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. 2023 Oct 19;67(1):e6.
doi: 10.1192/j.eurpsy.2023.2461.

Orbitofrontal sulcal patterns in catatonia

Mylène Moyal  1   2 , Alexandre Haroche  1   2 , David Attali  1   3 , Ghita Dadi  1 , Matthieu Raoelison  4 , Alice Le Berre  1   2 , Anton Iftimovici  1   2   5 , Boris Chaumette  1   2   6 , Sylvain Leroy  1 , Sylvain Charron  1   2 , Clément Debacker  1   2 , Catherine Oppenheim  1   2 , Arnaud Cachia  2   4 , Marion Plaze  1   2
Affiliations

Orbitofrontal sulcal patterns in catatonia

Mylène Moyal et al. Eur Psychiatry. .

Abstract

Background: Catatonia is a psychomotor syndrome frequently observed in disorders with neurodevelopmental impairments, including psychiatric disorders such as schizophrenia. The orbitofrontal cortex (OFC) has been repeatedly associated with catatonia. It presents with an important interindividual morphological variability, with three distinct H-shaped sulcal patterns, types I, II, and III, based on the continuity of the medial and lateral orbital sulci. Types II and III have been identified as neurodevelopmental risk factors for schizophrenia. The sulcal pattern of the OFC has never been investigated in catatonia despite the role of the OFC in the pathophysiology and the neurodevelopmental component of catatonia.

Methods: In this context, we performed a retrospective analysis of the OFC sulcal pattern in carefully selected homogeneous and matched subgroups of schizophrenia patients with catatonia (N = 58) or without catatonia (N = 65), and healthy controls (N = 82).

Results: Logistic regression analyses revealed a group effect on OFC sulcal pattern in the left (χ2 = 18.1; p < .001) and right (χ2 = 28.3; p < .001) hemispheres. Catatonia patients were found to have more type III and less type I in both hemispheres compared to healthy controls and more type III on the left hemisphere compared to schizophrenia patients without catatonia.

Conclusion: Because the sulcal patterns are indirect markers of early brain development, our findings support a neurodevelopmental origin of catatonia and may shed light on the pathophysiology of this syndrome.

Keywords: catatonic syndrome; neurodevelopment disorder; prefrontal cortex; schizophrenia; sulcogyral patterns.

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Conflict of interest statement

The authors have declared that there are no conflicts of interest in relation to the subject of this study.

Figures

Figure 1.
Figure 1.
Flow chart of the retrospective selection of the patients.
Figure 2.
Figure 2.
OFC sulcal pattern classification. Red sulci correspond to the lateral orbital sulcus (LOS), blue sulci to the medial orbital sulcus (MOS), yellow sulci to the transverse orbital sulcus (TOS), green and purple sulci to the intermediate orbital sulcus (IOS) and posterior orbital sulcus (POS) respectively. In type I, the rostral and caudal portions of the MOS are disconnected whereas the rostral and caudal portion of the LOS are connected. In type II, the rostral and caudal proportions of both MOS and LOS are connected and joined together by the transverse orbital sulcus (TOS). In type III, the rostral and caudal proportions of both MOS and LOS are disconnected. In the rare type IV, subgroup of type III, the rostral and caudal portions of the LOS are disconnected whereas the MOS continues. Additional sulci of the OFC were also identified, including the intermediate orbital sulcus (IOS) and the posterior orbital sulcus (POS). Additional sulci anterior to the TOS are IOS and posterior to the TOS are POS. Note that the IOS and POS can be dual (medial and lateral IOS and POS).
Figure 3.
Figure 3.
OFC sulcal pattern distribution. HC, healthy control; SSD, schizophrenia; SSD-c, schizophrenia patients with catatonia; SSD-nc, schizophrenia patients without catatonia.
See this image and copyright information in PMC

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