SOFT NEUROLOGICAL SIGNS IN BIPOLAR PATIENTS IN CURRENT AFFECTIVE EPISODE AND IN REMISSION

M. Stoyanova1, R. Iakimova2, L. Hranov2. 
1Mental health center “Prof. N. Shipkovenski”, Outpatient department, Sofia, Bulgaria. 
2University Hospital of Neurology and Psychiatry “Sveti Naum”, Second psychiatric clinic, Sofia, Bulgaria

Background and aims:  Soft neurological signs (SNS) are minimal, objective abnormalities that are supposed to reflect specific cognitive deficits. Recently, many data support the notion that SNS could be regarded as endophenotypic markers of bipolar disorder (BD). The aim of our study was to compare the incidence of SNS in BD patients manic/mixed episode (BD-M), BD patients in depressive episode (BD-D), BD patients in remission (BD-R) and healthy controls (HC).

Methods: We report data on 32 demographically matched DSM-IV-TR BD I patients having a current manic/mixed, 30 BD patients having a current depressive episode, 22 BD patients in remission and 37 HC with no Axis I or II mental condition. All groups were assessed by the Heidelberg Scale. 

Results: In comparison to HC, BD-M and BD-D patients had significantly higher SNS total (p<0,001), SNS motor (p0,001), SNS sensory (p0,001) and SNS complex scores (p<0,001). Additionally, BD-D patients had significantly higher SNS orientation signs in comparison to HC (p=0,008). BD-R patients had only significantly higher SNS motor score (p=0,011) in comparison to HC. There were no inter-group differences in hard signs scores.

Conclusions: 	Our results reveal that BD patients irrespective of the affective state (current manic/mixed/depressive episode or remission) have much more SNS in comparison to HC, i.e. have a discrete neurological dysfunction. Consequently, SNS could be regarded as a stable marker of BD.

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