Right lower prefronto-parietal cortical dysfunction in 
akinetic catatonia: a combined study of 
neuropsychology and regional cerebral blood flow

Northoff, Georg; Steinke, R.; Nagel, D; Czerwenka, C.; Großer, Oliver S.; Dános, P.; Genz, Axel; Krause, Reiner; Böker, Heinz; Otto, H.; Bogerts, Bernhard

doi:10.1017/s0033291799002007

Cited by 66 publications

(40 citation statements)

References 35 publications

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“…The prefrontal cortex seems to play a critical role in catatonia according to neuroimaging studies [70][71][72] and the observation that benzodiazepines might treat some catatonic symptoms by activating GABAergic neurons of this area [73]. Interestingly, the few rTMS cases for catatonia have also targeted the prefrontal areas [74][75][76], suggesting that this might be a suitable area for catatonia treatment, especially in the context of schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Brunoni

Shiozawa²,

Truong

et al. 2014

Expert Review of Medical Devices

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Although recent clinical studies using transcranial direct current stimulation (tDCS) for schizophrenia showed encouraging results, several tDCS montages were employed and their current flow pattern has not been investigated. We performed a systematic review to identify clinical tDCS studies in schizophrenia. We then applied computer head modeling analysis for prediction of current flow. Out of 41 references, we identified 12 relevant studies. The most employed montage was anode and cathode over the left dorsolateral prefrontal and temporoparietal cortex, respectively. Computational model analysis predicted activation and under-activation under the anode and the cathode, respectively, occurring in areas respectively associated with negative and positive symptoms. We also identified tDCS-induced electrical currents in cortical areas between the electrodes (frontoparietal network) and, to a lesser extent, in deeper structures involved in schizophrenia pathophysiology. Mechanisms of tDCS effects in schizophrenia and the usefulness of computer modeling techniques for planning tDCS trials in schizophrenia are discussed.

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Section: Discussionmentioning

confidence: 99%

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Brunoni

Shiozawa²,

Truong

et al. 2014

Expert Review of Medical Devices

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show abstract

“…However, single case reports noted reduced bilateral frontal CBF [156] or hypometabolism [157], along with bilateral thalamic hypermetabolism [157]. Similarly, the case series of Northoff et al [129,158] of a mixed-diagnosis catatonia group (3/10 with schizophrenia) revealed hypoperfusion in the middle and right lower prefrontal cortex. The finding was corroborated by functional magnetic resonance imaging (fMRI) demonstrating hypoactivation of M1 during a sequential finger opposition task in akinetic patients [159,160].…”

Section: Neurobiology Of the Motor System In Schizophreniamentioning

confidence: 99%

Motor Symptoms and Schizophrenia

Walther¹,

Strik²

2012

Neuropsychobiology

308

233

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Classical schizophrenia literature reports motor symptoms as characteristic of the disorder. After the introduction of neuroleptic drugs, the existence of genuine motor disorders was challenged. Renewed interest arose as symptoms were found in never-medicated patients. Reports focused on abnormal involuntary movements, parkinsonism, neurological soft signs, catatonia, negative symptoms, or psychomotor slowing. Since these syndromes refer to different concepts, however, the definitions are not congruent and the symptoms overlap. The prevalence rates of motor symptoms in schizophrenia are surprisingly high, and recent studies indicate a possible pathobiology. In particular, the development and maturation of the human motor system appears to be closely linked to the emergence of motor symptoms observed in schizophrenia. Post-mortem and neuroimaging results demonstrated aberrant structure and function of premotor and motor cortices, basal ganglia, thalamus, and the connecting white matter tracts. Animal models have focused on aberrant neurotransmission and genetic contributions. Findings of localized abnormal oligodendrocyte function and myelination point to the special role of the white matter in schizophrenia, and recent studies specifically found an association between motor abnormalities and white matter structure in schizophrenia. This review of the literature supports the idea that motor symptoms are closely related to the neurodevelopmental disturbances of schizophrenia and a distinct syndromal dimension with its own pathophysiology.

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“…Still, due to small samples with heterogeneous catatonic symptoms, the pathobiology of catatonia remains widely unknown. Case reports of brain perfusion during catatonia have revealed conflicting results (Galynker et al, 1997;Northoff et al, 2000;Tsujino et al, 2011). As many catatonic syndromes present with fluctuating and alternating signs such as agitation shifting into akinesia and back (Ungvari et al, 2010), the motor system in catatonia is likely to experience varying states of excitation.…”

Section: Catatoniamentioning

confidence: 99%

Psychomotor symptoms of schizophrenia map on the cerebral motor circuit

Walther

2015

Psychiatry Research: Neuroimaging

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Right lower prefronto-parietal cortical dysfunction in akinetic catatonia: a combined study of neuropsychology and regional cerebral blood flow

Abstract: Findings are preliminary but suggest right lower prefronto-parietal cortical dysfunction in catatonia, which may be closely related to psychomotor disturbances.

Cited by 66 publications

References 35 publications

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Understanding tDCS effects in schizophrenia: a systematic review of clinical data and an integrated computation modeling analysis

Motor Symptoms and Schizophrenia

Psychomotor symptoms of schizophrenia map on the cerebral motor circuit

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