Neurological soft signs in schizophrenic patients with obsessive-compulsive disorder

BackgroundNeurological soft signs (NSS) have been inconsistently reported in obsessive-compulsive disorder (OCD) but may make an impact on treatment response.MethodThe current study examined the presence of NSS in two independent European samples of OCD patients (combined 85 patients and 88 matched healthy controls) using a standardized instrument and conducted a meta-analysis of all published studies identified in the literature with the aim to provide a more definitive answer to the question of whether OCD patients are characterized by increased NSS.ResultsBoth empirical studies found elevated NSS scores in patients compared with matched controls. The results of the meta-analysis, which included 15 studies (combined 498 patients and 520 controls) showed large effect sizes (Hedges' g=1.27, 95% confidence interval 0.80–1.75), indicating that OCD patients have significantly higher rates of NSS than matched controls on both sides of the body and in multiple domains (motor coordination, sensory integration and primitive reflexes). The results were robust and remained largely unchanged in our reliability analyses, which controlled for possible outliers. Meta-regression was employed to examine the role of potential variables of interest including sociodemographic variables, symptom severity, medication effects and the use of different instruments, but none of these variables was clearly associated with NSS.ConclusionsAs a group, OCD patients are characterized by increased rates of NSS, compared with healthy controls. However, their origins and potential clinical importance remain to be clarified. Future directions for research are discussed.

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Smooth pursuit deficits in schizophrenia, affective disorder and obsessive–compulsive disorder

Psychological Medicine ◽

10.1017/s0033291703001314 ◽

2004 ◽

Vol 34 (3) ◽

pp. 451-460 ◽

Cited By ~ 24

Author(s):

R. LENCER ◽

P. TRILLENBERG ◽

K. TRILLENBERG-KRECKER ◽

K. JUNGHANNS ◽

A. KORDON ◽

...

Keyword(s):

Steady State ◽

Affective Disorder ◽

Obsessive Compulsive Disorder ◽

Frontal Eye Field ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Position Errors ◽

Schizophrenic Patients ◽

Eye Field ◽

Patient Groups

Background. In schizophrenia, affective disorders, and obsessive–compulsive disorder (OCD) dysfunction of frontal neuronal circuits has been suggested. Such impairments imply corresponding oculomotor deficits.Method. Eye movement response to foveofugal and foveopetal step–ramp stimuli was recorded within the same study design in patients with schizophrenia (N=16), affective disorder (N=15), and OCD (N=18) and compared with controls (N=23) using infra-red reflection oculography.Results. In the foveofugal task steady-state velocity was lower in all patient groups compared with controls. Post-saccadic eye velocity was also decreased in patients with schizophrenia and affective disorder. In the foveopetal stimulus steady-state velocity was reduced in schizophrenic patients, only. Changes of saccadic latencies or position errors were not found in any of the patient groups. Also, pursuit latency was unchanged and initial eye acceleration was not decreased.Conclusions. Unaltered saccadic parameters indicate intact motion perception in cortical visual area V5. Therefore, the observed deficit of pursuit maintenance implies a dysfunction of frontal networks in all patient groups including the pursuit region of the frontal eye field (FEF). In patients with schizophrenia and affective disorder reduced post-saccadic pursuit initiation may indicate an impaired interaction between the pursuit and the saccadic system.

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