et al. (1970) (1970)

NSS in Normative vs. Disordered PatientsNSS in Normative vs. Disordered Patients

Fellick et al., 2001

Cannon et al., 1999

Illowsky-Karp et al., 2001

NSS as a predictor?NSS as a predictor?

Simon Simon et al.et al. (2005) (2005)

Semerci Semerci et al. et al. (2004)(2004)

Fellick Fellick et al.et al. (2001) (2001)

ConclusionConclusion

Where research is nowWhere research is now

Future NSS researchFuture NSS research