Retrospective chart review of catatonia in child and adolescent psychiatric patients.

OBJECTIVE: Identify the frequency of catatonia among at-risk children and adolescents receiving psychiatric treatment. METHOD: Subjects were children and adolescents (<18 years), who had received psychiatric treatment at a University Hospital during 2004-2009, and were diagnosed with disorders with known risk for catatonia or displayed symptoms suggestive of catatonia. Approval was obtained from the Investigational Review Board (IRB). The first 101 (n = 101) subjects were selected among 570 subjects identified by psychiatric diagnoses: any pervasive developmental disorder, psychosis-NOS (Not Otherwise Specified), intermittent explosive disorder, mental retardation, catatonia and neuroleptic malignant syndrome. Subjects met study-defined criteria for catatonia, if they had three or more of the following symptoms: unexplained agitation/excitement, disturbed or unusual movements, reduced movements, repetitive or stereotyped movements, or reduced or loss of speech. RESULTS: Eighteen (17.8%) subjects, among a group suspected to be at a higher risk for catatonia, met the study-defined criteria for this syndrome. However, only two subjects had been diagnosed by their treatment providers. Higher rates of intellectual disability and aggression were found among the group that met study-criteria. CONCLUSION: We concluded that catatonia is under recognized and undertreated among children and adolescents receiving psychiatric treatment.

Brain activation and lexical learning: the impact of learning phase and word type.

This study investigated the neural correlates of second-language lexical acquisition in terms of learning phase and word type. Ten French-speaking participants learned 80 Spanish words-40 cognates, 40 non-cognates-by means of a computer program. The learning process included the early learning phase, which comprised 5 days, and the consolidation phase, which lasted 2 weeks. After each phase, participants performed an overt naming task during an er-fMRI scan. Naming accuracy was better for cognates during the early learning phase only. However, cognates were named faster than non-cognates during both phases. The early learning phase was characterized by activations in the left iFG and Broca's area, which were associated with effortful lexical retrieval and phonological processing, respectively. Further, the activation in the left ACC and DLPFC suggested that monitoring may be involved during the early phases of lexical learning. During the consolidation phase, the activation in the left premotor cortex, the right supramarginal gyrus and the cerebellum indicated that articulatory planning may contribute to the consolidation of second-language phonetic representations. No dissociation between word type and learning phase could be supported. However, a Fisher r-to-z test showed that successful cognate retrieval was associated with activations in Broca's area, which could reflect the adaptation of known L1 phonological sequences. Moreover, successful retrieval of non-cognates was associated with activity in the anterior-medial left fusiform and right posterior cingulate cortices, suggesting that their successful retrieval may rely upon the access to semantic and lexical information, and even on the greater likelihood of errors.