Cognitive Dysfunctions and Neurological Soft Signs in Drug-Naïve Schizophrenia: A Cross-Sectional Study

Abstract

Background: Cognitive impairments and neurological soft signs (NSS) are common in schizophrenia, often evident prior to treatment. This study investigates the relationship between cognitive deficits and NSS in drug-naïve schizophrenia patients.
Methods: A cross-sectional study was conducted with 60 drug-naïve schizophrenia patients. Cognitive performance was evaluated using the Montreal Cognitive Assessment (MoCA), with scores ≤26 indicating cognitive impairment. NSS were assessed via the Neurological Evaluation Scale (NES). Pearson Chi-square tests analysed associations between MoCA scores and specific NSS, with significance set at p < 0.05.
Results: Of the 60 patients, 39 (65%) showed cognitive impairment (MoCA ≤26). Significant correlations were found between cognitive deficits and several NSS, including Audio-Visual Integration (p = 0.001), graphesthesia (p = 0.027), fist-ring test (p = 0.001), and fist-edge-palm test (p = 0.001). Additional associations were noted with memory (p = 0.001), rhythm tapping test part A (p = 0.001), and rapid alternating movements (p = 0.001). No significant correlations were observed for cerebral dominance (p = 0.435), stereognosis (p = 0.459), or extinction (p = 0.459). Patients exhibited an average of 4.6 NSS, with 86.7% showing at least one NSS.
Conclusion: Cognitive impairments in drug-naïve schizophrenia patients are significantly associated with specific NSS, suggesting shared neurobiological underpinnings. These findings emphasize the need for early cognitive and neurological evaluations to guide treatment. Longitudinal studies are required to examine the progression of these deficits.