Luccarelli James, Smith Joshua R, Turley Niels, Rogers Jonathan P, Sun Haoqi, Kohrman Samuel I, Fricchione Gregory, Westover M Brandon
Departments of Psychiatry (Luccarelli, Kohrman, Fricchione) and Neurology (Sun, Westover), Harvard Medical School, Boston; Department of Psychiatry, Massachusetts General Hospital, Boston (Luccarelli, Kohrman, Fricchione); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Vanderbilt University Medical Center at Village of Vanderbilt, and Vanderbilt Kennedy Center, Vanderbilt University, Nashville (Smith); Department of Neurology, Beth Israel Deaconess Medical Center, Boston (Turley, Sun, Westover); Division of Psychiatry, University College London, London (Rogers).
J Neuropsychiatry Clin Neurosci. 2025 Jun 13:appineuropsych20240215. doi: 10.1176/appi.neuropsych.20240215.
Catatonia is an underdiagnosed disorder characterized by speech and motor abnormalities. EEG examinations may improve the accuracy of a catatonia diagnosis, but clinical and electrographic correlations have not been established. The authors describe catatonic features and EEG findings in a large multisite retrospective cohort.
The clinical records in two health care systems were searched for patients with an EEG recording and a catatonia assessment with the Bush-Francis Catatonia Rating Scale conducted within 24 hours of each other. Included patients were retrospectively screened for delirium through a chart-based assessment. Augmented inverse propensity weighting (AIPW) was used to estimate the causal effects of delirium and catatonia on the presence of an abnormal EEG finding.
Overall, 178 patients met inclusion criteria, 144 (81%) of whom had catatonia. Among the patients with catatonia, 43% also had delirium. EEG abnormalities were present among 43% of patients with catatonia, including 28% of patients with catatonia without delirium and 69% of the patients with co-occurring catatonia and delirium. Individual catatonic signs and EEG abnormalities showed only a weak correlation. In AIPW models, a delirium diagnosis was associated with significantly higher odds for an abnormal EEG finding (OR=6.75; 95% CI=2.83-16.14), whereas a diagnosis of catatonia was not (OR=1.83, 95% CI=0.79-4.24).
EEG abnormalities are common among individuals with catatonia, but these are difficult to disentangle from abnormalities resulting from co-occurring delirium. Further research is needed to define the role of EEG examinations in the assessments of catatonia and delirium.
紧张症是一种诊断不足的疾病，其特征为言语和运动异常。脑电图检查可能会提高紧张症诊断的准确性，但临床与脑电图之间的关联尚未确立。作者描述了一个大型多中心回顾性队列中的紧张症特征和脑电图检查结果。
在两个医疗系统的临床记录中，查找在彼此24小时内进行过脑电图记录和使用布什-弗朗西斯紧张症评定量表进行紧张症评估的患者。通过基于图表的评估对纳入患者进行谵妄的回顾性筛查。使用增强逆概率加权法（AIPW）来估计谵妄和紧张症对脑电图异常结果出现的因果效应。
总体而言，178名患者符合纳入标准，其中144名（81%）患有紧张症。在患有紧张症的患者中，43%也患有谵妄。43%的紧张症患者存在脑电图异常，其中包括28%无谵妄的紧张症患者和69%同时患有紧张症和谵妄的患者。个别紧张症体征与脑电图异常仅显示出微弱的相关性。在AIPW模型中，谵妄诊断与脑电图异常结果的显著更高几率相关（比值比=6.75；95%置信区间=2.83-16.14），而紧张症诊断则不然（比值比=1.83，95%置信区间=0.79-4.24）。
脑电图异常在紧张症患者中很常见，但这些异常很难与同时发生的谵妄所导致的异常区分开来。需要进一步研究来确定脑电图检查在紧张症和谵妄评估中的作用。
