Published September 29, 2022
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Molecular and cellular mechanisms leading to catatonia: an integrative approach from clinical and preclinical evidence
Creators
- 1. Universidad del Rosario
Description
This review aims to describe the clinical spectrum of catatonia, in order to carefully assess the involvement of astrocytes, neurons, oligodendrocytes, and microglia, and articulate the available preclinical and clinical evidence to achieve a translational understanding of the cellular and molecular mechanisms behind this disorder. Catatonia is highly common in psychiatric and acutely ill patients, with prevalence ranging from 7.6% to 38%. It is usually present in different psychiatric conditions such as mood and psychotic disorders; it is also a consequence of folate deficiency, autoimmunity, paraneoplastic disorders, and even autistic spectrum disorders. Few therapeutic options are available due to its complexity and poorly understood physiopathology. We briefly revisit the traditional treatments used in catatonia, such as antipsychotics, electroconvulsive therapy, and benzodiazepines, before assessing novel therapeutics which aim to modulate molecular pathways through different mechanisms, including NMDA antagonism and its allosteric modulation, and anti-inflammatory drugs to modulate microglia reaction and mitigate oxidative stress, such as lithium, vitamin B12, and NMDAr positive allosteric modulators.
Translated Descriptions
⚠️
This is an automatic machine translation with an accuracy of 90-95%
Translated Description (Arabic)
تهدف هذه المراجعة إلى وصف الطيف السريري للكاتاتونيا، من أجل تقييم مشاركة الخلايا النجمية والخلايا العصبية والخلايا قليلة التغصن والخلايا الدبقية الدقيقة بعناية، وتوضيح الأدلة قبل السريرية والسريرية المتاحة لتحقيق فهم متعد للآليات الخلوية والجزيئية وراء هذا الاضطراب. الكاتاتاتونيا شائعة للغاية في المرضى النفسيين والمرضى المصابين بأمراض حادة، مع انتشار يتراوح من 7.6 ٪ إلى 38 ٪. وعادة ما يكون موجودا في ظروف نفسية مختلفة مثل المزاج والاضطرابات الذهانية ؛ بل هو أيضا نتيجة لنقص حمض الفوليك، والمناعة الذاتية، واضطرابات جنيب الورم، وحتى اضطرابات طيف التوحد. لا يتوفر سوى عدد قليل من الخيارات العلاجية بسبب تعقيدها وسوء فهمها لعلم الأمراض الفيزيائية. نعيد النظر بإيجاز في العلاجات التقليدية المستخدمة في الجمود، مثل مضادات الذهان، والعلاج بالاختلاج الكهربائي، والبنزوديازيبينات، قبل تقييم العلاجات الجديدة التي تهدف إلى تعديل المسارات الجزيئية من خلال آليات مختلفة، بما في ذلك عداء NMDA وتعديله التفارغي، والأدوية المضادة للالتهابات لتعديل تفاعل الخلايا الدبقية الدقيقة وتخفيف الإجهاد التأكسدي، مثل الليثيوم، وفيتامين B12، ومعدلات NMDAr التفارغية الإيجابية.Translated Description (French)
Cette revue vise à décrire le spectre clinique de la catatonie, afin d'évaluer soigneusement l'implication des astrocytes, des neurones, des oligodendrocytes et des microglies, et d'articuler les preuves précliniques et cliniques disponibles pour parvenir à une compréhension translationnelle des mécanismes cellulaires et moléculaires à l'origine de ce trouble. La catatonie est très fréquente chez les patients psychiatriques et les patients gravement malades, avec une prévalence allant de 7,6 % à 38 %. Il est généralement présent dans différentes affections psychiatriques telles que les troubles de l'humeur et les troubles psychotiques ; il est également une conséquence de la carence en folates, de l'auto-immunité, des troubles paranéoplasiques et même des troubles du spectre autistique. Peu d'options thérapeutiques sont disponibles en raison de sa complexité et de sa physiopathologie mal comprise. Nous revisitons brièvement les traitements traditionnels utilisés dans la catatonie, tels que les antipsychotiques, la thérapie électroconvulsive et les benzodiazépines, avant d'évaluer de nouveaux traitements qui visent à moduler les voies moléculaires par différents mécanismes, y compris l'antagonisme NMDA et sa modulation allostérique, et les anti-inflammatoires pour moduler la réaction de la microglie et atténuer le stress oxydatif, tels que le lithium, la vitamine B12 et les modulateurs allostériques positifs NMDAr.Translated Description (Spanish)
Esta revisión tiene como objetivo describir el espectro clínico de la catatonia, con el fin de evaluar cuidadosamente la participación de astrocitos, neuronas, oligodendrocitos y microglía, y articular la evidencia preclínica y clínica disponible para lograr una comprensión traslacional de los mecanismos celulares y moleculares detrás de este trastorno. La catatonia es muy común en pacientes psiquiátricos y enfermos agudos, con una prevalencia que oscila entre el 7,6% y el 38%. Por lo general, está presente en diferentes afecciones psiquiátricas, como trastornos del estado de ánimo y psicóticos; también es consecuencia de la deficiencia de folato, la autoinmunidad, los trastornos paraneoplásicos e incluso los trastornos del espectro autista. Pocas opciones terapéuticas están disponibles debido a su complejidad y fisiopatología poco comprendida. Repasamos brevemente los tratamientos tradicionales utilizados en la catatonia, como los antipsicóticos, la terapia electroconvulsiva y las benzodiazepinas, antes de evaluar nuevas terapias que tienen como objetivo modular las vías moleculares a través de diferentes mecanismos, incluido el antagonismo de NMDA y su modulación alostérica, y fármacos antiinflamatorios para modular la reacción de la microglía y mitigar el estrés oxidativo, como el litio, la vitamina B12 y los moduladores alostéricos positivos de NMDAr.Files
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Additional details
Additional titles
- Translated title (Arabic)
- الآليات الجزيئية والخلوية المؤدية إلى الجمود: نهج تكاملي من الأدلة السريرية وقبل السريرية
- Translated title (French)
- Mécanismes moléculaires et cellulaires conduisant à la catatonie : une approche intégrative à partir de données cliniques et précliniques
- Translated title (Spanish)
- Mecanismos moleculares y celulares que conducen a la catatonia: un enfoque integrador a partir de la evidencia clínica y preclínica
Identifiers
- Other
- https://openalex.org/W4298006150
- DOI
- 10.3389/fnmol.2022.993671
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