Frontal release signs and cognition in people with schizophrenia, their siblings and healthy controls

Frontal release signs, a subset of neurological soft signs, are common in schizophrenia.

To explore the relationship between frontal release signs and neuropsychological tests of frontal lobe function in people with schizophrenia, their siblings and healthy controls.

Neuropsychological tests and frontal release signs were measured in a cohort of index cases (n=302), their siblings (n=240) and healthy controls (n=346).

The mean total score of frontal release signs was 1.5 (s.d.=1.58) in the schizophrenia group, 0.54 (s.d.=0.92) for siblings and 0.42 (s.d.=0.77) for controls. Schizophrenia group scores were greater than healthy control or sibling cohort scores (P < 0.0001), which did not differ. In all three cohorts, right grasp reflex scores positively correlated with number of perseverative errors on the Wisconsin Card Sort Task (P < 0.05). In the schizophrenia group, frontal release signs scores showed an inverse correlation with IQ (R=-0.199, P < 0.0005).

Our findings of relationships between frontal release signs and cognitive assays of cortical dysfunction and the increased frequency of these signs in people with schizophrenia implicate a cortical origin for these clinical signs and evidence of frontal lobe dysfunction in this disorder.