Cortical Contributions to Distinct Symptom Dimensions of Catatonia

Dusan Hirjak, Katharina M Kubera, Georg Northoff, Stefan Fritze, Alina L Bertolino, Cristina E Topor, Mike M Schmitgen, Robert C Wolf

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)


Catatonia is a central aspect of schizophrenia spectrum disorders (SSD) and most likely associated with abnormalities in affective, motor, and sensorimotor brain regions. However, contributions of different cortical features to the pathophysiology of catatonia in SSD are poorly understood. Here, T1-weighted structural magnetic resonance imaging data at 3 T were obtained from 56 right-handed patients with SSD. Using FreeSurfer version 6.0, we calculated cortical thickness, area, and local gyrification index (LGI). Catatonic symptoms were examined on the Northoff catatonia rating scale (NCRS). Patients with catatonia (NCRS total score ≥3; n = 25) showed reduced surface area in the parietal and medial orbitofrontal gyrus and LGI in the temporal gyrus (P < .05, corrected for cluster-wise probability [CWP]) as well as hypergyrification in rostral cingulate and medial orbitofrontal gyrus when compared with patients without catatonia (n = 22; P < .05, corrected for CWP). Following a dimensional approach, a negative association between NCRS motor and behavior scores and cortical thickness in superior frontal, insular, and precentral cortex was found (34 patients with at least 1 motor and at least 1 other affective or behavioral symptom; P < .05, corrected for CWP). Positive associations were found between NCRS motor and behavior scores and surface area and LGI in superior frontal, posterior cingulate, precentral, and pericalcarine gyrus (P < .05, corrected for CWP). The data support the notion that cortical features of distinct evolutionary and genetic origin differently contribute to catatonia in SSD. Catatonia in SSD may be essentially driven by cortex variations in frontoparietal regions including regions implicated in the coordination and goal-orientation of behavior.

Original languageEnglish
Pages (from-to)1184-1194
Number of pages11
JournalSchizophrenia Bulletin
Issue number6
Publication statusPublished - Oct 24 2019
Externally publishedYes


  • FreeSurfer
  • MRI
  • catatonia
  • cortical thickness
  • gyrification
  • motor and behavioral symptoms
  • psychosis

ASJC Scopus subject areas

  • Psychiatry and Mental health


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