Three patients with mood disorders showing catatonia and frontotemporal lobes atrophy

Abstract

Here we report the cases of three patients with mood disorders showing catatonia and frontotemporal lobe atrophy. Catatonia is a syndrome linked to frontal dysfunction that most frequently occurs in patients with mood disorders. The diagnostic criteria of catatonia and frontotemporal dementia partly overlap. In the present patients, catatonia might be closely related to frontal dysfunction caused by frontotemporal lobe atrophy. With regard to therapeutics for catatonia, we found that administering a low dose of lorazepam alone or after electroconvulsive therapy may be useful for treating and preventing catatonia. We also found that administering glutaminate antagonists such as memantine may be useful for treating lorazepam-resistant catatonia.

Memantine: New prospective in bipolar disorder treatment

“…Finally, memantine have been shown to be effective in a number of catatonia cases resistant to lorazepam and/or electroconvulsive therapy [123][124][125][126][127][128][129][130] .…”

Frontotemporal dementia with trans‐activation response DNA‐binding protein 43 presenting with catatonic syndrome

“…We supposed this case was an instance of bvFTD‐based catatonic syndrome, but it seemed atypical for the sudden onset. We found a study which reports an acute catatonic syndrome in some FTD patients . However, they had previously suffered from various psychiatric symptoms, such as depression, obsession and hypochondria, several years before the catatonic syndrome.…”

“…Additionally, the association between bvFTD and FTLD‐TDP type C has not been shown, so this case would be atypical in that regard. Several cases of clinical FTD with catatonic syndrome have been reported . but these were not pathologically examined.…”

“…Some of these symptoms are linked to frontal dysfunction, and the diagnostic criteria for catatonia and bvFTD partly overlap. Indeed, there are several reports of bvFTD cases that showed the catatonic syndrome . However, due to the lack of pathological examinations in these previous reports, the relation between bvFTD and catatonia is still unknown.…”

Recurrent Catatonia in Parkinson Disease

“…Both of these agents have been successfully used in treatment of lorazepam-resistant catatonic symptoms, ECT unresponsive catatonia, and apathy associated with neurological insults. 8,[10][11][12] Our final observation was that lorazepam should be administered cautiously for catatonia in the elderly patients with neurodegenerative diseases such as PD, because higher doses might result in a severe encephalopathy or deep sedation, and it might be particularly challenging to distinguish this complication in presence of catatonic stupor. It should be recognized that a general recommendation of benzodiazepines for the treatment of catatonia was reached after reports largely from young patients with primary psychiatric disorders.…”