Article (Scientific journals)
On the pathophysiology and treatment of akinetic mutism
Arnts, H.; van Erp, Willemijn; Lavrijsen, J. C. M. et al.
2020In Neuroscience and Biobehavioral Reviews, 112, p. 270-278
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Keywords :
Akinetic mutism; Behavior; Disorders of diminished motivation; Frontal-subcortical neurocircuitry; Review
Abstract :
[en] Akinetic mutism (AM) is a rare neurological disorder characterized by the presence of an intact level of consciousness and sensorimotor capacity, but with a simultaneous decrease in goal-directed behavior and emotions. Patients are in a wakeful state of profound apathy, seemingly indifferent to pain, thirst, or hunger. It represents the far end within the spectrum of disorders of diminished motivation. In recent years, more has become known about the functional roles of neurocircuits and neurotransmitters associated with human motivational behavior. More specific, there is an increasing body of behavioral evidence that links specific damage of functional frontal-subcortical organization to the occurrence of distinct neurological deficits. In this review, we combine evidence from lesion studies and neurophysiological evidence in animals, imaging studies in humans, and clinical investigations in patients with AM to form an integrative theory of its pathophysiology. Moreover, the specific pharmacological interventions that have been used to treat AM and their rationales are reviewed, providing a comprehensive overview for use in clinical practice. © 2020 The Authors
Disciplines :
Neurology
Author, co-author :
Arnts, H.;  Department of Neurosurgery, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, Netherlands
van Erp, Willemijn ;  Université de Liège - ULiège > GIGA
Lavrijsen, J. C. M.;  Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Center, Nijmegen, Netherlands
van Gaal, S.;  Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
Groenewegen, H. J.;  Department of Anatomy and Neurosciences, Neuroscience Campus Amsterdam, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, Netherlands
van den Munckhof, P.;  Department of Neurosurgery, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, Netherlands
Language :
English
Title :
On the pathophysiology and treatment of akinetic mutism
Publication date :
2020
Journal title :
Neuroscience and Biobehavioral Reviews
ISSN :
0149-7634
eISSN :
1873-7528
Publisher :
Elsevier, United Kingdom
Volume :
112
Pages :
270-278
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 31 December 2021

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