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. 2025 Jul:281:249-259.
doi: 10.1016/j.schres.2025.05.022. Epub 2025 May 27.

Gait examination in catatonia using 3D optical markerless motion tracking

Dilsa Cemre Akkoc Altinok  1 , Sebastian Volkmer  2 , Kristin Ohl  3 , Geva A Brandt  1 , Jonas Daub  1 , Stefan Fritze  1 , Robin Peretzke  4 , Peter F Neher  5 , Georg Northoff  6 , Andreas Meyer-Lindenberg  1 , Dusan Hirjak  7
Affiliations

Gait examination in catatonia using 3D optical markerless motion tracking

Dilsa Cemre Akkoc Altinok et al. Schizophr Res. 2025 Jul.

Abstract

Background: Three-dimensional (3D) markerless motion capture (MoCap) systems are emerging as powerful tools for the objective assessment of sensori-/psychomotor abnormalities in mental disorders. However, the application of 3D-MoCap technology for gait analysis in catatonia remains unexplored.

Methods: This study included 23 patients with and 53 patients without catatonia, classified according to ICD-11. Catatonia severity was assessed using the Northoff Catatonia Rating Scale (NCRS) and the Bush-Francis Catatonia Rating Scale (BFCRS). Gait was examined via a 3D markerless MoCap system, Salpêtrière Retardation Rating Scale (SRRS), the Unified Parkinson's Disease Rating Scale (UPDRS), and the Heidelberg Neurological Soft Signs Scale (NSS).

Results: Principal component (PC) analysis of spatiotemporal gait parameters revealed four principal components, accounting for 51.98 % (PC1), 23.46 % (PC2), 7.98 % (PC3), and 6.3 % (PC4) of the total gait variance. PC1 was primarily characterized by time-dependent features such as cycle time and stance time, while PC2 predominantly captured space-dependent features, including stride length and stride width. PC1 was significantly reduced in the catatonia group (p < 0.05); however, it was not significantly associated with catatonia severity. Total scores and gait-related subitems of the SRRS and UPDRS scales differed significantly between the catatonia and non-catatonia groups (p < 0.05, corrected).

Conclusion: The results of this study demonstrates for the first time that 3D markerless MoCap can effectively quantify gait in catatonia, revealing alterations in temporal and spatial gait dynamics. Future research should explore the longitudinal effects of catatonia treatment on gait patterns and investigate potential biomarkers for disease monitoring.

Keywords: 3D markerless motion capturing; Catatonia; Clinical rating scales; Gait analysis; Movement tracking.

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Conflict of interest statement

Declaration of competing interest DH has received honoraria from Rovi and Teva, speaker fees from DGPPN and editorial fees from Elsevier and Thieme Verlag. AML has received consultant fees from: Agence Nationale de la Recherche, Brain Mind Institute, Brainsway, CISSN (Catania International Summer School of Neuroscience), Daimler und Benz Stiftung, Fondation FondaMental, Hector Stiftung II, Janssen-Cilag GmbH, Lundbeck A/S, Lundbeckfonden, Lundbeck Int. Neuroscience Foundation, MedinCell, Sage Therapeutics, Techspert.io, Teva, The LOOP Zürich, University Medical Center Utrecht, von Behring Röntgen Stiftung. AML has received speaker fees from: Arztekammer Nordrhein, BAG Psychiatrie Oberbayern, Biotest¨ AG, Forum Werkstatt Karlsruhe, International Society of Psychiatric Genetics, Brentwood, Klinik für Psychiatrie und Psychotherapie Ingolstadt, Lundbeck SAS France, med Update GmbH, Merz-Stiftung, Siemens Healthineers, Society of Biological Psychiatry. AML has also received editorial fees from: American Association for the Advancement of Science, Elsevier, Thieme Verlag. The other authors declare that they have no conflict of interest in relation to the subject of the study.