Association between cerebral blood-flow measured by single photon emission computed tomography (Spect) and neurological soft signs in schizophrenia [Şizofrenide silik nörolojik belirtiler ile tek foton emisyon bilgisayarli{dotless} tomografi (Spect) ile ölçülen beyin kan aki{dotless}mi{dotless} anasi{dotless}ndaki i·lişki]

Objective: Neurological soft signs (NSS) are minor neurological abnormalities in sensory and motor performances identified by clinical examination that are not readily localizable to a specific brain region. NSS have been described to be abundant in schizophrenic patients. Studying anatomical correlates of NSS can provide a better understanding of the mechanism of NSS and the pathophysiology of schizophrenia. The main aim of this study was to explore the relationship between NSS and regional cerebral blood flow (rCBF) measured by Single Photon Emission Computed Tomography (SPECT). Methods: Forty four patients with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, were studied by SPECT and performed "Neurological Evaluation Scale" (NES) test to calculate NSS. Clinical characteristics investigated in this study were: duration of illness (months), duration of hospitalization (months), current antipsychotic dose (chlorpromazine equivalents in mg), negative and positive symptoms of schizophrenia, level of functioning, level of intelligence, verbal performance on intelligence test, way of onset of the illness (insidious vs. acute), response to treatment, family history of schizophrenia and family history of psychiatric illness. Negative and positive symptoms were evaluated with The Scale for the Assessment of Negative (SANS) and The Scale for the Assessment of Positive Symptoms (SAPS). Level of functioning was evaluated with The Global Assessment of Functioning Scale (GAF). The level of intelligence was evaluated by two clinical psychologists who were blind to the clinical attributes, using Wechsler Adult Intelligence Scale-Revised (WAIS-R). Findings: Cerebellum and whole brain normalized right frontal and right basal ganglia rCBF's are found to be associated with sensory integration subscale, while left temporal rCBF is found to be associated with motor sequencing subscale of NES, although this association is lost when a strict statistical significance level is applied by Bonferroni corrections for multiple comparisons. Discussion and Conclusion: The discrepancy between NSS and cognitive impairments and SPECT reveals a partial overlap between two different functional areas: one corresponding to the sensory integrative system and the other to a more generalized cognitive system, including the motor system