Catatonia as the Initial Manifestation of Dementia with Lewy Bodies

Saito, Yûsuke; Noto, Keisuke; Kobayashi, Ryota; Suzuki, Akihito; Morioka, Daichi; Hayashi, Hiroshi; Otani, Koichi

doi:10.12659/ajcr.932018

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…Neurological disorders: Dementia: Catatonia has been described in all dementia types, with reports in patients with Alzheimer’s disease (AD)[ 41 - 43 ]; frontotemporal dementia (FTD)[ 44 - 49 ]; dementia with Lewy bodies (DLB)[ 50 - 55 ]; and other cases with mixed, vascular, or nonspecified dementia[ 56 , 57 ]. Two prospective studies in psychogeriatric units reported a high prevalence of catatonia in patients with dementia using DSM-5 criteria, at 35.3%[ 16 ] and 42.8%[ 11 ].…”

Section: Resultsmentioning

confidence: 99%

Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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BACKGROUND Catatonia is a complex psychomotor syndrome that often goes unrecognized and untreated, even though its classification has evolved in recent years. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. The underrecognition of catatonia in older patients is also frequent, and research in this population is scarce. AIM To conduct a systematic review of the literature on catatonia in older people to ascertain its clinical characteristics across settings. METHODS Following the PRISMA guidelines, MEDLINE, EMBASE, and PsycINFO databases were searched from inception to December 2021, with a strategy aimed at identifying all articles published on catatonia in older adults. Titles and abstracts were scanned and selected independently by two authors. Papers investigating issues related to catatonia and/or catatonic symptoms in older people, with English abstracts available, were included. References of selected articles were revised to identify other relevant studies. RESULTS In total, 1355 articles were retrieved. After removing duplicates, 879 remained. Of the 879 identified abstracts, 669 were excluded because they did not meet the inclusion criteria. A total of 210 articles underwent full text review, and 51 were eliminated for various reasons. Fourteen more articles were selected from the references. Overall, 173 articles were reviewed: 108 case reports, 35 case series, 11 prospective cohort studies, 6 case-control studies, 3 retrospective cohort studies and 10 reviews. We found several particular aspects of catatonia in this population. Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. Older patients, compared to younger patients, have a higher risk of developing catatonia with benzodiazepine (BZD) withdrawal, in bipolar disorder, and in the general hospital. Age, together with other risk factors, was significantly associated with the incidence of deep venous thrombosis, neuroleptic malignant syndrome poor outcome, other complications and mortality. Treatment with BZDs and electroconvulsive therapy is safe and effective. Prompt treatment of its cause is essential to ensure a good prognosis. CONCLUSION Catatonia in older patients is highly prevalent and tends to have a multifactorial etiology. The risk of developing catatonia in some settings and conditions, as well as of developing complications, is high in this population. Symptomatic treatment is safe and effective, and timely etiologic treatment is fundamental.

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Section: Resultsmentioning

confidence: 99%

Catatonia in older adults: A systematic review

Jaimes-Albornoz¹,

Pellon-Santamaria²,

Nizama-Vía³

et al. 2022

WJP

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“…Diagnostic criteria and rating scales are useful guides for the recognition and rating of catatonic symptoms ( 40 – 42 ). Although catatonia has been described in a few instances of Alzheimer's ( 43 ) and Lewy body disease ( 44 ), most cases of catatonia in dementia have been reported in patients with FTD ( Table 1 ). In fact, catatonic symptoms such as perseverative and stereotyped behavior, echolalia, and mutism are core features of current operational definitions of bvFTD ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Catatonic Stupor in Behavioral Variant Frontotemporal Dementia

et al. 2022

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Catatonia is a psychomotor syndrome common to several medical and neuropsychiatric disorders. Here, we report on the case of a 95-year-old woman who underwent a radical change in personality characterized by sexual disinhibition, and physical and verbal aggressiveness. Over several months, she developed verbal stereotypies, gait deterioration, and double incontinence. She eventually developed mutism and an active opposition to all attempts to be fed or cared for. Benzodiazepines, olanzapine and electroconvulsive therapy were of no benefit. Magnetic resonance imaging revealed asymmetric (more severe on the right) frontotemporal, parietal, and upper brainstem atrophy. She died from sepsis without recovering from stupor seven years after the onset of symptoms. We believe that the initial behavioral disinhibition was related to the frontotemporal injury, whereas catatonic stupor reflected the progression of the degenerative process to the parietal cortices. Our case adds to the small number of cases of catatonia as a symptom of degenerative dementia. It also supports the idea that damage to the parietal cortex gives rise to pathological avoidance of which catatonic stupor represents an extreme form.

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“…There were two clinical case reports of catatonia as an early predominant symptom before developing DLB. 52,86 Bipolar disorders Koga et al investigated the frequency of late-onset mania pathologically in patients with LBD from brain banks of dementia or movement disorder. 87 They found that 13 of 1640 patients with LBD (0.8%) had bipolar disorder.…”

Section: Somatic Symptom Disorders (Somatoform Disorders)mentioning

confidence: 99%

“…In this case series, all nine patients had a depressive phase, six had psychotic symptoms, and two had manic symptoms. There were two clinical case reports of catatonia as an early predominant symptom before developing DLB 52,86 …”

Section: Clinical Profiles Of Psychiatric‐onset Prodromal Dlbmentioning

confidence: 99%

Clinical presentations and diagnostic application of proposed biomarkers in psychiatric‐onset prodromal dementia with Lewy bodies

Kobayashi,

Iwata‐Endo,

Fujishiro

2024

Psychogeriatrics

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Research criteria for the diagnosis of prodromal dementia with Lewy bodies (DLB) include three clinical subtypes: mild cognitive impairment with Lewy bodies (MCI‐LB), delirium‐onset prodromal DLB, and psychiatric‐onset prodromal DLB. Late‐onset psychiatric manifestations are at a higher risk of developing dementia, but its relation to prodromal DLB remains unclear. In addition to the risk of severe antipsychotic hypersensitivity reactions, accurate discrimination from non‐DLB cases is important due to the potential differences in management and prognosis. This article aims to review a rapidly evolving psychiatric topic and outline clinical pictures of psychiatric‐onset prodromal DLB, including the proposed biomarker findings of MCI‐LB: polysomnography‐confirmed rapid eye movement sleep behaviour disorder, cardiac [123I]metaiodobenzylguanidine scintigraphy, and striatal dopamine transporter imaging. We first reviewed clinical pictures of patients with autopsy‐confirmed DLB. Regarding clinical reports, we focused on the patients who predominantly presented with psychiatric manifestations and subsequently developed DLB. Thereafter, we reviewed clinical studies regarding the diagnostic applications of the proposed biomarkers to patients with late‐onset psychiatric disorders. Clinical presentations were mainly late‐onset depression and psychosis; however, other clinical manifestations were also reported. Psychotropic medications before a DLB diagnosis may cause extrapyramidal signs, and potentially influences the proposed biomarker findings. These risks complicate clinical manifestation interpretation during the management of psychiatric symptoms. Longitudinal follow‐up studies with standardised evaluations until conversion to DLB are needed to investigate the temporal trajectories of core features and proposed biomarker findings. In patients with late‐onset psychiatric disorders, identification of patients with psychiatric‐onset prodromal DLB provides the opportunity to better understanding the distinct prognostic subgroup that is at great risk of incident dementia. Advances in the establishment of direct biomarkers for the detection of pathological α‐synuclein may encourage reorganising the phenotypic variability of prodromal DLB.

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Catatonia as the Initial Manifestation of Dementia with Lewy Bodies

Cited by 6 publications

References 11 publications

Catatonia in older adults: A systematic review

Catatonia in older adults: A systematic review

Case Report: Catatonic Stupor in Behavioral Variant Frontotemporal Dementia

Clinical presentations and diagnostic application of proposed biomarkers in psychiatric‐onset prodromal dementia with Lewy bodies

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