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Brain mechanisms underlying catatonia: A systematic review
Giulia Cattarinussi1, Alessio A Gugliotta2, Dusan Hirjak3
1Department of Neuroscience (DNS), University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.
Schizophrenia Research
|November 20, 2022
Summary
Neuroimaging reveals widespread brain abnormalities in catatonia, including structural and functional changes. Further research is needed to fully understand the underlying neural mechanisms of this complex psychomotor disorder.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Catatonia is a complex psychomotor disorder with poorly understood pathomechanisms despite its long history.
- It presents with a range of motor, affective, and behavioral symptoms.
Purpose of the Study:
- To systematically review neuroimaging studies on catatonia.
- To identify and summarize findings on brain abnormalities associated with the disorder.
Main Methods:
- A systematic literature search was conducted on PubMed, Web of Science, and Scopus.
- Included studies utilized various neuroimaging techniques such as sMRI, fMRI, SPECT, PET, and MRS.
- 171 case reports were also retrieved and analyzed.
Main Results:
- Observational sMRI studies indicated diffuse atrophy and signal hyperintensities.
- fMRI studies revealed abnormalities in fronto-parietal, limbic regions, thalamus, striatum, orbitofrontal cortex, motor cortices, cerebellum, and brainstem.
- Metabolic and perfusion changes were noted in basal ganglia, prefrontal, and motor areas, with case reports describing white matter lesions and hypoperfusion.
Conclusions:
- Catatonia is associated with diverse cortico-subcortical abnormalities across structural, functional, perfusion, and metabolic domains.
- Significant heterogeneity in study populations and neuroimaging techniques necessitates cautious interpretation of current findings.
- Future neuroimaging research is crucial for a more comprehensive understanding of the neural underpinnings of catatonia's motor and psychomotor mechanisms.
