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Cortical release signs in psychiatry
Mark Walterfang1, Dennis Velakoulis
1Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia. mark.walterfang@mh.org.au
The Australian and New Zealand Journal of Psychiatry
|April 30, 2005
Summary
Cortical release signs (CRS), primitive reflexes that reappear with central nervous system (CNS) disease, are reviewed for their role in neuropsychiatry. While their interpretation is complex, CRS may aid in diagnosing and staging neuropsychiatric conditions.
Area of Science:
- Neuroscience
- Psychiatry
- Neurology
Background:
- Cortical release signs (CRS) are primitive reflexes normally inhibited during infant central nervous system (CNS) development.
- Re-emergence of CRS indicates CNS disease and is observed in various neuropsychiatric conditions.
Purpose of the Study:
- To review the role and clinical utility of cortical release signs (CRS) in neuropsychiatry.
- To describe the neurobiology, elicitation, and interpretation of individual CRS.
Main Methods:
- A comprehensive literature review was performed.
- Databases searched included Medline and Psychlit, supplemented by other relevant references.
Main Results:
- Elevated rates of neurological abnormalities, including CRS, are reported in conditions like schizophrenia, affective disorders, OCD, and dementias (Alzheimer's, vascular, frontotemporal).
- CRS can be utilized in clinical management for diagnostic assessment, treatment monitoring, and prognosis in neuropsychiatric patients.
Conclusions:
- Interpretation of CRS in neuropsychiatric illness is complicated by high base rates in some populations, increasing prevalence with age, lack of specificity, and uncertainty regarding 'abnormal' responses.
- Despite challenges, CRS can assist in diagnostic differentiation and illness staging in certain neuropsychiatric contexts.