Word countcambridge... · Web view[Raven’s Progressive Matrices]. Madrid: TEA Ediciones. Vega-Dienstmaier JM, Sal Y Rosas HJ, Mazzotti Suárez G, Vidal H, Guimas B, Adrianzén C,

SUPLEMENTARY MATERIAL

Methods of the empirical studies

Participants

Study 1 (UK). The first sample consisted of 74 individuals (35 OCD patients and 39

matched controls). OCD individuals were recruited consecutively from a specialized

cognitive behavioral therapy clinic in Beckenham, England. All patients were assessed

with the Structured Clinical Interview for DSM-IV (SCID-IV; First et al., 1995) by a

psychiatrist or nurse therapist from the Unit and met criteria for OCD. Patients with

secondary diagnoses were also included in the study provided that OCD was the

primary diagnosis and the reason for consultation. The most frequent comorbidities in

the OCD group were Major Depressive Disorder (N = 7; 19.4%), Dysthymic Disorder

(N = 7; 19.4%), Panic Disorder (N = 2; 5.6%), Posttraumatic Stress Disorder (N = 1;

2.8%), Specific Phobia (N = 1; 2.8%), Generalized Anxiety Disorder (N = 1; 2.8%), and

Body Dysmorphic Disorder (N = 1; 2.8%). Twenty-five out of 33 patients (75.7%) were

taking medication for the OCD (information from 2 patients is missing); 4 patients were

given clomipramine (12.1%), 1 patient was taking amitriptyline (3%), and the rest

(60.6%) were medicated with selective reuptake inhibitors. Exclusion criteria were

treatment with antipsychotic medication or benzodiazepines, history of head injury or

neurological illness, comorbid schizophrenia/psychosis, substance abuse, less than 9

years of education (equivalent to primary school education), and IQ of less than 90.

Healthy control subjects were either Institute of Psychiatry staff, students from

King’s College London, or were recruited from the local community. None of the

controls had a history of psychiatric disorder.

1

The Research Ethics Committee of the Maudsley Hospital and the Institute of

Psychiatry approved the study protocol. Written informed consent was obtained from all

subjects prior to testing. Participants were paid 25 pounds for their involvement in the

study.

Study 2 (Spain). The second sample consisted of 99 participants (50 outpatients with

primary diagnosis of OCD and 49 matched controls). OCD participants were recruited

from the Department of Psychiatry, Bellvitge University Hospital in Barcelona, Spain.

All patients were diagnosed in a semi-structured interview by two experienced

psychiatrists, who used a checklist that summarized relevant DSM-IV criteria. Patients

with other comorbid psychiatric diagnoses were not excluded, provided that OCD was

the dominant disorder for which treatment was sought. The most frequent comorbidities

were Major Depressive Disorder (N = 7; 14%), Dysthymic Disorder (N = 2; 4%), Panic

Disorder (N = 2; 4%), and Eating Disorders (N = 2; 4%). Forty-nine (98%) patients

were on medication; 18 (36%) were on clomipramine (CMI), 14 (28%) on CMI plus a

selective serotonin reuptake inhibitor (SSRI), 13 (26%) on a SSRI only, 2 (4%) on a

monoamine oxidase inhibitor, 1 (2%) on CMI plus antipsychotic, and 1 (2%) on SSRI

plus antipsychotic. Exclusion criteria were the presence of a diagnosed neurological

disorder, and/or history of drug abuse/dependence.

Forty-nine healthy comparison subjects were recruited from the local community

and were reimbursed for their participation in the study. They had no current or history

of psychiatric or neurological diagnoses, as determined on the basis of a brief interview.

Written informed consent was obtained from all participants. The study was

approved by the Ethics Committee of the Bellvitge University Hospital, Barcelona,

Spain.

2

Instrument and Procedures

Neurological Soft Signs were assessed in both samples using the Cambridge

Neurological Inventory (CNI) (Chen et al., 1995). The CNI is a brief standardized

clinical instrument specifically devised and validated for its use with psychiatric, rather

than neurological, patients. The soft signs section of the CNI is divided into three

groups: i) primitive reflexes, ii) motor coordination, and iii) sensory integration. The

primitive reflexes tests look at reflexes that are present from birth but normally

disappear during early childhood in healthy control subjects. The motor coordination

tests are concerned with repetitive sequential motor execution. The third group consists

of tests related to the integration of sensory information. Ratings on the CNI are

standardized to indicate ‘Normal’ (= 0), ‘Definitely Abnormal’ (= 1), or ‘Grossly

abnormal’ (= 2). In the assessment of the Spanish sample, an additional option

indicating ‘Subthreshold’ (= 0.5) was also applied when appropriate.

Each participant was given a summary score, which was calculated for each

assessed category of soft signs (primitive reflexes, motor coordination, and sensory

integration) by adding up scores of the relevant signs. A total composite score was

calculated for all signs, including a score for total left- and total right-sided signs.

In both samples, the examiners were trained in the administration of the

instrument. The assessment lasted approximately 20-25 minutes. Raters were not blind

to the participant’s patient or control status.

In order to assess the reliability of the CNI, 40% (N= 30) of the participants in

the UK sample were double-scored by a second examiner. Inter-rater reliability was

computed for all NSS using interclass correlation coefficients (ICC) and 95%

3

confidence intervals (CI). Reliability was excellent for total NSS (ICC = .81, 95% CI

= .61–.91) and sensory integration (ICC = .90, 95% CI = .80–.95), somewhat lower for

total right NSS (ICC = .72, 95% CI = .49–.86), total left NSS (ICC = .58, 95% CI

= .22–.79) and motor coordination (ICC = .68, 95% CI = .42–.84), and low for primitive

reflexes (ICC = .37, 95% CI = .04–.64).

Clinical measures

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) in its English (Deacon et al.,

2005; Goodman et al., 1989a, 1989b) and Spanish versions (Vega-Dienstmaier et al.,

2002) was administered to the OCD participants from the UK and Spain, respectively.

Depressive symptoms were assessed with the Beck Depression Inventory (BDI) (Beck

et al., 1961) and the Hamilton Depression Rating Scale (HDRS) (Hamilton, 1960;

Ramos-Brieva et al., 1988) in the UK and Spanish samples, respectively. IQ was

estimated with the National Adult Reading Test (NART) (Nelson, 1982) and Raven’s

Advanced Progressive Matrices (RAPM) (Raven et al., 1995) in the UK and Spanish

samples, respectively.

Statistical analysis

Data were analyzed using SPSS, version 15.0. Demographic and clinical variables for

OCD patients and healthy controls were compared using Student t-tests for continuous

variables and Chi-square tests or Fisher’s exact tests for categorical variables.

Between-group differences in OCD severity scores, mood measures, and NSS

scores were studied using non-parametric Mann-Whitney U tests. Mean ranks for NSS

4

scores in each group are shown since NSS are scored on an ordinal scale ranging

between 0 and 2.

Spearman’s correlation analyses were conducted in order to investigate the

relation between NSS scores and sociodemographic and clinical measures.

The sample size may vary for some of the analyses as a result of missing data.

Results of the empirical studies

Demographic and clinical variables

Table S1 shows the demographic and clinical characteristics of the two samples. There

were no significant differences between patients and controls in terms of sex,

handedness, or age in any of the two samples. In the UK sample, healthy controls were

marginally better educated than patients were. The mean of the estimated IQ (derived

from the NART) did not differ between patients and controls. Regarding the Spanish

sample, no differences were found between the two groups in terms of years of

education or intellectual level (derived from the RAPM). Patients’ mean scores on the

Yale-Brown Obsessive-Compulsive Scale (Goodman et al., 1989a, 1989b) suggested

moderate OCD severity in both samples.

Neurological Soft Signs

There was a near significant difference between patients and controls for total NSS (U =

507.50, z = -1.90, p = .06) in the UK sample. There was a significant difference, with

patients scoring higher than controls for total left NSS (U = 495.00, z = -2.06, p = .04),

and a near significant difference for total right NSS (U = 523.50, z = -1.74, p = .08).

5

Patients also scored significantly higher than controls in terms of primitive reflexes (U =

535.00, z = -2.41, p = .02). Although patients scored higher than controls for motor

coordination and sensory integration scales, these scores did not reach statistical

significance.

In the Spanish sample, there were significant differences between patients and

controls for total NSS (U = 306.00, z = -6.44, p = .000), total left NSS (U = 382.50, z =

-5.93, p = .000), and total right NSS (U = 321.50, z = -6.35, p = .000), as well as in all

three subscales, namely primitive reflexes (U = 661.50, z = -4.99, p = .000), motor

coordination (U = 322.50, z = -6.33, p = .000), and sensory integration (U = 855.50, z =

-2.71, p = .007) (see Table 1 in the main text).

Mann Whitney U tests for each one of the individual subtests composing the

subscales in both samples can be found in Tables S2 and S3.

Correlation analyses

In order to investigate whether NSS measures were related to the severity of the OCD

and depressive symptoms, Spearman’s correlation coefficients were computed between

the Y-BOCS, the BDI (UK sample), or the Hamilton Depression Scale (Spanish

sample), and NSS scores in the OCD group. The only correlation that reached

significance in the UK sample was the BDI score with the total NSS (r s = .35; p < .05).

In the Spanish sample, significant correlations were found between the total NSS score

and the Y-BOCS total score (rs = .47), as well as with the Y-BOCS obsessions scale (rs

= .41), the Y-BOCS compulsions scale (rs = .52), and the HDRS (rs = .50; all p < .01).

In this sample, significant correlations were also found between most of the subscales of

the CNI and the scores for total right/left signs and the Y-BOCS and the HDRS scores.

6

At an exploratory level, we also conducted Spearman’s correlations between

NSS scores and other socio-demographic variables (age, education in years, IQ

estimate, and duration of the illness). In the UK sample, the findings revealed that

‘years of education’ was negatively and significantly correlated with total NSS score (r s

= -.40), total right NSS (rs = -.35), total left NSS (rs = -.39), and the sensory integration

scale (rs = -.35; all p < .05). Similarly, in the Spanish sample, ‘years of education’

correlated negatively and significantly with total NSS score (rs = -.43), total left NSS (rs

= -.46), and the motor coordination scale (rs = -.41; all p < .01); the age of the OCD

participants correlated positively with the total NSS score (rs = .38; p < .01); the total

right (rs = .29) and the total left (rs = .32) scores (both p < .05), and the motor

coordination subscale (rs = .37; p < .01); the duration of the illness correlated with the

total NSS score (rs = .31) and the motor coordination subscale (rs = .31; both p < .05)

(see Tables S4 and S5).

7

SUPLEMENTARY MATERIAL REFERENCES

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961). An inventory for

measuring depression. Archives of General Psychiatry 4, 561-571.

Chen EY, Shapleske J, Luque R, McKenna PJ, Hodges JR, Calloway SP, Hymas

NF, Dening TR, Berrios GE (1995). The Cambridge Neurological Inventory: a

clinical instrument for assessment of soft neurological signs in psychiatric

patients. Psychiatry Research 56, 183-204.

Deacon BJ, Abramowitz JS (2005). The Yale-Brown Obsessive Compulsive Scale:

factor analysis, construct validity, and suggestions for refinement. Journal of

Anxiety Disorders 19, 573-585.

First MB, Spitzer RL, Gibbon M, Williams JBW (1995). Structured Clinical

Interview for DSM-IV (SCID-I) (User’s Guide and Interview), Research Version.

New York: Biometrics Research Department, New York Psychiatric Institute.

Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL,

Heninger GR, Charney DS (1989a). The Yale-Brown Obsessive Compulsive

Scale. I. Development, use, and reliability. Archives of General Psychiatry 46,

1006-1011.

Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR,

Charney DS (1989b). The Yale-Brown Obsessive Compulsive Scale. II. Validity.

Archives of General Psychiatry 46, 1012-1016.

Hamilton M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery

and Psychiatry 23, 56-61.

8

Nelson, HE (1982). National Adult Reading Test: Test Manual. Windsor, Berks:

NFER-Nelson.

Ramos-Brieva JA, Cordero-Villafafila A (1988). A new validation of the Hamilton

Rating Scale for Depression. Journal of Psychiatry Research 22, 21-28.

Raven, JC, Court JH, Raven, J (1995). [Raven’s Progressive Matrices]. Madrid: TEA

Ediciones.

Vega-Dienstmaier JM, Sal Y Rosas HJ, Mazzotti Suárez G, Vidal H, Guimas B,

Adrianzén C, Vivar R (2002). [Validation of a version in Spanish of the Yale-

Brown Obsessive-Compulsive Scale]. Actas españolas de psiquiatría 30, 30-35.

9

Table S1. Demographic and Clinical Characteristics of OCD patients and Healthy Control subjects in the UK sample (N = 74) and in the Spanish sample (N = 99).

UK sample Spanish sample

VariableOCD (N = 35) Control (N = 39)

Χ2 Df pOCD (N = 50) Control (N = 49)

Χ2 Df pN % n % N % N %

Sex, male 20 57.1 20 51.3 .25 1 .65 31 62 30 61.2 .01 1 1.00Handedness, right 32 91.4 36 92.3 .02 1 1.00 44 88 47 95.9 2.09 1 .27

mean SD mean SD F Df P mean SD mean SD F Df pAge, years 36.7 11.2 33.8 10.4 .66 69.66 .25 33.9 10.7 34 11 .12 96.82 .96

Education, years 13.3 2.5 14.6 2.6 .18 71.41 .04 12.3 3.3 12.7 2.8 .59 94.94 .52IQ (NART, UK sample / RAPM, Spanish sample)

113.9 7.4 115.2 7.5 .01 71.42 .47 50 9.3 49 9.7 .39 96.85 .43

Illness duration, years 21.2 12.2 - - - - - 13.9 9.9 - - - - -

mean SD mean SD U z p mean SD mean SD U z p

Y-BOCS, obsessions 12.3 3.7 - - - - - 10.2 3.5 - - - - -

Y-BOCS, compulsions 12.2 3.7 - - - - - 10.3 3.4 - - - - -

Y-BOCS, total 24.51 6.91 - - - - - 20.54 6.68 - - - - -Depression

(BDI,UK sample / HDRS, Spanish

sample)

19.49 10.05 4.67 5.19 123.50 .00 .000 11.22 4.69 - - - - -

10

Table S2. Mann Whitney U tests scores showing group differences in Neurological Soft Signs tasks between OCD and Control Groups in the UK sample.

NSS VariableMean rank

U* z pOCD (N = 35) Controls (N = 39)

Primitive reflexes Snout reflex 38.06 37.00 663.00 -1.06 .29 Grasp reflex 37.06 37.90 667.00 -0.49 .62 Palmomental reflex 42.04 33.42 523.50 -2.90 .004

Motor coordination Finger-nose test, left 38.63 36.49 643.00 -0.59 .56 Finger-nose test, right 38.49 36.62 648.00 -0.57 .57 Finger-thumb tapping, left 37.56 37.45 680.50 -0.08 .94 Finger-thumb tapping, right 37.56 37.45 680.50 -0.08 .94 Finger-thumb opposition, left 38.93 36.22 632.50 -0.80 .43 Finger-thumb opposition, right 40.26 35.03 586.00 -1.59 .11 Mirror movements (1), left 35.67 39.14 618.50 -0.79 .43 Mirror movements (1), right 34.79 39.94 587.50 -1.16 .24 Diadochokinesis, left 39.46 35.74 614.00 -1.20 .23 Diadochokinesis, right 39.46 35.74 614.00 -1.20 .23 Mirror movements (2), left 38.61 36.50 643.50 -1.50 .13 Mirror movements (2), right 38.06 37.00 663.00 -1.06 .29 Fist-edge-palm test, left 38.61 36.50 643.50 -0.54 .59 Fist-edge-palm test, right 41.07 34.29 557.50 -1.63 .10 Oseretsky test 41.26 34.13 551.00 -1.98 .05 Rhythm-tapping test 42.46 33.05 509.00 -2.25 .02 Go/no-go test 35.63 39.18 617.00 -1.20 .23

Sensory integration Extinction 38.13 36.94 660.50 -0.70 .49

Finger agnosia, left 36.79 38.14 657.50 -0.29 .77

Finger agnosia, right 38.07 36.99 662.50 -0.23 .82 Stereognosis, left 37.50 37.50 682.50 0.00 1.00 Stereognosis, right 37.50 37.50 682.50 0.00 1.00 Graphestesia, left 41.70 33.73 535.50 -2.41 .02 Graphestesia, right 40.96 34.40 561.50 -1.59 .11 Left-right disorientation 35.47 39.32 611.50 -1.01 .31

*Nonparametric tests were used because the dependent variable was a nominal, rather than interval variable (scored: 0, 1, 2).

11

Table S3. Mann Whitney U tests scores showing group differences in Neurological Soft Signs tasks between OCD and Control Groups in the Spanish sample (N = 99).

NSS VariableMean rank

U* z pOCD (N = 50) Controls (N = 49)

Primitive reflexes Snout reflex 61.03 38.74 673.50 -4.95 .000 Grasp reflex 50.49 49.50 1200.50 -0.99 .32 Palmomental reflex 50.00 50.00 1225.00 0.00 1.00

Motor coordination Finger-nose test, left 54.90 45.00 980.00 -3.28 .001 Finger-nose test, right 52.94 47.00 1078.00 -2.49 .01 Finger-thumb tapping, left 54.41 45.50 1004.50 -3.10 .002 Finger-thumb tapping, right 53.92 46.00 1029.00 -2.90 .004 Finger-thumb opposition, left 55.03 44.87 973.50 -2.05 .04 Finger-thumb opposition, right 56.45 43.42 902.50 -2.82 .005 Mirror movements (1), left 60.70 39.08 690.00 -3.97 .000 Mirror movements (1), right 63.15 36.58 567.50 -4.85 .000 Diadochokinesis, left 56.16 43.71 917.00 -2.58 .010 Diadochokinesis, right 58.07 41.77 821.50 -3.90 .000 Mirror movements (2), left 58.97 40.85 776.50 -3.59 .000 Mirror movements (2), right 59.56 40.24 747.00 -3.51 .000 Fist-edge-palm test, left 61.42 38.35 654.00 -4.22 .000 Fist-edge-palm test, right 62.35 37.40 607.50 -4.66 .000 Oseretsky test 58.18 41.65 816.00 -3.53 .000 Rhythm-tapping test 51.48 48.49 1151.00 -1.36 .17 Go/no-go test 51.47 48.50 1151.50 -1.73 .08

Sensory integration Extinction 50.49 49.50 1200.50 -0.99 .32 Finger agnosia, left 52.70 47.24 1090.00 -1.30 .19 Finger agnosia, right 55.40 44.49 955.00 -2.76 .006 Stereognosis, left 50.00 50.00 1225.00 0.00 1.00 Stereognosis, right 50.00 50.00 12.25.00 0.00 1.00 Graphestesia, left 56.28 43.59 911.00 -3.09 .002 Graphestesia, right 53.14 46.80 1068.00 -1.72 .09 Left-right disorientation 49.72 50.29 1211.00 -0.12 .90

*Nonparametric tests were used because the dependent variable was a nominal, rather than interval variable (scored: 0, 0.5, 1, 2).

12

Table S4. Spearman’s correlation coefficients between Neurological Soft Signs scores and Sociodemographic and Clinical Variables in the OCD Patients group in the UK sample.

Y-BOCS obsessions

Y-BOCS compulsions

Y-BOCS total BDI STAI state Education in

years AgeDuration of

illness in years

NART

Primitive reflexes, total -.03 -.21 -.12 -.14 -.30 .20 -.28 -.60 -.74

Motor coordination, total -.00 -.02 -.00 .28 .32 -.31 .23 .07 -.16

Sensory integration, total .06 -.08 .01 .31 .07 -.35* .24 .26 -.17

Total right NSS .16 .12 .16 .32 .30 -.35* .01 .07 -.16

Total left NSS -.12 -.29 -.17 .16 .02 -.39* .14 .12 -.29

Total NSS .05 -.07 .01 .35* .27 -.40* .20 .12 .14

** Correlation is significant at the .01 level.

* Correlation is significant at the .05 level.

13

Table S5. Spearman’s correlation coefficients between Neurological Soft Signs scores and Sociodemographic and Clinical Variables in the OCD Patients group in the Spanish sample.

Y-BOCS obsessions

Y-BOCS compulsions

Y-BOCS total HDRS STAI state Education in

years AgeDuration of

illness in years

Raven

Primitive reflexes, total .14 .30* .23 .24 .22 -.23 -.12 .03 -.22

Motor coordination, total .36** .45** .42** .51** .55** -.41** .37** .31* -.16

Sensory integration, total .22 .38** .30* .18 .23 -.23 .25 .19 .09

Total right NSS .30* .42** .36** .39** .42** -.23 .29* .28 -.18

Total left NSS .35* .45** .42** .48** .52** -.46** .32* .21 -.08

Total NSS .41** .52** .47** .50** .55** -.43** .38** .31* -.14

** Correlation is significant at the .01 level.

* Correlation is significant at the .05 level.

14

Figure S1. Forest plot for total left Neurological Soft Signs score in OCD patients vs. healthy controls (N = 5).

NOTE: Weights are from random effects analysis

Overall (I-squared = 81.2%, p = 0.000)

Mataix-Cols 2003

Jaafari 2011

UK sample 2006

Study

ID

Spanish sample 2008

Stein 1994

0.72 (0.22, 1.21)

1.14 (0.59, 1.69)

0.16 (-0.23, 0.55)

0.53 (0.07, 1.00)

SMD (95% CI)

1.40 (0.96, 1.84)

0.37 (-0.23, 0.97)

100.00

19.05

21.58

20.39

%

Weight

20.76

18.22

0.72 (0.22, 1.21)

1.14 (0.59, 1.69)

0.16 (-0.23, 0.55)

0.53 (0.07, 1.00)

SMD (95% CI)

1.40 (0.96, 1.84)

0.37 (-0.23, 0.97)

100.00

19.05

21.58

20.39

%

Weight

20.76

18.22

0-1.84 0 1.84

15

Figure S2. Forest plot for total right Neurological Soft Signs score in OCD patients vs. healthy controls (N = 5).



Jaafari 2011

Study

Mataix-Cols 2003

Spanish sample 2008

ID

UK sample 2006

Stein 1994

0.68 (0.15, 1.21)

0.21 (-0.18, 0.60)

0.79 (0.26, 1.31)

1.62 (1.16, 2.07)

SMD (95% CI)

0.42 (-0.04, 0.88)

0.34 (-0.26, 0.94)

100.00

21.34

%

19.45

20.44

Weight

20.36

18.41

0.68 (0.15, 1.21)

0.21 (-0.18, 0.60)

0.79 (0.26, 1.31)

1.62 (1.16, 2.07)

SMD (95% CI)

0.42 (-0.04, 0.88)

0.34 (-0.26, 0.94)

100.00

21.34

%

19.45

20.44

Weight

20.36

18.41

0-2.07 0 2.07

16

Figure S3. Forest plot for Primitive Reflexes score in OCD patients vs. healthy controls (N = 4).



Bolton 1

UK sample 2006

Spanish sample 2008

Mataix-Cols 2003

ID

Study

0.80 (0.47, 1.14)

1.00 (0.61, 1.39)

0.59 (0.12, 1.05)

1.15 (0.73, 1.58)

0.38 (-0.13, 0.89)

SMD (95% CI)

100.00

27.95

24.04

25.98

22.03

Weight

%

0.80 (0.47, 1.14)

1.00 (0.61, 1.39)

0.59 (0.12, 1.05)

1.15 (0.73, 1.58)

0.38 (-0.13, 0.89)

SMD (95% CI)

100.00

27.95

24.04

25.98

22.03

Weight

%

0-1.58 0 1.58

17

Figure S4. Forest plot for Sensory Integration score in OCD patients vs. healthy controls (N = 8).



Sevincok 2006

Bolton 1

ID

UK sample 2006

Study

Jaafari 2011

Spanish sample 2008

Mataix-Cols 2003

Stein 1994

Poyurovsky 2007

0.67 (0.30, 1.04)

0.17 (-0.40, 0.74)

1.66 (1.24, 2.09)

SMD (95% CI)

0.25 (-0.21, 0.70)

0.66 (0.26, 1.06)

0.55 (0.15, 0.96)

0.86 (0.33, 1.40)

0.09 (-0.51, 0.68)

1.04 (0.49, 1.59)

100.00

11.64

13.22

Weight

12.87

%

13.53

13.48

12.05

11.33

11.88

0.67 (0.30, 1.04)

0.17 (-0.40, 0.74)

1.66 (1.24, 2.09)

SMD (95% CI)

0.25 (-0.21, 0.70)

0.66 (0.26, 1.06)

0.55 (0.15, 0.96)

0.86 (0.33, 1.40)

0.09 (-0.51, 0.68)

1.04 (0.49, 1.59)

100.00

11.64

13.22

Weight

12.87

%

13.53

13.48

12.05

11.33

11.88

0-2.09 0 2.09

18

Figure S5. Forest plot for Motor Coordination score in OCD patients vs. healthy controls (N = 10).



ID

Guz & Aygun 2004

Spanish sample 2008

UK sample 2006

Hymas (slow) 1991

Jaafari 2011

Mataix-Cols 2003

Study

Stein 1994

Poyurovsky 2007

Bolton 1

Sevincok 2006

0.61 (0.00, 1.22)

SMD (95% CI)

(Excluded)

1.62 (1.17, 2.08)

0.41 (-0.05, 0.88)

1.31 (0.55, 2.07)

-1.23 (-1.65, -0.80)

0.93 (0.40, 1.47)

0.31 (-0.29, 0.91)

0.78 (0.25, 1.32)

1.09 (0.70, 1.49)

0.35 (-0.23, 0.92)

100.00

Weight

0.00

11.37

11.35

10.20

11.47

11.10

%

10.87

11.11

11.56

10.97

0.61 (0.00, 1.22)

SMD (95% CI)

(Excluded)

1.62 (1.17, 2.08)

0.41 (-0.05, 0.88)

1.31 (0.55, 2.07)

-1.23 (-1.65, -0.80)

0.93 (0.40, 1.47)

0.31 (-0.29, 0.91)

0.78 (0.25, 1.32)

1.09 (0.70, 1.49)

0.35 (-0.23, 0.92)

100.00

Weight

0.00

11.37

11.35

10.20

11.47

11.10

%

10.87

11.11

11.56

10.97

0-2.08 0 2.08

19

Figure S6. Meta-regression analysis showing a non-significant association between symptom severity (Y-BOCS total score) and total scores on Neurological Soft Signs.

02

46

SM

D

18 20 22 24 26 28YBOCS_Total

20

Figure S7. Meta-regression analysis showing a trend towards significance of the year of publication on the Neurological Soft Signs total scores.

02

46

SM

D

1990 1995 2000 2005 2010Year

21

Figure S8. Forest plot with a breakdown of the instrument used to assess Neurological Soft Signs in OCD patients vs. healthy controls.


.

.

.

.

.


UK sample 2006

CNI

Hollander 1990

Sevincok 2006

Guz & Aygun 2004PANESS

Conde López 1990

Stein 1994

Salama 2008

NES

Hymas (slow) 1991

Subtotal (I-squared = 95.5%, p = 0.000)

Spanish sample 2008

Nickoloff 1991


ID

Poyurovsky 2007


Jaafari 2011Subtotal (I-squared = .%, p = .)

Kreb's

Bihari 1991

Mataix-Cols 2003Bolton 1


Clinical Exam

Study

1.28 (0.80, 1.75)

0.47 (0.00, 0.93)

1.05 (0.48, 1.62)

0.75 (0.17, 1.34)

0.65 (0.13, 1.17)

0.92 (0.27, 1.58)

0.40 (-0.20, 1.00)

0.80 (0.40, 1.21)

1.31 (0.55, 2.07)

1.88 (0.42, 3.34)

1.62 (1.17, 2.08)

2.11 (0.95, 3.26)

1.45 (0.65, 2.26)

SMD (95% CI)

1.74 (1.15, 2.34)

1.18 (0.65, 1.72)

-0.14 (-0.53, 0.25)-0.14 (-0.53, 0.25)

5.95 (4.92, 6.98)

1.08 (0.54, 1.62)1.55 (1.13, 1.96)

0.74 (0.42, 1.06)

100.00

7.03

6.80

6.76

6.91

6.59

6.73

7.14

6.32

32.01

7.04

5.22

18.72

Weight

6.74

28.05

7.177.17

5.57

6.867.12

14.05

%

1.28 (0.80, 1.75)

0.47 (0.00, 0.93)

1.05 (0.48, 1.62)

0.75 (0.17, 1.34)

0.65 (0.13, 1.17)

0.92 (0.27, 1.58)

0.40 (-0.20, 1.00)

0.80 (0.40, 1.21)

1.31 (0.55, 2.07)

1.88 (0.42, 3.34)

1.62 (1.17, 2.08)

2.11 (0.95, 3.26)

1.45 (0.65, 2.26)

SMD (95% CI)

1.74 (1.15, 2.34)

1.18 (0.65, 1.72)

-0.14 (-0.53, 0.25)-0.14 (-0.53, 0.25)

5.95 (4.92, 6.98)

1.08 (0.54, 1.62)1.55 (1.13, 1.96)

0.74 (0.42, 1.06)

100.00

7.03

6.80

6.76

6.91

6.59

6.73

7.14

6.32

32.01

7.04

5.22

18.72

Weight

6.74

28.05

7.177.17

5.57

6.867.12

14.05

%

0-6.98 0 6.98

22

Documents

Word countcambridge... · Web view[Raven’s Progressive Matrices]. Madrid: TEA Ediciones. Vega-Dienstmaier JM, Sal Y Rosas HJ, Mazzotti Suárez G, Vidal H, Guimas B, Adrianzén C,