Research Projects
Characterizing clinical and functional outcomes of neurological soft-signs in first-episode schizophrenia: A 10-year follow-up study

Neurological soft-signs (NSS) are subtle and non-localizable neurological abnormalities. NSS are elevated in schizophrenia patients across different illness stages. This biomarker may reflect the underlying neurodevelopmental abnormality of schizophrenia. This proposed project aims to characterize 10-year naturalistic clinical and functional outcome of NSS in first-episode schizophrenia patients, and will utilize our existing cohort of 194 first-episode schizophrenia patients who have already been assessed in 2010-2015 for baseline NSS, and patients’ data regarding the initial 1-year progression of NSS is readily available. We will reassess this naturalistic cohort after 10 years, and evaluate patients’ end-point NSS and long-term outcome. Three important outcome domains will be assessed, namely (1) selfcare, social and vocational functioning, (2) psychopathology/symptom levels, and (3) emergence of treatment-resistance. For functional outcome, we utilize both interview-based and performance-based assessments. For clinical outcome, we define treatment-resistant conditions stringently according to the Treatment Response and Resistance in Psychosis (TRRIP) Working Group consensus criteria. We will compare the 10-year evolution patterns of NSS (baseline, 10 years) between treatment-resistant versus treatment-responsive schizophrenia patients in the nested cohort. Linear regression models will examine predictive ability of NSS for predicting clinical (symptoms levels and treatment response) and functional outcome. Moreover, we utilize our multiple time-point (baseline, 6 months, 12 months, 10 years) data of NSS to conduct latent growth modelling for categorizing the cohort into subgroups with different evolution patterns of NSS. ANCOVAs will be used to compare the 10-year outcome between the schizophrenia subgroups of varied NSS progression, with age, estimated IQ, premorbid functioning, depressive symptoms and medication side-effects as covariates. Our expected findings will provide strong evidence to evaluate NSS as a putative prognostic marker for schizophrenia. NSS are important but often-ignored clinical signs, and can be objectively and reliably measured in daily clinical practice. Clarifying its clinical utility will facilitate the incorporation of NSS measures into the standard care for better treatments of schizophrenia patients. Our study will also pave ways for more research on motor abnormalities in schizophrenia. 

Professor SSY Lui , Department of Psychiatry

Professor Simon Lui is a clinician-scientist specializing in psychosis. His research interests include clinical studies in psychosis, schizotypy, cognitive markers and endophenotype, and prospection.  

Biography
HKU Scholars Hub
ORCID
lsy570@hku.hk

For more information or to express interest for this project, please email the supervisor or the specified contact point in the project description.  Interested candidates are advised to enclose with your email:

1. your CV,
2. a brief description of your research interest and experience, and
3. two reference letters (not required for HKUMed UG students seeking MRes[Med]/URIS projects).

Information on the research programme, funding support and admission documentations could be referenced online at the Research Postgraduate Admissions website. General admission enquiries should be directed to rpgmed@hku.hk.

HKUMed MBBS students interested in the Master of Research in Medicine (MRes[Med]) programme may visit the programme website for more information.  

HKUMed UG students interested in the Undergraduate Research Internship Scheme (URIS) may visit the scheme’s website for more information.