Background. Catatonia, a symptom complex with motor, affective and cognitive symptoms seen in
a variety of psychotic conditions and with organic disease, was examined using a motor task
using functional magnetic resonance imaging (fMRI).
Methods. Two acute catatonic patients and two age- and sex-matched healthy controls performed
sequential finger opposition (SFO) after being medicated with 2 mg of lorazepam (i.v.). Functional
magnetic resonance images were collected using a gradient echo pulse sequence (EPI).
Results. Patients with catatonia showed reduced motor activation of the contralateral motor cortex
during SFO of the right hand, ipsilateral activation was similar for patients and controls. There were
no differences in the activation of the SMA. During left hand activation the right-handed catatonic
patients showed more activation in the ipsilateral cortex, a reversal from the normal pattern of
activation in which the contralateral side shows four to five times more activation than the
Conclusions. In catatonic patients there is a decreased activation in motor cortex during a motor
task compared to matched medicated healthy controls. In addition activation of the non-dominant
side, left-handed activity in right-handed patients, results in a total reversal of the normal pattern
of lateral activation suggesting a disturbance in hemispheric localization of activity during a