Relationships between Soft Neurological Signs and Therapeutic Effects of Antipsychotic Drugs in Patients with Schizophrenia

Koo, Min Seong; Kim, Chan Hyung; Lee, Hong Shick

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.