On the pathophysiology and treatment of akinetic mutism

Arnts, H.; van Erp, Willemijn; Lavrijsen, J. C. M.; van Gaal, S.; Groenewegen, H. J.; van den Munckhof, P.

doi:10.1016/j.neubiorev.2020.02.006

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On the pathophysiology and treatment of akinetic mutism

Arnts, H.; van Erp, Willemijn; Lavrijsen, J. C. M. et al.

2020 • In Neuroscience and Biobehavioral Reviews, 112, p. 270-278

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10.1016/j.neubiorev.2020.02.006

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32044373

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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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