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Going Back to Kahlbaum's Psychomotor (and GABAergic) Origins: Is Catatonia More Than Just a Motor and Dopaminergic Syndrome?
- Source :
-
Schizophrenia bulletin [Schizophr Bull] 2020 Feb 26; Vol. 46 (2), pp. 272-285. - Publication Year :
- 2020
-
Abstract
- In 1874, Karl Kahlbaum described catatonia as an independent syndrome characterized by motor, affective, and behavioral anomalies. In the following years, various catatonia concepts were established with all sharing the prime focus on motor and behavioral symptoms while largely neglecting affective changes. In 21st century, catatonia is a well-characterized clinical syndrome. Yet, its neurobiological origin is still not clear because methodological shortcomings of hitherto studies had hampered this challenging effort. To fully capture the clinical picture of catatonia as emphasized by Karl Kahlbaum, 2 decades ago a new catatonia scale was developed (Northoff Catatonia Rating Scale [NCRS]). Since then, studies have used NCRS to allow for a more mechanistic insight of catatonia. Here, we undertook a systematic review searching for neuroimaging studies using motor/behavioral catatonia rating scales/criteria and NCRS published up to March 31, 2019. We included 19 neuroimaging studies. Studies using motor/behavioral catatonia rating scales/criteria depict cortical and subcortical motor regions mediated by dopamine as neuronal and biochemical substrates of catatonia. In contrast, studies relying on NCRS found rather aberrant higher-order frontoparietal networks which, biochemically, are insufficiently modulated by gamma-aminobutyric acid (GABA)-ergic and glutamatergic transmission. This is further supported by the high therapeutic efficacy of GABAergic agents in acute catatonia. In sum, this systematic review points out the difference between motor/behavioral and NCRS-based classification of catatonia on both neuronal and biochemical grounds. That highlights the importance of Kahlbaum's original truly psychomotor concept of catatonia for guiding both research and clinical diagnosis and therapy.<br /> (© The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Humans
Brain diagnostic imaging
Brain metabolism
Brain physiopathology
Catatonia classification
Catatonia diagnostic imaging
Catatonia metabolism
Catatonia physiopathology
Psychomotor Disorders classification
Psychomotor Disorders diagnostic imaging
Psychomotor Disorders metabolism
Psychomotor Disorders physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1745-1701
- Volume :
- 46
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Schizophrenia bulletin
- Publication Type :
- Academic Journal
- Accession number :
- 31361896
- Full Text :
- https://doi.org/10.1093/schbul/sbz074