Alteration of Functional Connectivity before and after Electroconvulsive Therapy in a Single Patient with Depression and Catatonia
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Catatonia, a severe neuropsychiatric condition, is distinguished by a range of prominent motor features such as immobility, mutism, negativism, rigidity, posturing, staring, stereotypy, automatic obedience, echolalia, and mannerism. A female patient of middle age was admitted to the open psychiatric ward of a hospital after exhibiting suicidal ideation, delusions, depression, insomnia, refusal to eat, difficulty in swallowing, and decreased motivation for four months prior to admission. Following 14 electroconvulsive therapy (ECT) sessions, her symptoms improved in the order of appetite, immobility, speech volume, mood, and delusions. The post-ECT functional connectivity was found to be improved compared to pre-ECT. The patient was discharged to outpatient clinics with medications that included aripiprazole, mirtazapine, quetiapine, and trazodone. This case reveals that ECT is an efficacious treatment in a depressive patient with catatonia, with movement symptoms responding to ECT more rapidly than affective symptoms. In addition to the improvement of movement and affective symptoms, functional connectivity much improved after ECT.
Abstract
Catatonia, a severe neuropsychiatric condition, is distinguished by a range of prominent motor features such as immobility, mutism, negativism, rigidity, posturing, staring, stereotypy, automatic obedience, echolalia, and mannerism. A female patient of middle age was admitted to the open psychiatric ward of a hospital after exhibiting suicidal ideation, delusions, depression, insomnia, refusal to eat, difficulty in swallowing, and decreased motivation for four months prior to admission. Following 14 electroconvulsive therapy (ECT) sessions, her symptoms improved in the order of appetite, immobility, speech volume, mood, and delusions. The post-ECT functional connectivity was found to be improved compared to pre-ECT. The patient was discharged to outpatient clinics with medications that included aripiprazole, mirtazapine, quetiapine, and trazodone. This case reveals that ECT is an efficacious treatment in a depressive patient with catatonia, with movement symptoms responding to ECT more rapidly than affective symptoms. In addition to the improvement of movement and affective symptoms, functional connectivity much improved after ECT.
참고문헌 (15)
- Tadel F, "Brainstorm : a user-friendly application for MEG", EEG analysis, 2011, pp.2011, 879716~
- Luchini F, "Electroconvulsive therapy in catatonic patients : Efficacy and predictors of response", World J Psychiatry, 5, pp.182~192 (2015)
- Lloyd JR, "Electroconvulsive therapy for patients with catatonia : Current perspectives", Neuropsychiatr Dis Treat, 16, pp.2191~2208 (2020)
- Hawkins JM, "Somatic treatment of catatonia", Int J Psychiatry Med, 25, pp.345~369 (1995)
- Milev RV, "Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 4. Neurostimulation treatments", Can J Psychiatry, 61, pp.561~575 (2016)
- Bhati MT, "Clinical manifestations, diagnosis, and empirical treatments for catatonia", Psychiatry(Edgmont), 4, pp.46~52 (2007)
- Edinoff AN, "Catatonia : Clinical overview of the diagnosis, treatment, and clinical challenges", Neurol Int, 13, pp.570~586 (2021)
- Northoff G, "Decreased density of GABA-A receptors in the left sensorimotor cortex in akinetic catatonia : Investigation of in vivo benzodiazepine receptor binding", J Neurol Neurosurg Psychiatry, 67, pp.445~450 (1999)
- Mythri SV, "Catatonic syndrome in anti-NMDA receptor encephalitis", Indian J Psychol Med, 38, pp.152~154 (2016)
- Ariza-Salamanca DF, "Molecular and cellular mechanisms leading to catatonia : An integrative approach from clinical and preclinical evidence", Front Mol Neurosci, 15, pp.993671~ (2022)
- Ko M, "Altered functional connectivity of the nucleus accumbens and amygdala in cyber addiction : a resting state functional magnetic resonance imaging study", Clin Psychopharmacol Neurosci, 21, pp.304~312 (2023)
- Park SY, "A comparative investigation of functional connectivity utilizing electroencephalography in insomnia patients with and without restless leg syndrome", Clin Psychopharmacol Neurosci, 22, pp.314~321 (2024)
- De Tiége X, "Regional cerebral glucose metabolism in akinetic catatonia and after remission", J Neurol Neurosurg Psychiatry, 74, pp.1003~1004 (2003)
- Foucher JR, "A double dissociation between two psychotic phenotypes : Periodic catatonia and cataphasia", Prog Neuropsychopharmacol Biol Psychiatry, 86, pp.363~369 (2018)
- Fritze S, "Structural alterations of amygdala and hypothalamus contribute to catatonia", Schizophr Res (2022)[DOI]