Journal Article

Orbitofrontal Cortical Dysfunction in Akinetic Catatonia: A Functional Magnetic Resonance Imaging Study During Negative Emotional Stimulation

Georg Northoff, Rolf Kötter, Frank Baumgart, Peter Danos, Heinz Boeker, Thomas Kaulisch, Florian Schlagenhauf, Henrik Walter, Alexander Heinzel, Thomas Witzel and Bernhard Bogerts

in Schizophrenia Bulletin

Published on behalf of Maryland Psychiatric Research Center

Volume 30, issue 2, pages 405-427
Published in print January 2004 | ISSN: 0586-7614
Published online January 2004 | e-ISSN: 1745-1701 | DOI: http://dx.doi.org/10.1093/oxfordjournals.schbul.a007088
Orbitofrontal Cortical Dysfunction in Akinetic Catatonia: A Functional Magnetic Resonance Imaging Study During Negative Emotional Stimulation

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Catatonia is a psychomotor syndrome characterized by concurrent emotional, behavioral, and motor anomalies. Pathophysiological mechanisms of psychomotor disturbances may be related to abnormal emotional-motor processing in prefrontal cortical networks. We therefore investigated prefrontal cortical activation and connectivity patterns during emotional-motor stimulation using functional magnetic resonance imaging (FMRI). We investigated 10 akinetic catatonic patients in a postacute state and compared them with 10 noncatatonic postacute psychiatric controls (age-, sex-, diagnosis-, and medication-matched) and 10 healthy controls. Positive and negative pictures from the International Affective Picture System were used for emotional stimulation. FMRI measurements covered the whole frontal lobe, activation signals in various frontal cortical regions were obtained, and functional connectivity between the different prefrontal cortical regions was investigated using structural equation modeling. Catatonic patients showed alterations in the orbitofrontal cortical activation pattern and in functional connectivity to the premotor cortex in negative and positive emotions compared to psychiatric and healthy controls. Catatonic behavioral and affective symptoms correlated significantly with orbitofrontal activity, whereas catatonic motor symptoms were rather related to medial prefrontal activity. It is concluded that catatonic symptoms may be closely related to dysfunction in the orbitofrontal cortex and consequent alteration in the prefrontal cortical network during emotional processing. Because we investigated postacute patients, orbitofrontal cortical alterations may be interpreted as a trait marker predisposing for development of catatonic syndrome in schizophrenic or affective psychosis.

Keywords: Catatonia; orbitofrontal cortex; emotions; FMRI; effective connectivity

Journal Article.  0 words. 

Subjects: Child and Adolescent Psychiatry

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