Cognitive Dysfunctions and Neurological Soft Signs in Drug-Naïve Schizophrenia: A Cross-Sectional Study
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https://doi.org/10.54169/ijocp.v5i02.07Keywords:
Keywords: Schizophrenia, Neurological soft signs, Cognitive dysfunctions, Drug-naïve, First-episode psychosisDimensions Badge
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Copyright (c) 2025 Shruti Singh, OmPrakash Raichandani, Neha Ramsinghani

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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.Abstract
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.
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1. Green MF. Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. J Clin Psychiatry. 2006;67(Suppl 9):3-8. 2. Keefe RS, Fenton WS. How does cognitive impairment in schizophrenia impact real-world functioning? CNS Spectr. 2007;12(10):741-745. 3. Bombin I, Arango C, Buchanan RW. Significance and meaning of neurological signs in schizophrenia: a review. Schizophr Bull. 2005;31(4):962-977. 4. Chan RC, Gottesman II. Neurological soft signs as candidate endophenotypes for schizophrenia: a shooting gallery of new ideas. Neurosci Biobehav Rev. 2008;32(3):558-569. 5. Dazzan P, Murray RM. Neurological soft signs in first-episode psychosis: a systematic review. Br J Psychiatry. 2002;181(Suppl 43):s50-s57. 6. Weinberger DR. Implications of normal brain development for the pathogenesis of schizophrenia. Arch Gen Psychiatry. 1987;44(7):660-669. 7. Andreasen NC, Paradiso S, O’Leary DS. "Cognitive dysmetria" as an integrative theory of schizophrenia: a dysfunction in cortical-subcortical-cerebellar circuitry? Schizophr Bull. 1998;24(2):203-218. 8. Thara R, Eaton WW. Outcome of schizophrenia: the Madras longitudinal study. Aust N Z J Psychiatry. 1996;30(4):516-522. 9. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699. 10. Buchanan RW, Heinrichs DW. The Neurological Evaluation Scale (NES): a structured instrument for the assessment of neurological signs in schizophrenia. Psychiatry Res. 1989;27(3):335-350. 11. Javitt DC. Sensory processing in schizophrenia: neither simple nor intact. Schizophr Bull. 2009;35(6):1059-1064. 12. Bottmer C, Bachmann S, Pantel J, et al. Reduced cerebellar volume and neurological soft signs in first-episode schizophrenia. Psychiatry Res. 2005;140(3):239-250. 13. Torrey EF. Schizophrenia and the cerebellum: a new hypothesis. Schizophr Res. 2007;96(1-3):1-3. 14. Karnath HO, Fruhmann Berger M, Küker W, et al. The anatomy of spatial neglect based on voxelwise statistical analysis: a study of 140 patients. Cereb Cortex. 2004;14(10):1164-1172. 15. Wykes T, Huddy V, Cellard C, et al. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry. 2011;168(5):472-485. 16. Howes OD, Kapur S. The dopamine hypothesis of schizophrenia: version III—the final common pathway. Schizophr Bull. 2009;35(3):549-562.
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