Neurologische Soft Signs bei Patienten mit Zwangsstörung (Übersichtsreferat)

Zusammenfassung

Neurologische Soft Signs (NSS) sind diskrete neurologische Normabweichungen, die unspezifische zerebrale Dysfunktionen reflektieren. Mehrere Studien zeigen eine abnorm hohe Prävalenz von NSS bei Zwangsstörung; ihre Bedeutung ist allerdings noch unklar. Wir präsentieren eine Synopsis jener Studien, die NSS bei Zwangsstörung mittels klinischer oder kinematischer Methoden untersuchten. In den meisten Studien zeigten Patienten mit Zwangsstörung NSS abnorm häufig, vor allem Störungen der motorischen Koordination, der sensorischen Integration und pathologische Reflexe. Diese NSS waren häufig mit stärkeren Zwangsgedanken sowie Störungen visuell-räumlicher Funktionen und des visuellen Gedächtnisses assoziiert. Sie scheinen oft schon in der Kindheit - zusammen mit Angststörungen - aufzutreten und somit ein Vulnerabilitätsmarker für Zwangsstörung zu sein. Es bedarf weiterer Studien, um sensorische und motorische Soft Signs bei Zwangsstörung methodisch rigoros zu untersuchen, die Ergebnisse mit Befunden aus der Bildgebung zu integrieren und die Rolle von NSS als Marker neuropsychologischer Störungen bei Zwangsstörung aufzuklären.

Abstract

Neurological soft signs (NSS) are minor neurological deviations signifying unspecific brain dysfunction. Several studies have reported an abnormally high prevalence of NSS in obsessive-compulsive disorder (OCD); however, the significance of their presence in OCD patients is not yet clear. We reviewed studies that investigated NSS in OCD patients, using a clinical examination or kinematical methods. In most studies, OCD patients showed an excess of NSS, especially in the areas of motor coordination, sensory integration and primitive reflexes. NSS in OCD patients may be associated with more severe obsessions as well as disturbances of visuo-spatial function and visual memory. Moreover, they may be already present at childhood, combined with anxiety disorders, thus possibly representing a marker of high risk for OCD. In conclusion, more studies are needed in order to assess both sensory and motor soft signs associated with OCD in a methodologically rigorous manner, to integrate the results with neuroimaging findings and to elucidate the role of NSS as markers of neuropsychological dysfunction in OCD.

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