Neurological Soft Signs and Brain Abnormalities in Schizophrenia: A Literature Review

Neurological soft signs (NSS) are subtle neurological impairments in sensory integration, motor coordination, balance, and sequencing of complex motor acts. The prevalence of NSS is well over 50% in schizophrenic patients compared to about 5% in healthy controls. About 30% of schizophrenia patients are resistant to treatment. The main reason for not finding better pharmaceutical agents is the inability to elicit the underlying neurophysiological and neuroanatomical basis of schizophrenia. The most common NSS can be divided into three domains: motor coordination, sequencing of complex motor acts, and sensory integration. Here, the neuroimaging correlates of the abovementioned NSS are reviewed. Most of the studies found a negative correlation of NSS subs cores motor coordination and complex motor tasks with the cerebellum, inferior frontal gyrus, and postcentral gyrus. There was a negative correlation between cortical thickness and NSS total scores in the left paracentral lobule, precuneus, middle frontal cortex, right inferior temporal cortex, left/right superior parietal cortex. Instead of considering NSS as a mere trait or state markers, its active inclusion in patient management is required to improve patients' quality of life. Future studies on larger cohorts, combining different imaging modalities are needed to elucidate how these factors might relate to each other and contribute to NSS.