Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Schizophr Res. 2024 Jan;263:18-26. doi: 10.1016/j.schres.2023.04.002. Epub 2023 May 3.
In the 19th century, postmortem brain examination played a central role in the search for the neurobiological origin of psychiatric and neurological disorders. During that time, psychiatrists, neurologists, and neuropathologists examined autopsied brains from catatonic patients and postulated that catatonia is an organic brain disease. In line with this development, human postmortem studies of the 19th century became increasingly important in the conception of catatonia and might be seen as precursors of modern neuroscience. In this report, we closely examined autopsy reports of eleven catatonia patients of Karl Ludwig Kahlbaum. Further, we performed a close reading and analysis of previously (systematically) identified historical German and English texts between 1800 and 1900 for autopsy reports of catatonia patients. Two main findings emerged: (i) Kahlbaum's most important finding in catatonia patients was the opacity of the arachnoid; (ii) historical human postmortem studies of catatonia patients postulated a number of neuroanatomical abnormalities such as cerebral enlargement or atrophy, anemia, inflammation, suppuration, serous effusion, or dropsy as well as alterations of brain blood vessels such as rupture, distension or ossification in the pathogenesis of catatonia. However, the exact localization has often been missing or inaccurate, probably due to the lack of standardized subdivision/nomenclature of the respective brain areas. Nevertheless, Kahlbaum's 11 autopsy reports and the identified neuropathological studies between 1800 and 1900 made important discoveries, which still have the potential to inform and bolster modern neuroscientific research in catatonia.
在 19 世纪，尸检大脑检查在寻找精神疾病和神经障碍的神经生物学起源方面发挥了核心作用。当时，精神病学家、神经学家和神经病理学家检查了来自紧张症患者的尸检大脑，并推测紧张症是一种器质性脑病。与这一发展相一致，19 世纪的人类尸检研究在紧张症的概念中变得越来越重要，并且可以被视为现代神经科学的前身。在本报告中，我们仔细检查了卡尔·路德维希·克拉夫特（Karl Ludwig Kahlbaum）的 11 例紧张症患者的尸检报告。此外，我们还对 1800 年至 1900 年间之前（系统地）确定的历史德国和英语文本进行了仔细阅读和分析，以寻找紧张症患者的尸检报告。主要有两个发现：（i）克拉夫特在紧张症患者中最重要的发现是蛛网膜不透明；（ii）对紧张症患者的历史人类尸检研究提出了一些神经解剖学异常，例如大脑增大或萎缩、贫血、炎症、化脓、浆液性渗出或水肿，以及大脑血管改变，如在紧张症发病机制中破裂、扩张或骨化。然而，由于缺乏相应脑区的标准化细分/命名，确切的定位往往缺失或不准确。尽管如此，克拉夫特的 11 份尸检报告和 1800 年至 1900 年间确定的神经病理学研究做出了重要发现，这些发现仍然有可能为现代紧张症神经科学研究提供信息和支持。
