Neurological Signs Reported in Schizophrenia

Declaration of interest None. Funding fromthe Stanley Foundation and the Medical Research Council (UK). Neurological soft signs (NSS) are minor (‘soft’) neurological abnormalities in sensory and motor performance identified by clinical examination. They have been described in excess in patients with schizophrenia (Buchanan & Heinrichs, 1989). There is still a lack of consensus on the neurodysfunctional area underlying NSS; some authors suggest that NSS reflect a failure in the integration within or between sensory and motor systems (Griffiths et al, 1998), whereas others advocate deficits in neuronal circuits involving subcortical structures (e.g. basal ganglia, brain-stem and limbic system; Heinrichs & Buchanan, 1988). Although the presence of NSS has been documented extensively in schizophrenia as a whole, the same cannot be said for patients undergoing their first psychotic episode. This review will briefly describe the NSS that have been commonly reported in patients with schizophrenia, and then concentrate on studies that have specifically investigated NSS at the time of the first psychotic episode.