Catatonia: A narrative review of its historical development, diagnosis, pathophysiology, and therapeutics.

Autor:	Arancibia M; Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile., Cavieres Á; Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile., Ríos U; Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile.
Jazyk:	English; Spanish; Castilian
Zdroj:	Medwave [Medwave] 2023 Jul 31; Vol. 23 (6). Date of Electronic Publication: 2023 Jul 31.
DOI:	10.5867/medwave.2023.06.2703
Abstrakt:	Catatonia was initially a clinical presentation of certain types of schizophrenia, but basic and epidemiological evidence has demonstrated its association with multiple somatic and psychiatric conditions. We describe and discuss current clinical, etiological, pathophysiological, and therapeutic concepts regarding catatonia. We conducted a broad narrative review of articles published in MEDLINE/PubMed. The diagnosis is clinical and can be supported by additional tests, but there are psychometric instruments with different clinical focus. The most validated subtypes are inhibited and excited catatonia. It is mostly associated with somatic, neurological, affective, psychotic, and autistic spectrum disorders. Genetic factors related to oligodendrocytes have been studied in its pathophysiology. Some findings point to an imbalance in neurotransmission and density of GABA and dopamine receptors, consistent with their function in motor pathways and therapeutic response with benzodiazepines. Likewise, glutamatergic activity has been analyzed from the pathophysiological model of autoimmune encephalitis. The cortico-cortical and cortico-subcortical pathways would have a central role, including structures such as the orbitofrontal and temporal cortex, basal nuclei, and brainstem, involved in decision-making, emotion regulation, storage, planning, and motor processing. The main therapeutic lines are benzodiazepines and electroconvulsive therapy. Other interventions studied are zolpidem, antipsychotics, mood stabilizers, glutamatergic modulators, and transcranial magnetic stimulation. New neurobiological findings challenge nosological and therapeutic precepts, renewing the cycle in the conceptualization of catatonia. We highlight the affective component of the psychomotor syndrome and the role of interventions aimed at its modulation. Competing Interests: The authors completed the ICMJE conflict of interest statement and declared that they received no funds for the realization of this article; they have no financial relationships with organizations that may have had an interest in the published article in the last three years and have no other relationships or activities that may influence the publication of the article. Forms can be requested by contacting the corresponding author. (This work is licensed under a Creative Commons Attribution 4.0 International License.)
Databáze:	MEDLINE
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