{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T16:40:53Z","timestamp":1793810453466,"version":"4.6.1"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2003,8,11]],"date-time":"2003-08-11T00:00:00Z","timestamp":1060560000000},"content-version":"unspecified","delay-in-days":314,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav Brain Sci"],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p>Differential diagnosis of motor symptoms, for example, akinesia, may be difficult in clinical neuropsychiatry. Symptoms may be either of neurologic origin, for example, Parkinson's disease, or of psychiatric origin, for example, catatonia, leading to a so-called \u201cconflict of paradigms.\u201d Despite their different origins, symptoms may appear more or less clinically similar. Possibility of dissociation between origin and clinical appearance may reflect functional brain organisation in general, and cortical-cortical\/subcortical relations in particular. It is therefore hypothesized that similarities and differences between Parkinson's disease and catatonia may be accounted for by distinct kinds of modulation between cortico-cortical and cortico-subcortical relations. Catatonia can be characterized by concurrent motor, emotional, and behavioural symptoms. The different symptoms may be accounted for by dysfunction in orbitofrontal-prefrontal\/parietal cortical connectivity reflecting \u201chorizontal modulation\u201d of cortico-cortical relation. Furthermore, alteration in \u201ctop-down modulation\u201d reflecting \u201cvertical modulation\u201d of caudate and other basal ganglia by GABA-ergic mediated orbitofrontal cortical deficits may account for motor symptoms in catatonia. Parkinson's disease, in contrast, can be characterized by predominant motor symptoms. Motor symptoms may be accounted for by altered \u201cbottom-up modulation\u201d between dopaminergic mediated deficits in striatum and premotor\/motor cortex. Clinical similarities between Parkinson's disease and catatonia with respect to akinesia may be related with involvement of the basal ganglia in both disorders. Clinical differences with respect to emotional and behavioural symptoms may be related with involvement of different cortical areas, that is, orbitofrontal\/parietal and premotor\/motor cortex implying distinct kinds of modulation \u2013 \u201cvertical\u201d and \u201chorizontal\u201d modulation, respectively.<\/jats:p>","DOI":"10.1017\/s0140525x02000109","type":"journal-article","created":{"date-parts":[[2003,9,23]],"date-time":"2003-09-23T18:22:16Z","timestamp":1064341336000},"page":"555-577","source":"Crossref","is-referenced-by-count":299,"title":["What catatonia can tell us about \u201ctop-down modulation\u201d: A neuropsychiatric hypothesis"],"prefix":"10.1017","volume":"25","author":[{"given":"Georg","family":"Northoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2003,8,11]]},"container-title":["Behavioral and Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0140525X02000109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T20:39:08Z","timestamp":1557175148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0140525X02000109\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,10]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2002,10]]}},"alternative-id":["S0140525X02000109"],"URL":"https:\/\/doi.org\/10.1017\/s0140525x02000109","relation":{},"ISSN":["0140-525X","1469-1825"],"issn-type":[{"value":"0140-525X","type":"print"},{"value":"1469-1825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,10]]}}}