Differentiation in Neurological Soft Sign Scores on Schizophrenic Patients with Antipsychotic Treatment

Authors

  • Wempy Thioritz Department of Psychiatry, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
  • Erlyn Limoa Department of Psychiatry, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia https://orcid.org/0000-0002-4597-797X
  • J. C. Hutomo Department of Psychiatry, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
  • Saidah Syamsuddin Department of Psychiatry, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia
  • Sonny T. Lisal Department of Psychiatry, Faculty of Medicine, University of Hasanuddin, Makassar, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6356

Keywords:

Haloperidol, Risperidone, Schizophrenia, Neurological soft sign

Abstract

Background: Schizophrenia is a chronic mental illness that affects cognitive aspect of a patient which need long term care with antipsychotics. Long term use of antipsychotic itself causes neurobiological change in the brain which results in alteration of cognitive function. The latest research had demonstrated that NSS (Neurological Soft Sign) reflect a rather wide range of cognitive impairments in schizophrenia which was not accounted for by age, education or severity of global cognitive deficits. Therefore, we examined the effects and impact of antipsychotic Haloperidol and Risperidone treatment in schizophrenic patient using NSS scores.

The Study showed that chronic schizophrenia patients had a higher NSS scores than acute patients. NSS also significantly associated with all neuropsychological domains of MMSE in both groups and were confirmed when age, education and severity of global cognitive deficits were not accounted for. This study also obtained a lower NSS score in patients who received Risperidone therapy compared to Haloperidol with p = 0.003. Out of 5 NSS domain in the Heidelberg scale, there was a significant improvement in motor coordination and motor sequencing (p = 0.004) and (p = 0.048) in patients who received Risperidone therapy compared to Haloperidol. There was an association between the chronicity of the disease and NSS, NSS also shows that it’s not influenced by age, education and severity of global cognitive deficits as a screening instrument. Finally the improvement of NSS scores in the Risperidone group was far superior compared to the Haloperidol group particularly in motor coordination and motor sequencing.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Khamker N. First episode schizophrenia. S Afr Fam Pract. 2015;57(5):29-33.

Kaplan HI, Sadock BJ. Schizophrenia, Synopsis of Psychiatry. 11th ed. New York: Lippincott Williams & Wilkins.

Yang Y, Raine A. Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: A meta-analysis. Psychiatry Res. 2009;174(2):81-8. https://doi.org/10.1016/j.pscychresns.2009.03.012 PMid:19833485 DOI: https://doi.org/10.1016/j.pscychresns.2009.03.012

Bray T, Cvetic. Soft Neurological Signs and Schizophrenia a Looking Glass into Core Pathology? Zagreb, Croatia: Medicinka Naklada; 2009.

Santosa D. Hubungan Tanda Neurologi Lunak dan Gejala Negatif pada Pasien Skizofrenia di Rumah Sakit Dadi di Makassar. Indonesia: PDSKJI; 2002.

Judhi H. Hubungan Gejala Klinis Skizofrenia dan Neurological Soft Sign (NSS); 2018.

Herold CJ, Lässer MM, Seidl UW, Hirjak D, Thomann PA, Schröder J. Neurological soft signs and psychopathology in chronic schizophrenia: A cross-sectional study in three age groups. Front Psychiatry. 2018;9:98. https://doi.org/10.3389/fpsyt.2018.00098 PMid:29632500 DOI: https://doi.org/10.3389/fpsyt.2018.00098

Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, et al. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry. 2005;62(4):361-70. https://doi.org/10.1001/archpsyc.62.4.361 PMid:15809403 DOI: https://doi.org/10.1001/archpsyc.62.4.361

He J, Kong J, Tan QR, Li XM. Neuroprotective effect of atypical antipsychotics in cognitive and non-cognitive behavioral impairment in animal models. Cell Adh Migr. 2009;3(1):129-37. https://doi.org/10.4161/cam.3.1.740 PMid:19372744 DOI: https://doi.org/10.4161/cam.3.1.7401

van Haren NE, Schnack HG, Cahn W, van den Heuvel MP, Lepage C, Collins L, et al. Changes in cortical thickness during the course of illness in schizophrenia. Arch Gen Psychiatry. 2011;68(9):871-80. https://doi.org/10.1001/archgenpsychiatry.2011.88 PMid:21893656 DOI: https://doi.org/10.1001/archgenpsychiatry.2011.88

Roiz-Santiañez R, Suarez-Pinilla P, CrespoFacorro B. Brain structural effects of antipsychotic treatment in schizophrenia: A systematic review. Curr Neuropharmacol. 2015;13(4):422-34. https://doi.org/10.2174/1570159x13666150429002536 PMid:26412062 DOI: https://doi.org/10.2174/1570159X13666150429002536

Smith RC, Kadewari RP. Neurological soft signs and response to Risperidone in chronic schizophrenia. Biol Psychiatry. 1996;40(10):1056-9. https://doi.org/10.1016/s0006-3223(96)00251-x PMid:8915566 DOI: https://doi.org/10.1016/S0006-3223(96)00251-X

Wu Y, Kang R, Yan Y, Gao K, Li Z, Jiang J, et al. Epidemiology of schizophrenia and risk factors of schizophrenia-associated aggression from 2011 to 2015. J Int Med Res. 2018;46(10):4039-49. https://doi.org/10.1177/0300060518786634 PMid:30088782 DOI: https://doi.org/10.1177/0300060518786634

Chan CK, Xu T, Heinrichs RW, Yu Y, Wang Y. Neurological soft signs in schizophrenia: A Meta-analysis. Schizophr Bull. 2010;36(6):1089-104. https://doi.org/10.1093/schbul/sbp011 PMid:19377058 DOI: https://doi.org/10.1093/schbul/sbp011

Dazzan P, Robin MR. Neurological soft signs in first-episode psychosis: A systematic review. Br J Psychiatry Suppl. 2002;43:s50-7. https://doi.org/10.1192/bjp.181.43.s50 PMid:12271801 DOI: https://doi.org/10.1192/bjp.181.43.s50

Çakmak S, Süt H, Öztürk S, Tamam L, Bal U. The effects of occupational therapy and psychosocial interventions on interpersonal functioning and personal and social performance levels of corresponding patients. Noro Psikiyatr Ars. 2016;53(3):234-40. https://doi.org/10.5152/npa.2015.10130 PMid:28373800 DOI: https://doi.org/10.5152/npa.2015.10130

Mizrahi R, Bagby RM, Zipursky RB, Kapur S. How antipsychotics work: The patients’ perspective. Prog Neuropsychopharmacol Biol Psychiatry. 2005;29(5):859-64. https://doi.org/10.1016/j.pnpbp.2005.03.001 PMid:15908094 DOI: https://doi.org/10.1016/j.pnpbp.2005.03.001

Ojagbemi A, Chiliza B, Bello T, Asmal L, Esan O, Emsley R, Gureje O. Neurological soft signs, spontaneous and treatment emergent extrapyramidal syndromes in black Africans with first episode schizophrenia. Front Psychiatry. 2018;9:172. https://doi.org/10.3389/fpsyt.2018.00172 PMid:29780333 DOI: https://doi.org/10.3389/fpsyt.2018.00172

Nasrallah HA. Impaired Neuroplasticity in Schizophrenia and the Neuro-Regenerative Effects of Atypical Antipsychotics. Virginia: LEN; 2019.

Rosenheck RA, Krystal JH, Lew R, Barnett PG, Fiore L, Valley D, et al. Long-acting risperidone and oral antipsychotics in unstable schizophrenia. N Engl J Med. 2011;364(9):842-51. https://doi.org/10.1056/nejmoa1005987 PMid:21366475 DOI: https://doi.org/10.1056/NEJMoa1005987

Downloads

Published

2021-07-02

How to Cite

1.
Thioritz W, Limoa E, Hutomo JC, Syamsuddin S, Lisal ST. Differentiation in Neurological Soft Sign Scores on Schizophrenic Patients with Antipsychotic Treatment. Open Access Maced J Med Sci [Internet]. 2021 Jul. 2 [cited 2024 Apr. 26];9(T3):249-53. Available from: https://oamjms.eu/index.php/mjms/article/view/6356

Most read articles by the same author(s)