Cargando…

Movement disorders in psychiatric patients

The observability of movement gives it advantages when trying to draw connections between brain and mind. Disturbed motor function pervades schizophrenia, though it is difficult now to subtract the effects of antipsychotic treatment. There is evidence from patients never exposed to these drugs that...

Descripción completa

Detalles Bibliográficos
Autores principales: Perju-Dumbrava, Laura, Kempster, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871724/
https://www.ncbi.nlm.nih.gov/pubmed/33681793
http://dx.doi.org/10.1136/bmjno-2020-000057
_version_ 1783649066016571392
author Perju-Dumbrava, Laura
Kempster, Peter
author_facet Perju-Dumbrava, Laura
Kempster, Peter
author_sort Perju-Dumbrava, Laura
collection PubMed
description The observability of movement gives it advantages when trying to draw connections between brain and mind. Disturbed motor function pervades schizophrenia, though it is difficult now to subtract the effects of antipsychotic treatment. There is evidence from patients never exposed to these drugs that dyskinesia and even parkinsonism are to some degree innate to schizophrenia. Tardive dyskinesia and drug-induced parkinsonism are the most common movement disorders encountered in psychiatric practice. While D2 dopamine receptor blockade is a causative factor, both conditions defy straightforward neurochemical explanation. Balanced against the need to manage schizophrenic symptoms, neither prevention nor treatment is easy. Of all disorders classified as psychiatric, catatonia sits closest to organic neurology on the neuropsychiatric spectrum. Not only does it occur in the setting of unequivocally organic cerebral disease, but the alterations of consciousness it produces have ‘organic’ qualities even when the cause is psychiatric. No longer considered a subtype of schizophrenia, catatonia is defined by syndromic features based on motor phenomenology. Both severe depression and obsessive-compulsive disorder may be associated with ‘soft’ extrapyramidal signs that resemble parkinsonian bradykinesia. As functional neuroimaging studies suggest, movement and psychiatric disorders involve the same network connections between the basal ganglia and the cerebral cortex.
format Online
Article
Text
id pubmed-7871724
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-78717242021-03-04 Movement disorders in psychiatric patients Perju-Dumbrava, Laura Kempster, Peter BMJ Neurol Open Review The observability of movement gives it advantages when trying to draw connections between brain and mind. Disturbed motor function pervades schizophrenia, though it is difficult now to subtract the effects of antipsychotic treatment. There is evidence from patients never exposed to these drugs that dyskinesia and even parkinsonism are to some degree innate to schizophrenia. Tardive dyskinesia and drug-induced parkinsonism are the most common movement disorders encountered in psychiatric practice. While D2 dopamine receptor blockade is a causative factor, both conditions defy straightforward neurochemical explanation. Balanced against the need to manage schizophrenic symptoms, neither prevention nor treatment is easy. Of all disorders classified as psychiatric, catatonia sits closest to organic neurology on the neuropsychiatric spectrum. Not only does it occur in the setting of unequivocally organic cerebral disease, but the alterations of consciousness it produces have ‘organic’ qualities even when the cause is psychiatric. No longer considered a subtype of schizophrenia, catatonia is defined by syndromic features based on motor phenomenology. Both severe depression and obsessive-compulsive disorder may be associated with ‘soft’ extrapyramidal signs that resemble parkinsonian bradykinesia. As functional neuroimaging studies suggest, movement and psychiatric disorders involve the same network connections between the basal ganglia and the cerebral cortex. BMJ Publishing Group 2020-12-01 /pmc/articles/PMC7871724/ /pubmed/33681793 http://dx.doi.org/10.1136/bmjno-2020-000057 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review
Perju-Dumbrava, Laura
Kempster, Peter
Movement disorders in psychiatric patients
title Movement disorders in psychiatric patients
title_full Movement disorders in psychiatric patients
title_fullStr Movement disorders in psychiatric patients
title_full_unstemmed Movement disorders in psychiatric patients
title_short Movement disorders in psychiatric patients
title_sort movement disorders in psychiatric patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871724/
https://www.ncbi.nlm.nih.gov/pubmed/33681793
http://dx.doi.org/10.1136/bmjno-2020-000057
work_keys_str_mv AT perjudumbravalaura movementdisordersinpsychiatricpatients
AT kempsterpeter movementdisordersinpsychiatricpatients