title: Neurological soft signs and brainstem morphology in first-episode schizophrenia.
abstract: BACKGROUND
  Minor motor and sensory deficits or neurological soft signs (NSS) have frequently been reported in patients with schizophrenia at any stage of their illness. NSS have been demonstrated to correlate with neuroanatomical abnormalities in various brain regions. Despite its important role in the integration and coordination of automatic motor actions, the brainstem has so far rather been ignored in previous neuroimaging studies on NSS in schizophrenia.
  
  
  METHODS
  We investigated 21 right-handed first-episode schizophrenia patients using high-resolution magnetic resonance imaging at 3 T. The severity of NSS was measured with the Heidelberg Scale. Associations between NSS and both brainstem volume and shape changes were examined.
  
  
  RESULTS
  Higher NSS scores were significantly associated with structural alterations in the brainstem. According to volume measurements higher NSS scores correlated with global changes of the brainstem. Using shape analyses these associations referred to regionally specific morphometric alterations predominantly in the midbrain and pons.
  
  
  CONCLUSIONS
  The findings suggest that brainstem morphometric alterations are associated with the severity of NSS in patients with first-episode schizophrenia. They further indicate the involvement of the brainstem in the pathogenesis of schizophrenia.
authors.affiliation: Structural Neuroimaging Group, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany. dusan.hirjak @ med.uni-heidelberg.de
authors.forename: Dusan
authors.initials: D
authors.lastname: Hirjak
authors.forename: Robert Christian
authors.initials: RC
authors.lastname: Wolf
authors.forename: Bram
authors.initials: B
authors.lastname: Stieltjes
authors.forename: Thomas
authors.initials: T
authors.lastname: Hauser
authors.forename: Ulrich
authors.initials: U
authors.lastname: Seidl
authors.forename: Ulf
authors.initials: U
authors.lastname: Thiemann
authors.forename: Johannes
authors.initials: J
authors.lastname: Schröder
authors.forename: Philipp Arthur
authors.initials: PA
authors.lastname: Thomann
mesh_terms: D000328:Adult; D001933:Brain Stem / Q000473:pathology*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D059906:Neuroimaging; D012559:Schizophrenia / Q000175:diagnosis* / Q000473:pathology*; D012720:Severity of Illness Index