Duque Laura, Ghafouri Mohammad, Nunez Nicolas A, Ospina Juan Pablo, Philbrick Kemuel L, Port John D, Savica Rodolfo, Prokop Larry J, Rummans Teresa A, Singh Balwinder
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
J Psychosom Res. 2024 Apr;179:111640. doi: 10.1016/j.jpsychores.2024.111640. Epub 2024 Mar 11.
Catatonia is a challenging and heterogeneous neuropsychiatric syndrome of motor, affective and behavioral dysregulation which has been associated with multiple disorders such as structural brain lesions, systemic diseases, and psychiatric disorders. This systematic review summarized and compared functional neuroimaging abnormalities in catatonia associated with psychiatric and medical conditions.
Using PRISMA methods, we completed a systematic review of 6 databases from inception to February 7th, 2024 of patients with catatonia that had functional neuroimaging performed.
A total of 309 studies were identified through the systematic search and 62 met the criteria for full-text review. A total of 15 studies reported patients with catatonia associated with a psychiatric disorder (n = 241) and one study reported catatonia associated with another medical condition, involving patients with N-methyl-d-aspartate receptor antibody encephalitis (n = 23). Findings varied across disorders, with hyperactivity observed in areas like the prefrontal cortex (PFC), the supplementary motor area (SMA) and the ventral pre-motor cortex in acute catatonia associated to a psychiatric disorder, hypoactivity in PFC, the parietal cortex, and the SMA in catatonia associated to a medical condition, and mixed metabolic activity in the study on catatonia linked to a medical condition.
Findings support the theory of dysfunction in cortico-striatal-thalamic, cortico-cerebellar, anterior cingulate-medial orbitofrontal, and lateral orbitofrontal networks in catatonia. However, the majority of the literature focuses on schizophrenia spectrum disorders, leaving the pathophysiologic characteristics of catatonia in other disorders less understood. This review highlights the need for further research to elucidate the pathophysiology of catatonia across various disorders.
紧张症是一种具有挑战性的异质性神经精神综合征，表现为运动、情感和行为失调，与多种疾病相关，如脑结构病变、全身性疾病和精神障碍。本系统评价总结并比较了与精神和医学状况相关的紧张症患者的功能神经影像学异常。
采用PRISMA方法，我们对6个数据库进行了系统评价，涵盖从数据库建立至2024年2月7日期间接受功能神经影像学检查的紧张症患者。
通过系统检索共识别出309项研究，其中62项符合全文审查标准。共有15项研究报告了与精神障碍相关的紧张症患者（n = 241），1项研究报告了与另一种医学状况相关的紧张症，涉及N-甲基-D-天冬氨酸受体抗体脑炎患者（n = 23）。不同疾病的研究结果各不相同，与精神障碍相关的急性紧张症患者在前额叶皮质（PFC）、辅助运动区（SMA）和腹侧运动前皮质等区域观察到活动亢进，与医学状况相关的紧张症患者在PFC、顶叶皮质和SMA观察到活动减退，而与医学状况相关的紧张症研究中观察到混合代谢活动。
研究结果支持紧张症患者皮质-纹状体-丘脑、皮质-小脑、前扣带回-内侧眶额皮质和外侧眶额皮质网络功能障碍的理论。然而，大多数文献集中在精神分裂症谱系障碍，其他疾病中紧张症的病理生理特征了解较少。本综述强调需要进一步研究以阐明不同疾病中紧张症的病理生理学。
