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Review
. 2019 Jul;6(7):620-630.
doi: 10.1016/S2215-0366(19)30190-7. Epub 2019 Jun 10.

Catatonia and the immune system: a review

Jonathan P Rogers  1 , Thomas A Pollak  2 , Graham Blackman  2 , Anthony S David  3
Affiliations
Review

Catatonia and the immune system: a review

Jonathan P Rogers et al. Lancet Psychiatry. 2019 Jul.

Abstract

Catatonia is a psychomotor disorder featuring stupor, posturing, and echophenomena. This Series paper examines the evidence for immune dysregulation in catatonia. Activation of the innate immune system is associated with mutism, withdrawal, and psychomotor retardation, which constitute the neurovegetative features of catatonia. Evidence is sparse and conflicting for acute-phase activation in catatonia, and whether this feature is secondary to immobility is unclear. Various viral, bacterial, and parasitic infections have been associated with catatonia, but it is primarily linked to CNS infections. The most common cause of autoimmune catatonia is N-methyl-D-aspartate receptor (NMDAR) encephalitis, which can account for the full spectrum of catatonic features. Autoimmunity appears to cause catatonia less by systemic inflammation than by the downstream effects of specific actions on extracellular antigens. The specific association with NMDAR encephalitis supports a hypothesis of glutamatergic hypofunction in catatonia.

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Figures

Figure
Figure
A model for glutamatergic hypofunction in catatonia NMDAR= N-methyl-D-aspartate receptor.
See this image and copyright information in PMC

Comment in

  • A diversified theory of catatonia.
    Oldham M. Oldham M. Lancet Psychiatry. 2019 Jul;6(7):554-555. doi: 10.1016/S2215-0366(19)30212-3. Epub 2019 Jun 10. Lancet Psychiatry. 2019. PMID: 31196792 No abstract available.

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