Right lower prefronto-parietal cortical dysfunction in akinetic catatonia:a combined study of neuropsychology and regional cerebral blood flow

Background. Catatonia is a psychomotor syndrome that can be characterized b y behavioural, affective and motor abnormalities. In order to reveal furthe r underlying pathophysiological mechanisms of psychomotor disturbances in c atatonia we investigated neuropsychological function and regional cerebral perfusion (r-CBF) in a combined study. Methods. Ten catatonic patients were investigated with Tc-99mECD brain SPEC T and compared with 10 psychiatric (similar age, sex, medication and underl ying psychiatric diagnosis but without catatonic syndrome) and 20 healthy c ontrols. Neuropsychological measures included tests for general intelligenc e, attention, executive functions and right parietal visual-spatial abiliti es. Correlational analyses were performed between neuropsychological measur es, catatonic symptoms and r-CBF. Results. Catatonic patients showed a significant decrease of r-CBF in right lower and middle prefrontal and parietal cortex compared with psychiatric and healthy controls as well as significantly poorer performance in visual- spatial abilities associated with right parietal function. Correlational an alysis revealed significant correlations between visual-spatial abilities a nd right parietal r-CBF only in psychiatric and healthy controls but not in catatonic patients. In contrast, attentional measures correlated significa ntly with motor symptoms, visual-spatial abilities and right parietal r-CBF in catatonia only but not in psychiatric or in healthy controls. Conclusion. Findings are preliminary but suggest right lower prefronto-pari etal cortical dysfunction in catatonia, which may be closely related to psy chomotor disturbances.