The Related Study On Neurological Soft Signs And Neurocognition Of Childhood-onset Schizophrenia

Objective: To evaluate the influence of age onset on neurocognition and neurological soft signs(NSS)in patients with schizophrenia and investigate the association between neurocognition and neurological soft signs of patients with schizophrenia.Method: 20 patients with childhood-onset(Age onset ? 15)schizophrenia and 20 patients with Adulthood-onset(Age onset ?18)schizophrenia paired with the former according to age,gender and education years were recruited,respectively as Research Group and Control Group.The neurocognitive functions of two groups were evaluated by several measures including Logic Memory Task,Visual Memory Task,Digit Span Test,Letter-number Span Sequencing,Sustained Attention to Response Task,Verbal Fluency Task,Prospective and Retrospective Memory Questionnaire,Dysexecutive Questionnaire and Information Subscale,Arithmetic Subscale and Similarities Test from Chinese Wechsler Intelligence Scale for Adults,and neurological soft signs with Cambridge Neurological Inventory.The participants were grouped into two groups by the median of total scores on CNI,namely High NSS and Low NSS,and the differences of neurocognitive functions between two groups were analyzed.Results: Compared with adulthood-onset patients,the patients with childhood-onset schizophrenia showed significantly more impairments in logic memory(t=-0.024,p=0.024;t=-2.527,p=0.016),visual memory(t=-4.679,p=0.000;t=-5.940,p=0.000),letter-number span(t=-2.040,p=0.048;t=-2.153,p=0.038),attention(t=2.025,p=0.049),executive functions(t=2.280,p=0.028),prospective and retrospective memory(t=2.035,p=0.049)and general cognitive ability(t=-2.141,p=0.039)as well as significant higher NSS total scores(t=3.167,p=0.003)on CNI and significant higher scores(t=3.380,p=0.002)on Motor Coordination Subscale.Through the analysis of covariance with controlling the psychiatric symptoms,the difference of the delayed task for logic memory(F=4.322,p=0.045),visual memory(F=19.130,p=0.000;F=32.178,p=0.000),letter-number span(F=4.664,p=0.037;F=5.621,p=0.023),executive functions(F=5.352,p=0.026)and arithmetic subscale(F=7.388,p=0.010)between research group and controls remained significantly.As for High NSS and Low NSS,the participants of Low NSS performed significantly better than that of High NSS on measures of delayed task for logic memory(t=2.362,p=0.023),visual memory(t=4.234,p=0.000;t=5.053,p=0.000),working memory(t=4.513,p=0.000;t=2.195,p=0.034),attention(t=-5.547,p=0.000),verbal fluency(t=2.909,p=0.006),and information(t=2.902,p=0.006),arithmetic(t=2.527,p=0.016)and similarities subtest(t=2.437,p=0.020)for general cognitive ability.And controlling the illness duration,the psychiatric symptoms and AIMS,the CNI total scores had significantly negative partial-correlation with delayed visual memory(r=-0.37,p<0.05),working memory(r=-0.39,p<0.05;r=-0.48,p<0.01),verbal fluency(r=-0.46,p<0.01),and general cognitive ability(r=-0.47,p<0.01),and significantly positive partial-correlation with sustained attention(r=0.41,p<0.05).The NSS scores on Motor Coordination subscale of CNI were significantly negative partial-correlated with delayed visual memory(r=-0.47,p<0.01),letter-number span for working memory(r=-0.34,p<0.05),verbal fluency(r=-0.40,p<0.05)and general cognitive ability(r=-0.32,p<0.05).And the NSS scores on sensory Integration Subscale were significantly negative partial-correlated with working memory(r=-0.33,p<0.05;r=-0.42,p<0.05)and general cognitive ability(r=-0.32,p<0.05),and positively partial-correlated with sustained attention(r=0.33,p<0.05).Conclusion: 1.Compared with adulthood-onset schizophrenia,childhood-onset schizophrenia impairs worse in neurocognition and neurological soft signs.2.The neurocognitive functions,especially visual memory,working memory,attention,verbal ability and general cognitive ability,are to some extend correlated with neurological soft signs.And the worse NSS probably companied the worse neurocognition.