Neurological soft signs and schizophrenia

CNS Spectr. 2023 Dec;28(6):657-661. doi: 10.1017/S1092852923001189. Epub 2023 Mar 16.

Abstract

Neurological soft signs (NSS) are likely to represent abnormal neurodevelopment and aberration in neural maturation and connectivity. They may not be unique to schizophrenia, but they appear to be a trait characteristic in psychosis and therefore could serve as an objective measure for the assessment of serious psychiatric disorder in the prodromal phase, at onset, and along the course of the disease. Evidence so far proposes that NSS are independent of antipsychotic treatment and therefore constitute a trait symptom, independent of the illness stage and medication. Somatomotor and somatosensory regions, spatial orientation, and visual processing areas, cerebellum, and basal ganglia are implicated as possible structural substrates of NSS. Several studies have examined the relationship between NSS and schizophrenia positive, negative symptoms and deficit syndrome; however, results have been so far ambiguous. Neurocognitive symptoms have been moderately related to NSS suggesting that neurocognitive deficits may contribute to the construct of NSS. Regardless of the fact that NSS are not unique to schizophrenia but extend across to the schizotypy continuum, they may help identify individuals at risk of developing schizophrenia later in life.

Keywords: NSS; Schizophrenia; endophenotype; neurocognition; neurological soft signs.

Publication types

  • Review

MeSH terms

  • Humans
  • Neurologic Examination
  • Phenotype
  • Psychotic Disorders* / diagnosis
  • Schizophrenia* / diagnosis