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Neurological Soft Signs as Predictors of Treatment Response to Selective Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder

Received October 15, 2003; revised May 3, 2004; accepted May 7, 2004. From the Department of Psychiatry, Mt. Sinai School of Medicine, New York, New York; Clinical Operations, Solvay Pharmaceuticals, Inc., Marietta, Georgia; the Department of Psychiatry and Behavioral Sciences, Stanford Medical Center, Stanford, California. Address correspondence to Dr. Hollander, Mt. Sinai School of Medicine, One Gustave Levy Place, Box 1230, NY, NY 10029. Eric.Hollander{at}mssm.edu (E-mail).

Neurological soft-sign abnormalities have been implicated in obsessive-compulsive disorder (OCD). This first comprehensive data analysis evaluated the association between baseline neurological soft signs and treatment response in 117 OCD patients treated with controlled-release fluvoxamine in a double-blind placebo-controlled trial. Total and right-sided soft signs for the responders and the nonresponders did not differ significantly. Left-sided visuospatial soft signs were significantly increased in treatment nonresponders compared to responders. These subtle neurological abnormalities may implicate a potential subgroup of OCD patients with poorer treatment response. This may have treatment implications and therefore serve as a screening tool in OCD.

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