Abstract
BackgroundNeurological soft signs in remitted state of bipolar disorder may represent trait deficits and the aim of this study was to examine the extent of neurological soft signs in euthymic patients with bipolar I disorder as compared to healthy controls. We conducted this study in Zagazig University Hospital upon 60 subjects divided into two groups: euthymic patients with bipolar I disorder group (30 patients) and control group (30 healthy individuals). Assessment of neurological soft signs was performed through Neurological Evaluation Scale and the euthymic state was determined by Young Mania Rating Scale and Hamilton Depression Rating Scale.ResultsThe euthymic patient group exhibited a significantly worse performance in the total Neurological Evaluation Scale and the whole four subtest scores than healthy control subjects. There was a statistically significant association between total neurological soft sign score and mood stabilizer therapy in the studied patients. The age of onset of the disorder was correlated to the total score of Neurological Evaluation Scale which is statistically significant. The best cutoff points of the total neurological soft signs score in the discrimination between the euthymic patient group and control group was 3.5 according to the receiver operating characteristic curve.ConclusionThis study may emphasize the role of neurological soft signs as a sign of organic brain disorder; however, further studies may be able to extend our findings to explore the etiology and pathogenesis of bipolar I disorder.
Highlights
Neurological soft signs in remitted state of bipolar disorder may represent trait deficits and the aim of this study was to examine the extent of neurological soft signs in euthymic patients with bipolar I disorder as compared to healthy controls
The study was conducted on 30 Egyptian subjects who were diagnosed to have bipolar I disorder in full remission which were selected by simple random sampling technique and on 30 apparently healthy persons as control group
Recruitment was conducted between 1 October 2017 and 31 December 2018, and subjects who met the following eligibility criteria at enrollment were invited to participate: (1) both sexes were included: (2) age ranged from 20 to 50 years old: (3) patients fulfill the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IVTR) criteria for bipolar I disorder in full remission [11]: (4) all participants in both groups were matched for age, gender, and social classes
Summary
Neurological soft signs in remitted state of bipolar disorder may represent trait deficits and the aim of this study was to examine the extent of neurological soft signs in euthymic patients with bipolar I disorder as compared to healthy controls. We conducted this study in Zagazig University Hospital upon 60 subjects divided into two groups: euthymic patients with bipolar I disorder group (30 patients) and control group (30 healthy individuals). Assessment of neurological soft signs was performed through Neurological Evaluation Scale and the euthymic state was determined by Young Mania Rating Scale and Hamilton Depression Rating Scale. Neurological soft signs (NSS) are described as sensory and motor performance non-localizing defects recognized through clinical examination. Previous biological studies have demonstrated that these soft signs reflect functional disorders in the brain [1, 2]. As improvements can be produced with early management, appropriate early detection techniques such as biological peripheral biomarkers need to be developed [5, 6]
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