Neurological Soft Signs and Post-Traumatic Stress Disorder: A Biomarker of Severity?

Abstract

Background: The psychophysiological changes for individual suffering from chronic post-traumatic stress disorder (PTSD) raise to the questions of how facilitate recovery and return to work. Negative alterations in neuro-cognition remain a complaint for patients and participate to long-term functional impairments. Neurological soft signs (NSSs) appear as a candidate for better understanding these complaints. They have been reported in several mental disorders. They are found in several behavioral and/or neurocognitive disorders and are taken into account by psychiatric rehabilitation programs to support recovery. As few studies evaluate NSSs in PTSD, our exploratory study aims to assess NSSs in chronic PTSD and their relationships with PTSD severity.Method: Twenty-two patients with a clinical diagnosis of chronic PTSD were evaluated in terms of PTSD severity (post-traumatic checklist scale, PCL5), NSSs (NSSs psychomotor skills scale, PASS), and well-being upon arrival to the hospital and compared with 15 healthy subjects. Statistical non-parametric analyses assessed the relationships between these variables.Results: PTSD subjects exhibited higher NSSs compared with healthy subjects. NSSs were positively associated with PTSD severity, with negative alterations in cognition and mood, and with impairment in well-being. They were higher in women compared with men. No impact of age was found. Three groups were identified based on the severity of the PTSD. Severe PTSD exhibited NSSs characterized by motor integration alterations.Conclusions: This pilot study suggests that NSSs might be a biomarker of PTSD severity. This proof of concept highlights the need for further research for better evaluating the clinical neuro-functional impairment. This will be helping for defining neurological remediation for promoting PTSD recovery.

Neurological soft signs are increased in major depressive disorder irrespective of treatment

“…In our study, NSS were correlated with depressive symptoms independent of age. This is in agreement with a recent study that found a strong correlation of NSS with PTSD severity (Belrose et al 2020 ), leading the authors to conclude that NSS might be biomarkers of severity. Accordingly, future research aimed at the identification of disorder-specific neurological abnormalities should ensure that different diagnostic groups are matched not only on the basis of socio-demographic factors but also with regard to illness severity.…”

“…Past research has focused on the significance of NSS in schizophrenia (Cox and Ludwig 1979a ; Manschreck and Ames 1984 ; Heinrichs and Buchanan 1988 ; Bombin et al 2005 ; Chan et al 2010 ) and bipolar disorder (Goswami et al 2006 ; Bora et al 2018 ). However, increased NSS have also been found in obsessive compulsive disorder (Hollander et al 2005 ; Karadag et al 2011 ; Tumkaya et al 2012 ), borderline personality disorder (De la Fuente et al 2006 ), post-traumatic stress disorder (Gurvits et al 1993 , 2000 , 2006 ; Belrose et al 2020 ) and affective disorders (Cox and Ludwig 1979b ; Gureje 1988 ; Cherian and Kuruvilla 1989 ). Some signs, such as deficits in stereognosis and rhythm tapping, have even been found more frequently in mood disorders than in schizophrenia (Boks et al 2000 ).…”