• Amir Krivoy, Shai Shrot, Matan Avrahami, Tsvi Fischel, Abraham Weizman, Yael Mardor, David Guez, Dianne Daniels, Athos Katelaris, David Last, and Chen Hoffmann.
• Geha Mental Health Center, Petah Tikva, Israel.
• Isr Med Assoc J. 2021 Oct 1; 23 (10): 625-630.

BackgroundOnly a small proportion of schizophrenia patients present with catatonic symptoms. Imaging studies suggest that brain motor circuits are involved in the underlying pathology of catatonia. However, data about diffusivity dysregulation of these circuits in catatonic schizophrenia are scarce.ObjectivesTo assess the involvement of brain motor circuits in schizophrenia patients with catatonia.MethodsDiffusion tensor imaging (DTI) was used to measure white matter signals in selected brain regions linked to motor circuits. Relevant DTI data of seven catatonic schizophrenia patients were compared to those of seven non-catatonic schizophrenia patients, matched for sex, age, and education level.ResultsSignificantly elevated fractional anisotropy values were found in the splenium of the corpus callosum, the right peduncle of the cerebellum, and the right internal capsule of the schizophrenia patients with catatonia compared to those without catatonia. This finding showed altered diffusivity in selected motor-related brain areas.ConclusionsCatatonic schizophrenia is associated with dysregulation of the connectivity in specific motoric brain regions and corresponding circuits. Future DTI studies are needed to address the neural correlates of motor abnormalities in schizophrenia-related catatonia during the acute and remitted state of the illness to identify the specific pathophysiology of this disorder.

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