Neurological soft signs (NSS) are minor ('soft') neurological abnormalities in sensory and motor performances, which are frequently reported in patients with schizophrenia at any stage of their illness. It has been demonstrated that NSS vary in the clinical course of the disorder: longitudinally NSS decrease in parallel with remission of psychopathological symptoms, an effect which mainly applies to patients with a remitting course. These findings are primarily based on patients with a first episode of the disorder, while the course of NSS in patients with chronic schizophrenia and persisting symptoms is rather unknown. Therefore, we investigated NSS twice in 21 patients with chronic schizophrenia (initial mean duration of illness: 23 ± 11 years) with a mean follow-up interval of 7 years. NSS were evaluated by the Heidelberg Scale, established instruments were used to rate neuropsychological performance and psychopathological symptoms. NSS showed significant increases on the subscales "motor coordination" and "integrative functions", while positive and negative symptoms, including apathy, showed only minor, non-significant changes. Verbal memory, verbal fluency, and cognitive flexibility along with severity of global cognitive deficits demonstrated a significant deterioration. Regression analyses identified executive dysfunction (cognitive flexibility and verbal fluency) at baseline as significant predictors of NSS increase at follow-up. Our findings indicate that NSS deteriorate in the long-term course of chronic schizophrenia. This effect may be accounted for by a decrease of executive functions and logical memory, which can be attributed to premature brain aging.

中文翻译：

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慢性精神分裂症晚期的神经软体征和认知：一项纵向研究。

神经软体征 (NSS) 是感觉和运动表现中的轻微（“软”）神经系统异常，在精神分裂症患者的任何疾病阶段都经常报告这种异常。已经证明 NSS 在疾病的临床过程中有所不同：纵向 NSS 减少与精神病理学症状的缓解平行，这种效果主要适用于缓解过程的患者。这些发现主要基于首次发作的患者，而慢性精神分裂症和持续症状患者的 NSS 病程尚不清楚。因此，我们在 21 名慢性精神分裂症患者（初始平均病程：23 ± 11 年）中对 NSS 进行了两次调查，平均随访时间为 7 年。NSS由海德堡量表评估，已建立的仪器用于评估神经心理表现和精神病理学症状。NSS 在“运动协调”和“综合功能”分量表上显示出显着增加，而包括冷漠在内的阳性和阴性症状仅显示出轻微的、不显着的变化。语言记忆、语言流利度和认知灵活性以及整体认知缺陷的严重程度都显示出显着恶化。回归分析将基线时的执行功能障碍（认知灵活性和语言流畅性）确定为随访时 NSS 增加的重要预测因素。我们的研究结果表明，NSS 在慢性精神分裂症的长期病程中恶化。这种影响可能是由于执行功能和逻辑记忆的减少，