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- Title
A Brain Imaging-Based Diagnostic Biomarker for Periodic Catatonia: Preliminary Evidence Using a Bayesian Approach.
- Authors
Foucher, Jack René; de Billy, Clément; Jeanjean, Ludovic Christophe; Obrecht, Alexandre; Mainberger, Olivier; Clauss, Julie Marie Estelle; Schorr, Benoit; Lupu, Madalina Carmen; de Sousa, Paulo Loureiro; Lamy, Julien; Noblet, Vincent; Sauleau, Erik André; Landré, Lionel; Berna, Fabrice
- Abstract
Periodic catatonia (PC) is a psychomotor phenotype with a progressive-remitting course. While it can fit any disorder diagnosis of the schizoaffective spectrum, its core features consist of a mix of hypo- and hyperkinesias resulting in distortions of expressive movements such as grimacing and parakinesias. The replication of cerebral blood flow (CBF) increases in the left supplementary motor area (L-SMA) and lateral premotor cortex (L-LPM) in acute and remitting PC patients indicates that these increases could be used as diagnostic biomarkers. In this proof-of-concept study, 2 different MRI sequences were repeated on 3 separate days to get reliable measurement values of CBF in 9 PC and 26 non-PC patients during different cognitive tasks. Each patient was compared to 37 controls. In L-SMA [–9; +10; +60] and L-LPM [–46; –12; +43], a test was positive if the t value was >2.02 (α < 0.05; two tailed). The measurements had good analytical performance. Regarding the tests, their sensitivities and specificities were significantly different from the chance level on both measures, except for L-SMA sensitivities. When combining all the tests, among regions and methods, sensitivity was 98% (95% credible interval [CI] 76–100%) and specificity 88% (72–97%). Bayesian inferences of its negative predictive values for PC were >95% regardless of the context, while its positive predictive values reached 94% but only when used in combination with clinical criteria. The case-by-case analysis suggests that non-PC patients with neurological motor deficits are at risk to be false positive.
- Subjects
BIOMARKERS; CEREBRAL circulation; CATATONIA; PREMOTOR cortex
- Publication
Neuropsychobiology, 2020, Vol 79, Issue 4/5, p352
- ISSN
0302-282X
- Publication type
Article
- DOI
10.1159/000501830