Soft Signs Research Articles

Comparing Essential Tremor with and without Soft Dystonic Signs and Tremor Combined with Dystonia: The TITAN Study.

Tremor disorders remain as clinical diagnoses and the rate of misdiagnosis between the commonest non-parkinsonian tremors is relatively high. To compare the clinical features of Essential Tremor without other features (pure ET), ET plus soft dystonic signs (ET + DS), and tremor combined with dystonia (TwD). We compared the clinical features of patients with pure ET, ET + DS, and TwD enrolled in The ITAlian tremor Network (TITAN). Linear regression models were performed to determine factors associated with health status and quality of life. Three-hundred-eighty-three patients were included. Sex distribution was significantly different between the groups with males being more represented in pure ET and females in TwD. The initial site of tremor was different between the groups with about 40% of TwD having head tremor and ET + DS unilateral upper limb tremor at onset. This pattern mirrored the distribution of overt dystonia and soft dystonic signs at examination. Sensory trick, task-specificity, and position-dependence were more common, but not exclusive, to TwD. Pure ET patients showed the lowest degree of alcohol responsiveness and ET + DS the highest. Midline tremor was more commonly encountered and more severe in TwD than in the other groups. Regression analyses demonstrated that tremor severity, sex, age, and to a lesser degree the variable "group", independently predicted health status and quality of life, suggesting the existence of other determinants beyond tremor. Pure ET and TwD manifest with a phenotypic overlap, which calls for the identification of diagnostic biomarkers. ET + DS shared features with both syndromes, suggesting intra-group heterogeneity.

Clinical and Sociodemographic Correlations with Neurological Soft Signs in Hospitalized Patients with Schizophrenia: A Preliminary Longitudinal Study.

Schizophrenia is a severe, chronic neuropsychiatric disorder characterized by symptoms that profoundly impact behavior, cognition, perception, and emotions, leading to a reduced quality of life and physical impairment. Given the complexity of schizophrenia, there is a pressing need for clinical markers and tools to predict its course, enhance disease staging, facilitate early intervention, improve differential diagnosis, and tailor individualized treatment approaches. Previous studies focused on the relationship between neurological soft signs (NSS) and factors such as age, illness duration, and symptomatology, indicating NSS as state markers improving in parallel with psychotic symptom remission or predicting treatment resistance. However, there is a lack of consensus on NSS assessment tools, hindering routine clinical monitoring despite diagnostic and prognostic potential. The present longitudinal study involved 81 psychiatric inpatients diagnosed with schizophrenia. Patients were assessed at three time points: baseline, 1 month, and 6 months. The examination included the use of scales to evaluate psychotic and neurological symptoms, as well as the identification of adverse extrapyramidal reactions caused by neuroleptic treatment. The progression of NSS was correlated to both the symptomatology and the sociodemographic data of the patients. The main findings from the present investigation revealed a statistical correlation between NSS and psychopathological symptoms, especially with negative symptoms of schizophrenia. However, it is important to note that neuroleptic side effects only had a limited impact on NSS. Therefore, instead of being linked to extrapyramidal symptoms caused by neuroleptics, NSS appears to be more frequently related with symptoms of schizophrenia. Our findings provide further support for their strong association with the course of schizophrenia, independent of treatment side effects, thus emphasizing their potential as reliable assessment tools in both research and clinical settings.

Deciphering the interplay between psychopathological symptoms, sensorimotor, cognitive and global functioning: a transdiagnostic network analysis.

Understanding the relationship between psychopathology and major domains of human neurobehavioral functioning may identify new transdiagnostic treatment targets. However, studies examining the interrelationship between psychopathological symptoms, sensorimotor, cognitive, and global functioning in a transdiagnostic sample are lacking. We hypothesized a close relationship between sensorimotor and cognitive functioning in a transdiagnostic patient sample. We applied network analysis and community detection methods to examine the interplay and centrality [expected influence (EI) and strength] between psychopathological symptoms, sensorimotor, cognitive, and global functioning in a transdiagnostic sample consisting of 174 schizophrenia spectrum (SSD) and 38 mood disorder (MOD) patients. All patients (n = 212) were examined with the Positive and Negative Syndrome Scale (PANSS), the Heidelberg Neurological Soft Signs Scale (NSS), the Global Assessment of Functioning (GAF), and the Brief Cognitive Assessment Tool for Schizophrenia consisted of trail making test B (TMT-B), category fluency (CF) and digit symbol substitution test (DSST). NSS showed closer connections with TMT-B, CF, and DSST than with GAF and PANSS. DSST, PANSS general, and NSS motor coordination scores showed the highest EI. Sensory integration, DSST, and CF showed the highest strength. The close connection between sensorimotor and cognitive impairment as well as the high centrality of sensorimotor symptoms suggests that both domains share aspects of SSD and MOD pathophysiology. But, because the majority of the study population was diagnosed with SSD, the question as to whether sensorimotor symptoms are really a transdiagnostic therapeutic target needs to be examined in future studies including more balanced diagnostic groups.

Neurological soft signs and sociodemographic and clinical characteristics among patients with schizophrenia with and without a history of violence

Neurological soft signs, considered to be an endophenotype in schizophrenia patients, have also been investigated in patients with schizophrenia as a clinical correlate of violent/aggressive behavior. We aimed to establish a homogeneous group in the context of violent behavior by including patients with schizophrenia who were admitted to a forensic psychiatry service and who were under protection. The pre-criminal employment rate for the case group was lower than that for the control group, and the history of substance abuse was significantly higher in criminal schizophrenia patients. No statistically significant difference was found between the two groups when the neurological soft symptoms, PANSS scores, Stroop test scores, and other sociodemographic factors were compared.

Emergency surgery for penetrating neck trauma and common carotid artery laceration presenting with shock: a case report

Introduction: The neck is an important anatomical junction connecting the head and limbs to the trunk and several vital neurovascular and aerodigestive structures pass through it. Zone II is the commonest site of penetrating neck injuries (PNI) and is commonly associated with vascular injury. The mortality rate following PNI is approximately 10%, increasing to 20% with concomitant penetrating carotid injury. Case description: A 43-year-old was brough to the emergency department in class III haemorrhagic shock with a 5mm, bleeding, penetrating neck injury in zone II of the neck. He had soft signs of vascular injury, bleeding was controlled with direct pressure, and resuscitation was commenced with intravenous crystalloids and blood products. Surgical exploration revealed a 5mm laceration in the distal common carotid artery which was repaired primarily. Postoperative computed tomography (CT) angiogram was normal and the patient had an uneventful recovery. Discussion: Traumatic disruption of the platysma is described as PNI and accounts for 10% of all penetrating injuries. Vascular injuries are most commonly seen in zone II and are usually associated with hard and soft signs of vascular injury. Zone II injuries require operative exploration with preoperative CT angiography recommended in haemodynamically stable patients to identify the type of injury. Small defects in the carotid artery can be repaired primarily. Conclusions: Open surgical exploration is mandatory for all patients with penetrative neck injury and haemodynamic instability. CT angiogram is recommended prior to open exploration is stable patients with zone II PNI.

Children had increased risks of impaired motor and visual-motor skills after prenatal exposure to opioid maintenance therapy.

Preschool children prenatally exposed to opioid maintenance therapy (OMT) have an increased risk of neurodevelopmental impairments. We aimed to investigate long-term motor and visual-motor integration outcome in children aged 5-13 Years, born to mothers in OMT. From January 2018 to June 2021, 63 children prenatally exposed to OMT and 63 comparison children matched for age and gender, were examined at two Norwegian hospitals. Motor skills were assessed by the Movement-ABC test and visual-motor integration by the Beery VMI test. A motor function neurological assessment test was used to examine neuromotor soft signs. In the OMT-exposed group, 16% had motor impairment, 35% had motor problems and 19% had visual-motor integration problems. Forty-three percent of the exposed children had neuromotor soft signs. Strabismus had some influence on motor and visual-motor outcomes but could not explain the group differences. Children prenatally exposed to opioid maintenance therapy have an increased risk of long-term motor impairment and visual-motor problems. In addition, they exhibit significantly more neuromotor soft signs, which may affect general well-being, leisure activities and school performance.

Selenium supplementation in inactive moderate to severe Graves’ orbitopathy patients: a randomized controlled trial

ABSTRACT Purpose This study was designed to evaluate the effect of selenium supplementation in inactive moderate-severe Graves’ orbitopathy (GO) patients. Methods This study was a single-center, placebo-controlled, double-masked, randomized trial. Inactive moderate-severe GO participants were randomized to receive six months of 200 micrograms/day of selenium supplementation or placebo. Thorough eye exams, clinical activity score (CAS), Graves’ Ophthalmopathy quality of life questionnaire (GO-QOL), and serum selenium level were evaluated at baseline and 6 months after the interventions. The chi-squared or Fisher’s exact test was used to compare categorical variables. The t-test and the paired t-test were used to compare continuous variables between two independent samples and two dependent samples, respectively. Results A total of 25 participants were enrolled, 13 in the selenium group and 12 in the placebo group. Both groups had adequate baseline serum selenium levels at 98.96 ± 15.63 mcg/L and 102.55 ± 17.71 mcg/L, respectively. After 6 months of intervention, the selenium group showed a greater improvement in palpebral aperture (mean difference: −1.4 ± 1.7 mm, p = .04) compared to the placebo group (−0.3 ± 2.7 mm). Notably, 5(41.67%) people in the placebo group developed larger palpebral apertures. Proptosis, ocular motility, and soft tissue signs did not change significantly. GO-QOL and CAS score improvement showed no statistically significant difference between both groups. Minor adverse effects were observed. Conclusions Selenium supplementation has a positive effect on eyelid aperture even in inactive moderate-to-severe GO patients with a sufficient baseline selenium level.

Relapse in schizophrenia: The role of factors other than non-adherence to treatment.

Relapse rates are very high in schizophrenia. However, little is known about the predictors of the time to relapse other than treatment non-adherence. We investigated possible risk factors for the time to relapse in patients with first-episode schizophrenia (n = 107) who received assured treatment by way of long-acting injectable antipsychotic over 24 months and who underwent regular clinical, cognitive, and metabolic assessments. Using Cox regression analyses we assessed selected premorbid and baseline potential predictors of time to relapse. Relapse was defined using operationally defined relapse criteria. In the primary analysis only neurological soft signs total score retained significance, with higher scores predicting shorter time to relapse (HR = 1.05, 95% CI = 1.01-1.10, p = .029). In a more detailed secondary analysis poorer social relationships predicted shorter time to relapse (HR = 0.85, 95% CI = 0.76-0.95, p = .003). Our predominantly negative findings suggest that many of the previously implicated risk factors for the time to relapse are mediated by non-adherence rather than having a direct effect on relapse-proneness. Neurological soft signs, and perhaps quality of life in social relationships appear to play a role and merit further investigation.

Specific association between retinal neural layer thinning and neurological soft signs in schizophrenia.

There is growing evidence of disproportionate retinal thinning in schizophrenia, but doubts are still raised regarding its significance in the context of the neurobiology of the disease. Therefore, we examined whether these abnormalities are significantly associated with neurological soft signs (NSS) which are closely related to the risk of schizophrenia. This cross-sectional study analyzing linear correlations between variables involved 56 schizophrenia inpatients and 60 controls. The results confirmed such relationships, and only in the patient sample. In addition, retinal abnormalities and NSS were significantly correlated with duration of illness. These findings provide further evidence for linked neurodevelopmental and neurodegenerative aspects of schizophrenia.

Clinical evaluation of direct restorations performed through the injectable composite resin technique in anterior teeth. Case report

The injectable composite resin technique refers to a combined indirect and direct method that uses a clear silicone key to accurately and predictably transfer a diagnostic wax-up to a composite restoration, without the need to prepare the teeth. The clinical case of two female patients, aged between 30 and 40 years, is presented. The treatment plan included composite resin restorations in the anterosuperior sector. With the help of an intraoral scanner, 3D images of the dental anatomical structures were generated, from which the waxing was performed. Subsequently, a transparent silicone key was manufactured and the mock-up was verified in the oral cavity. The teeth were restored by injecting a fluid compound, which was light-polymerized through the silicone key. The selection of the resin was based on its versatility, suitable for both small and extensive restorations. This material offers the advantage of being repairable without the need to replace the entire previous restoration, making it an ideal option for direct procedures. In addition, it allows rapid hardening of the material using ultraviolet light, accelerating the process compared to other materials that require weeks of laboratory preparation. As a result, aesthetic restorations were obtained in harmony with the face, achieving diastema closure and restoring the shape and function of the teeth. In subsequent checks, no soft tissue inflammation or signs of significant wear were observed. The technique described is minimally invasive and accessible in terms of resources

Enhancing brain tumor detection: a novel CNN approach with advanced activation functions for accurate medical imaging analysis.

Brain tumors are characterized by abnormal cell growth within or around the brain, posing severe health risks often associated with high mortality rates. Various imaging techniques, including magnetic resonance imaging (MRI), are commonly employed to visualize the brain and identify malignant growths. Computer-aided diagnosis tools (CAD) utilizing Convolutional Neural Networks (CNNs) have proven effective in feature extraction and predictive analysis across diverse medical imaging modalities. This study explores a CNN trained and evaluated with nine activation functions, encompassing eight established ones from the literature and a modified version of the soft sign activation function. The latter demonstrates notable efficacy in discriminating between four types of brain tumors in MR images, achieving an accuracy of 97.6%. The sensitivity for glioma is 93.7%; for meningioma, it is 97.4%; for cases with no tumor, it is 98.8%; and for pituitary tumors, it reaches 100%. In this manuscript, we propose an advanced CNN architecture that integrates a newly developed activation function. Our extensive experimentation and analysis showcase the model's remarkable ability to precisely distinguish between different types of brain tumors within a substantial and diverse dataset. The findings from our study suggest that this model could serve as an invaluable supplementary tool for healthcare practitioners, including specialized medical professionals and resident physicians, in the accurate diagnosis of brain tumors.

Value of the short time inversion recovery sequence of magnetic resonance imaging in the staging of Klippel-Trenaunay syndrome complicated with lymphedema

ObjectiveCurrently, the focus on limb lymphedema (LE) is on classification and staging. However, few scholars have conducted staging for Klippel-Trenaunay syndrome complicated LE (KTS-LE). This study aimed to investigate the value of the short time inversion recovery sequence of magnetic resonance imaging (MRI) in the staging of KTS-LE. MethodsForty-six patients who were diagnosed with KTS-LE were recruited for this retrospective study from July 2011 to November 2022. Referring to the clinical staging standard of lower extremity LE of the International Society of Lymphology in 2020, all patients were divided into three groups: stages I, II, and III. The MRI indicators of the three groups were recorded and statistically compared: LE range (unilateral bilateral, lower limbs, only thighs, only calves and ankles), abnormal parts (skin thickening, abnormal subcutaneous fat signal, abnormal muscle signal, muscle hypertrophy or contraction, abnormal bone signal, hyperostosis), and subcutaneous soft tissue signs (parallel line sign, grid sign, band sign, honeycomb sign, lymph lake sign, crescent sign, and nebula sign). ResultsThere was a significant difference in the honeycomb sign among the three periods (P = .028). There was a significant difference between stage II and stage I disease (P < .05). There was a significant difference between stage II and stage III disease (P < .05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the honeycomb sign in diagnosing KTS-LE of stage II were 87.5%, 63.2%, 33.3%, 96.0%, and 67.4%, respectively. In contrast, the other signs were not statistically significant among the three periods. ConclusionsThe short time inversion recovery sequence of MRI is of great value in KTS-LE. The honeycomb sign is an important imaging indicator for the diagnosis of stage II disease. It is necessary to evaluate the severity of edema with MRI for KTS-LE, which is very important for therapeutic options.

Adaptive event‐triggered control for strict‐feedback systems With time‐varying parameters

AbstractIn this article, we develop a new adaptive event‐triggered asymptotic control scheme for strict‐feedback systems with fast time‐varying parameters. To deal with time‐varying parameters with unknown variation boundaries in the feedback path and the input path, we construct three adaptive laws for parameter estimation, two for the uncertain parameters in the feedback path and one for the uncertain parameters in the input path. In particular, two sets of tuning functions are introduced to avoid over‐parametrization. Additionally, an event‐triggering mechanism is embedded in this adaptive control framework to reduce the data transmission from the controller to the actuator. We also introduce a soft sign function to handle the perturbations caused by sampling errors to achieve asymptotic stability and avoid the so‐called parameter drift. The stability analysis shows that the closed‐loop system is globally uniformly asymptotically stable and the Zeno behavior can be excluded. Simulation results verify the effectiveness and performance of the proposed adaptive scheme.

A Study of Neurological Soft Signs and Cognition in Schizophrenia.

Neurological soft signs (NSS) are delicate neurological abnormalities that comprise deficits in motor coordination, problems with the sequencing of complex motor acts, and sensory integration difficulties. These are nonspecific with no specific localization in the brain. NSS are found in many patients with Schizophrenia. Cognitive dysfunctions are also present in more than two-thirds of patients with Schizophrenia. This study aims at assessing the NSS and its association with cognitive impairment in patients with Schizophrenia. A total of 100 Schizophrenia patients were included in the study. The Heidelberg scale was used for assessing the NSS. The Montreal Cognitive Assessment Scale(MoCA) for cognitive impairment, the Positive and Negative Syndrome Scale(PANSS) for Schizophrenia, and the Brief Psychiatric Rating Scale (BPRS) were used to assess the severity. Statistical analysis was performed by Pearson's Chi-square test, Kruskal-Wallis test, Wilcoxon rank testsand Spearman rank correlation along with mean and standard deviation. NSS were present in 68% (N=68) of the patients with motor coordination being maximally affected. Cognitive impairment was found in 73% (N=73) of patients with a MoCA score <26. Patients with predominant negative symptoms had higher NSS scores and lower MoCA scores. A "statistically significant" correlation was observed between cognitive impairment and NSS. Most patients with NSS and impaired cognition were in the "markedly ill" category of BPRS. A significant association was observed between cognitive deficits, negative symptoms, and NSS in Schizophrenia.NSS and cognitive dysfunctions are integral parts of Schizophrenia symptomdomains and need to be assessed as the negative symptoms and severity of illness are associated with NSS, especially problems with motor coordination and cognitive dysfunctions.

Indications for computed tomography angiography in limb trauma.

Computed tomography angiograms (CTAs) are useful in detecting vascular injury. There is a lack of consensus regarding the indications of CTAs in limb trauma, leading to overutilisation of CTAs in some centres and exposing patients to unnecessary harm. Thus, the aim of this study is to define the appropriate indications for CTAs in limb trauma. This is a retrospective cohort study of consecutive CTAs performed in a tertiary hospital from January to December 2022. Demographic and clinical factors were collected from the patients' charts including physical examination findings and arterial pressure index (API) measurements. Physical examination findings include hard signs (e.g. absent pulse) or soft signs (e.g. non-expanding haematoma). These data were analysed to detect correlation with vascular injury on the patient's CTA. Forty-nine CTAs were included, of which 10 (20.4%) found vascular injury. Hard signs (P < 0.001) and an API <0.9 (P = 0.02) were significantly correlated with vascular injury. Hard signs had a sensitivity of 90% and specificity of 82%, whereas APIs had a specificity and sensitivity of 100%. Soft signs were not correlated with vascular injury due to poor specificity but had a sensitivity of 100%. Knee dislocations were not associated with vascular injury (P = 0.5). This small study suggests that CTAs are indicated if there are hard signs of vascular compromise or an API <0.9, provided the patient is haemodynamically stable. The presence of soft signs can help identify which patients should receive an API measurement. CTAs may not be routinely indicated in knee dislocations.

61 Delayed Language Development in Mexican Toddlers Following Lockdown During COVID-19: The Case of Peer Socialization

Objective:Socialization is a crucial factor in children’s language acquisition. Lack of socialization could affect language development, causing a delay that can be spotted early by identifying neurological soft signs (NSS). This study aimed to compare NSS and language performance between two samples of children (pre and post-pandemic) since the lockdown carried out by Covid-19 restricted socialization in post-pandemic kids.Participants and Methods:Two groups of 30 children (aged 3 to 5 years old, ten children per age group; 50% boys and 50% girls) were assessed with the NSS and language subtest from the SNB-MX battery (Salvador, Tovar, Segura, Armengol &amp; Ledesma, 2019). The first group was selected and evaluated before the covid lockdown; the second group was selected and assessed after the lockdown. Hence the second group of children was less exposed to socialization since schools changed to digital format. We compared the language performance of both groups.Results:Results include the comparison between samples pre and post-pandemic. Post-pandemic children performed lower in language skills. We also found a correlation between the language and NSS.Conclusions:We conclude that socialization is an essential factor in language development. Also, identifying Neurological Soft Signs could help predict language delay. We thank project PAPIIT IN308219 for sponsoring this research.

A93Addressing patient-safety themes and fostering cohesive teamwork through weekly multidisciplinary in-situ simulation in an Acute Care Unit

The Acute Care Unit (ACU) is the busy admissions ward at the trust. Many junior doctors rotate through the ACU for their acute medicine training and the department frequently welcomes newly-qualified nurses or nurses new to the NHS. All staff are involved in managing acutely unwell admissions with a range of presentations. In this dynamic environment, ensuring time is dedicated to teaching is an important part of staff development. In addition, it is important to create opportunities for team-building between disciplines, and evidence shows that this improves outcomes for patients [1]. Teaching for different professional disciplines is often delivered separately. Whilst sometimes preferable, we recognized the department could benefit from simulation sessions involving all members of the clinical team to represent realistic clinical practice. The aims were to: Address recent clinical incidents Practice managing common medical emergencies as a multidisciplinary team Build a greater sense of team between the ACU staff. We designed and implemented a programme of weekly multidisciplinary in-situ simulation on ACU. Sessions involve a range of nursing and medical staff and students and are delivered in an empty bed space on the ACU. Simulations focus on clinical scenarios that might reasonably arise in the department. We use iSimulate technology and re-use the simulation suite’s equipment to reduce resource burden and maintain sustainability. Feedback is collected after each session to quality assure and improve the sessions, and 2 further quality improvement reviews completed to explore how to maximize engagement and learning. This has led to coordination of scenarios with the established weekly seminar-based departmental teaching, to consolidate learning across settings and this is reinforced with a ‘learning point of the week’. Sessions have been successfully delivered on a near-weekly basis throughout the year, despite significant clinical pressures. This has been achieved through coordinated efforts from the simulation team, ACU fellows and registrars, charge nurses and Practice Development Nurse. We estimate to have reached more than 50 colleagues, with typically 4-8 attendees per session. We have rotated through 15 different scenarios and counting, covering key topics including various medical emergencies, violence and aggression, and ‘soft signs’ of deterioration. The programme has been well received, and feedback has specifically commented on the benefit of simulation in a multidisciplinary and in-situ setting. We demonstrate it is possible to maintain an effective regular simulation programme in the department to support patient safety initiatives and team working. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Neurological soft signs and cognition among inpatients with schizophrenia

ABSTRACT Introduction: Evidence has shown that neurological soft signs are strongly associated with neurocognitive dysfunction. Therefore, the primary objective of this study was to assess the association between NSS and cognitive impairments in a sample of inpatients with schizophrenia. The secondary objective was to explore the association between NSS total scores and functioning. Methods: The study enrolled 95 inpatients diagnosed with schizophrenia disorders and 45 healthy controls. The neurological evaluation scale (NES) was used to assess neurological soft sign while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate cognitive functioning in patients with schizophrenia. Results: Patients with schizophrenia had significantly higher mean scores on the NES total test and subtests than the control group. Higher cognition was significantly associated with lower NES total and subtest scores. Higher functional independence was significantly associated with a lower NES total score (Beta = −.25), lower motor coordination subtest score (Beta = −.04), and lower others subtest (Beta = −.12). When taking the functional independence scale as the dependent variable, a higher NES total score was significantly associated with lower functioning (Beta = −0.03). Conclusion: NSS were associated to neurocognitive impairments in almost every domain among patients with schizophrenia. Further prospective research is still needed to confirm this role.

2.13 A Study of Neurological Soft Signs in Children With ADHD: Patterns and Correlations

2.13 A Study of Neurological Soft Signs in Children With ADHD: Patterns and Correlations

Neurological Soft Signs and Social Cognition in Patients with Schizophrenia: the Missing Link

Schizophrenia is a debilitating mental disorder characterised by a pronounced decline in mental, physical, and social functioning. Our study aims to investigate the relationship between the socio-cognitive and the subtle motor and sensory symptoms of schizophrenia, which are, respectively, represented by facial emotion recognition deficits (FERD) and neurological soft signs (NSS). Thus, we assessed 60 patients diagnosed with schizophrenia. FERD was measured with the “Averaged Karolinska Directed Emotional Faces” set, and NSS was assessed with the Neurological Evaluation Scale. A strong and significant negative correlation was found between the NSS total score and the FERD total score (r = –0.7, p &lt; 0.001). There was also a significant negative correlation between several of the subscores of both instruments. The results show that impaired social cognition is significantly associated with soft neurological disturbances in patients suffering from schizophrenia. Taken together, this reinforces the notion that schizophrenia is characterised by dysfunction and disconnection of a complex cerebral network, which can probably be influenced by psychosocial and physical nonpharmacological therapeutic interventions.