ABSTRACT
Introducción: Los signos neurológicos blandos se han asociado con dificultades motoras, alteraciones comportamentales menores e incluso como factores de vulnerabilidad para la aparición de afecciones como, esquizofrenia, trastorno de déficit de atención e hiperactividad, trastorno disocial y episodios psicóticos. Aunque la investigación sobre los signos ha venido aumentando, no se tiene claridad sobre qué puede predisponer su aparición. Objetivo: Describir la asociación entre factores de riesgo prenatales, perinatales y neonatales y la aparición de los signos neurológicos blandos en niños con estos factores riesgo y en niños sin ellos. Métodos: Estudio de tipo descriptivo comparativo, de corte transversal, con diseño no experimental. La población en estudio se conformó por 550 niños y niñas, con edades entre seis y ocho años organizados. en cuatro grupos: los que presentaban riesgos prenatales, perinatales, neonatales, y el grupo que no presentaba ningún riesgo. Las aplicaciones se llevaron a cabo durante el primer semestre de 2017. Los datos se tomaron de las historias clínicas y los. signos neurológicos blandos se evaluaron a través del apartado de la Evaluación Neuropsicológica Infantil. Resultados: La mayoría de los signos neurológicos blandos presentaron diferencias significativas y valores altos en la comparación de los rendimientos en cada uno de los grupos con riesgo. Conclusiones: la presencia de riesgos prenatales, perinatales y neonatales producen una serie de alteraciones en el desarrollo del niño que se van acumulando y pueden estar asociados con la aparición de los signos neurológicos blandos(AU)
Introduction: The soft neurological signs have been associated with motor difficulties, lower behavioural alterations and even with vulnerability factors for the appearance of conditions such as schizophrenia, attention deficit disorder and hyperactivity, disocial disorder and psychotic episodes. Although research on the signs has been increasing, it is not clear what may predispose their appearance. Objective: To describe the association between prenatal, perinatal and neonatal risk factors and the appearance of the soft neurological signs in children with these risk factors and in children without them. Methods: Descriptive, comparative, cross-sectional non-experimental design´s study. The study´s population was formed by 550 boys and girls between the ages of six and eight years organized in four groups: with prenatal risks, with perinatal risks, with neonatal risks, and the group that did not present any risks. The tests were carried out during the first semester of 2017. The data were taken from the medical records and the soft neurological signs were evaluated through the item called Neuropsychological Assessment of Children. Results: Most of the soft neurological signs showed significant differences and high values in the performance comparison in each of the groups with risks. Conclusions: The presence of prenatal, perinatal and neonatal risks produce a series of alterations in the development of the child that are accumulated and may be associated with the appearance of the soft neurological signs(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child Development/physiology , Risk Factors , Nervous System/physiopathology , Nervous System Diseases/epidemiology , Neuropsychological Tests/standards , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
La esquizofrenia es un trastorno que incluye múltiples signos y síntomas en diferentes áreas (positiva, negativa, afectiva, motora, cognitiva, entre otras). De ellas, la dimensión motora ha adquirido notable importancia durante las últimas décadas. En tal contexto, los llamados signos neurológicos blandos (NSS) son de especial interés como posible expresión endofenotípica de la esquizofrenia, debido a su alta prevalencia en pacientes con este trastorno, y en sus familiares de primer grado. Estas alteraciones neurológicas están asociadas con síntomas negativos y de desorganización conductual, así como con deterioro neurocognitivo y pobre rendimiento funcional. Además, los NSS permitirían diferenciar distintos subgrupos de pacientes esquizofrénicos, con requerimientos específicos en cuanto a tratamiento, seguimiento, rehabilitación social y neurocognitiva. Asimismo, en estudios de neuroimágenes se han puesto en evidencia una gran variedad de alteraciones estructurales y funcionales, relacionadas con la heterogeneidad de los NSS. El presente artículo es una revisión actualizada de la literatura respecto al tema, intentando presentar una visión general de los estudios más representativos.
Schizophrenia is a disorder that includes multiple signs and symptoms in different areas or domains (positive, negative, affective, motor, cognitive, among others). From them, the motor dimension has acquired remarkable importance during the last decades. Among these motor disorders, the so-called neurological soft signs (NSS) are of particular interest, as they have been identified as possible endophenotypic expressions of schizophrenia, due to their high prevalence in patients with this disorder, and in their closest relatives. These neurological abnormalities are associated with negative symptoms and behavioral disorganization, besides neurocognitive impairment and poor functional performance. In addition, NSS would allow a differentiation between several subgroups of schizophrenic patients, with specific features regarding treatment, follow-up, social and neurocognitive rehabilitation. Likewise, neuroimaging studies have revealed a great variety of structural and functional alterations linked to the heterogeneity of NSS. This article is an updated review of the literature on the topic in an attempt to provide a general perspective of the most representative studies.
ABSTRACT
Clinical studies have shown various relationships between soft neurological signs and therapeutic effects of antipsychotic drugs in patients with schizophrenia. This study was purposed to compare soft neurological signs in patients before and after administration of antipsychotic drugs and thus to confirm the relationships between soft neurological signs and therapeutic effects of antipsychotic drugs in patients with schizophrenia. Twenty-five schizophrenic patients were treated with antipsychotic drugs for 8 weeks after at least 7 days of drug-free period. The soft neurological signs were assessed by using the Neurological Evaluation Scale-Korean Version(NES-K). The baseline assessment was performed just before the antipsychotic drug trial and following assessments were repeated every 4 weeks until the end of 8-week antipsychotic drug treatment. The therapeutic effects were assessed by using Positive and Negative Syndrome Scale(PANSS) at baseline just before antipsychotic drug trial, and every 4 weeks until the end of 8-week antipsychotic drug treatment. Total scores of NES-K, scores of its subcategories including sensory integration, motor coordination, sequencing of complex motor acts, and other items were shown to decrease significantly 8 weeks after initiation of antipsychotic drugs. Among those above scores, both the changes of total scores of NES-K and other items were significantly correlated with the changes of negative scores, general psychopathology scores, and total scores of PANSS. Thirteen patients who were categorized as responders, showed at least 20% decrease in PANSS total score. The responders showed more decrement(p<0.05) in total scores of NES-K and scores of sequencing of complex motor acts than twelve nonresponders. These results showed that the scores of NES-K were significantly correlated with the improvement of PANSS score. It is therefore reasonable to suggest that the changes of NES-K scores were significantly correlated with the therapeutic effects of antipsychotic drugs. The changes of soft neurological signs in patients with schizophrenia may be associated with the antipsychotic drug effect.