神经软体征和神经认知功能的缺损长期以来被认为是精神分裂症的重要特征。以前的相关研究发现神经软体征和神经认知功能之间存在较为显著的相关。但是，大部分研究在设计和方法上都有一定的局限，主要采用了相关设计以及基于西方的被试群体。
最近，中科院心理研究所神经心理学与应用认知科学实验室及心理健康院重点实验室的陈楚侨研究员和他的团队为神经软体征和神经认知功能的关系提供了新的证据，在精神分裂症病人和健康对照组中都存在较强的关系，研究结果在PLoS ONE上发表。在这个研究中，陈楚侨采用了严格的结构方程模型来考查神经软体征和神经认知功能的内在联系。结构方程模型的优势在于可以同时考查神经软体征和神经认知功能的潜变量及它们之间的关系。这样，我们就可以在解释的层面而不是探索的层面（以前的大部分研究都是在探索层面）来考查这两个概念。共有118个精神分裂症患者和160个健康被试参加了研究，他们都完成了剑桥神经学检查的软体征部分和一套神经心理学测量。结果发现，神经软体征、执行注意、言语记忆和视觉记忆在病人和控制组中都存在中等程度的联系，在正常人中的联系相对较小。这些结果说明运动协调、感觉整合及抑制失调贡献于神经软体征这一潜变量，神经认知功能贡献于执行注意、言语记忆和视觉记忆这些潜变量，在病人和正常人中都是如此。
本研究结果对神经软体征和传统神经认知功能所测量的是同一水平的脑功能这一观点提供了少有的支持。这些结果为我们理解两个明显不同的概念实际测量的是相同或相似的脑高级功能的看法提供了证据。这两个概念的显著相关，特别是被认为是精神分裂症内表型的言语记忆和执行功能，提示了神经软体征也是精神分裂症的一个潜在内表型。
生物谷推荐原始出处：
PLoS ONE 4(12): e8469. doi:10.1371/journal.pone.0008469
Neurological Soft Signs and Their Relationships to Neurocognitive Functions: A Re-Visit with the Structural Equation Modeling Design
Raymond C. K. Chan1,2,3*, Ya Wang1,2, Li Wang2, Eric Y. H. Chen3, Theo C. Manschreck4, Zhan-jiang Li5, Xin Yu6, Qi-yong Gong7
1 Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, Beijing, China, 2 Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China, 3 Department of Psychiatry, the University of Hong Kong, Hong Kong Special Administrative Region, China, 4 Department of Psychiatry, Harvard Medical School, Boston, Massuchusetts, United States of America, 5 Beijing Anding Hospital, Capital Medical University, Beijing, China, 6 Institute of Mental Health, Peking University, Beijing, China, 7 Huaxi MR Research Centre, Department of Radiology, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
Background
Neurological soft signs and neurocognitive impairments have long been considered important features of schizophrenia. Previous correlational studies have suggested that there is a significant relationship between neurological soft signs and neurocognitive functions. The purpose of the current study was to examine the underlying relationships between these two distinct constructs with structural equation modeling (SEM).
Methods
118 patients with schizophrenia and 160 healthy controls were recruited for the current study. The abridged version of the Cambridge Neurological Inventory (CNI) and a set of neurocognitive function tests were administered to all participants. SEM was then conducted independently in these two samples to examine the relationships between neurological soft signs and neurocognitive functions.
Results
Both the measurement and structural models showed that the models fit well to the data in both patients and healthy controls. The structural equations also showed that there were modest to moderate associations among neurological soft signs, executive attention, verbal memory, and visual memory, while the healthy controls showed more limited associations.
Conclusions
The current findings indicate that motor coordination, sensory integration, and disinhibition contribute to the latent construct of neurological soft signs, whereas the subset of neurocognitive function tests contribute to the latent constructs of executive attention, verbal memory, and visual memory in the present sample. Greater evidence of neurological soft signs is associated with more severe impairment of executive attention and memory functions. Clinical and theoretical implications of the model findings are discussed.
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