Catatonia: Current Perspectives on Pathophysiology, Clinical Features, and Therapeutic Strategies
DOI:
https://doi.org/10.53819/81018102t7027Abstract
Catatonia is a complex neuropsychiatric syndrome characterized by a spectrum of motor and
behavioral symptoms, including stupor, catalepsy, and agitation. This review examines the current
understanding of catatonia, focusing on its clinical presentation, pathophysiology, and treatment
options. Catatonia can manifest in various forms, including motor abnormalities, altered mental
status, and mood disturbances. Symptoms often include immobility, echolalia, and posturing,
which may severely impact daily functioning and quality of life. The pathophysiology of catatonia
involves disruptions in neural circuits, particularly in the supplementary motor area and prefrontal
cortex. Key neurotransmitter systems, including GABAergic and glutamatergic pathways, are
implicated. NMDA receptor dysfunction and autoimmune mechanisms are also significant areas
of research. Prompt diagnosis and intervention are critical for favorable outcomes. Short-term
treatment often includes benzodiazepines and electroconvulsive therapy (ECT), which can lead to
rapid symptom resolution. Long-term outcomes vary based on the underlying condition and the
duration of untreated catatonia. Untreated catatonia can lead to severe complications, including
permanent neurological damage and progression to malignant catatonia. Advances in
understanding catatonia are ongoing. Future research should focus on molecular and cellular
mechanisms, genetic and epigenetic factors, and novel therapeutic interventions. Longitudinal
studies are needed to assess the durability and safety of current treatments and to explore new
approaches such as transcranial magnetic stimulation, deep brain stimulation, and emerging
pharmacological agents. Further epidemiological studies are also necessary to determine the
prevalence of catatonia across different populations and settings, considering cultural,
environmental, and socioeconomic factors.
Keywords: Catatonia, neuropsychiatric syndrome, benzodiazepines, NMDA receptor antagonists,
multidisciplinary approach
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