Relationship between nailfold plexus visibility and clinical, neuropsychological, and brain structural measures in schizophrenia

Background: Although all published studies investigating the association be tween nailfold plexus visibility and schizophrenia have found the subpapill ary plexus (the vascular network into which capillaries drain) to be unusua lly, visible in many schizophrenia patients, little else is known about thi s putative marker for schizophrenia liability. Methods: Plexus visibility was rated in 63 chronic schizophrenia, 67 first- episode schizophrenia, 9 schizophreniform, and 66 unipolar and bipolar depr essed patients, all with psychosis, and 119 nonpsychiatric controls. Smooth -pursuit eye tracking, clinical features, neuropsychological performance, a nd lateral ventricle size were assessed. Results: Approximately 21% of chronic schizophrenia, 22% of first-episode s chizophrenia, and 22% of schizophreniform patients had highly visible plexu s compared to only 8% of unipolar, bipolar, and nonpsychiatric controls. Sc hizophrenia patients with visible plexus had worse oculomotor performance. Additionally, chronic schizophrenia patients with visible plexus had more n egative symptoms, worse course, more severe illness, wet-se occupational fu nctioning, and worse neuropsychological performance on tasks thought to be sensitive to frontal dysfunction. An inverse relationship between plexus vi sibility and lateral ventricle size was found. Conclusions: This study provides evidence that schizophrenia patients with plexus visibility are characterized by oculomotor dysfunction, negative sym ptoms, severe symptomatology, chronic course, neuropsychological dysfunctio n, and an absence of enlarged ventricles. (C) 1999 Society of Biological Ps ychiatry.