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Review
. 2024 Apr 6;14(4):362.
doi: 10.3390/brainsci14040362.

Tic-Related Obsessive-Compulsive and Eating Disorders in Dandy-Walker Variant: A Case Report and Systematic Reappraisal of Psychiatric Profiles

Riccardo Bortoletto  1 , Anna Candolo  1 , Alessandra Nicotra  1 , Luana Saetti  1 , Laura Perini  1 , Matteo Balestrieri  1 , Marco Colizzi  1   2 , Carla Comacchio  1
Affiliations
Review

Tic-Related Obsessive-Compulsive and Eating Disorders in Dandy-Walker Variant: A Case Report and Systematic Reappraisal of Psychiatric Profiles

Riccardo Bortoletto et al. Brain Sci. .

Abstract

Dandy-Walker complex (DWC) consists of a continuum of brain malformations involving the posterior fossa, often leading to psychiatric manifestations during adulthood. We discussed the case of a young woman with Dandy-Walker variant (DWV) and a comorbid complex neuropsychiatric presentation, who was diagnosed with an eating disorder, obsessive-compulsive disorder, and a tic disorder. Afterwards, we conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review reappraising all evidence of psychiatric outcomes in adults with DWC. Overall, 34 studies were eligible for data extraction, comprising 36 patients. Psychiatric profiles were more common among young adult males, with DWC lesions, especially DWV subtype, being often discovered incidentally after admission to mental health inpatient facilities. Most patients were diagnosed with psychosis and bipolar disorder, often comorbid with cognitive impairment. Psychotropic polypharmacy was frequently prescribed, generally leading to complete recovery. Evidence from our case report and systematic review indicates the importance of monitoring long-term psychiatric sequelae among adult patients with DWC malformations.

Keywords: Blake pouch cyst; antidepressants; antipsychotics; cerebellum; intellectual disability; mega cisterna magna; mood stabilizers; neurodevelopment; schizophrenia.

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Conflict of interest statement

M.C. has been a consultant/advisor to GW Pharma Limited, F. Hoffmann-La Roche Limited, and GW Pharma Italy SRL, outside of this work. The remaining authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Dandy–Walker complex represents a continuum of posterior fossa anomalies, primarily characterized by abnormal cerebellum development, with implications for several neuropsychiatric disorders. ↑, increase; ↓, decrease; ADHD, Attention-Deficit/Hyperactivity Disorder; ASD, Autism Spectrum Disorder; BPAD, Bipolar Affective Disorder; Cbm, Cerebellum; FED, Feeding and Eating Disorder; GM, Gray Matter; MDD, Major Depressive Disorder; OCD, Obsessive–Compulsive Disorder; TS, Tourette syndrome.
Figure 2
Figure 2
PRISMA flow-chart of search strategy for systematic review.
See this image and copyright information in PMC

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