title: Motor sequencing abnormalities are the trait marking neurological soft signs of schizophrenia.
abstract: We describe the profile of NSS across the one-year course of schizophrenia in 84 Nigerian first-episode patients. They were assessed at baseline and 3 monthly for 12 months using the Neurological Evaluation Scale and the Positive and Negative Syndrome Scale (PANSS), and treated with flupenthixol decanoate. The pattern of NSS total and sub-category scores obtained from repeated measurements were investigated for responders (≥ 50% reduction of baseline PANSS scores) and non-responders using the method of repeated measures analysis of variance. Trait-like features of NSS categories were quantified using intraclass correlation coefficients (ICCs). NSS were present in 96.4% of the patients at baseline (mean 21.5 ± 11.1). The motor-sequencing sub-category was found unrelated to changes in schizophrenia psychopathology with treatment (positive, r=0.19, p=0.136., negative, r=0.12, p=0.350; disorganization, r=0.16, p=0.245; overall, r=0.20, p=0.112). Regardless of decrements in psychopathology, motor-sequencing scores remained relatively unchanged across the course of the disease (main effects: 'responders' F=2.44, p=0.930, 'poor responders' F=0.27, p=0.764, entire sample F=1.87, p=0.160). ICC was "substantial" at 0.8 (95% C.I=0.6-0.9). Only the motor-sequencing NSS appear to be trait marker of schizophrenia in this sample. Other NSS seem to reflect symptomatic states of the disorder.
authors.affiliation: World Health Organization (W.H.O) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria. Electronic address: drakinjagbemi@yahoo.com.
authors.forename: Akin
authors.initials: A
authors.lastname: Ojagbemi
authors.affiliation: World Health Organization (W.H.O) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria.
authors.forename: Oluyomi
authors.initials: O
authors.lastname: Esan
authors.affiliation: Department of Psychiatry, Stellenbosch University, South Africa.
authors.forename: Robin
authors.initials: R
authors.lastname: Emsley
authors.affiliation: World Health Organization (W.H.O) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria.
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D044383:Black People; D005260:Female; D005475:Flupenthixol / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; C007761:flupenthixol decanoate; D005475:Flupenthixol
keywords: Biological markers; Neurological soft signs; Psychopathology; Schizophrenia