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In this review, we discuss the hypothesis that reduced striatal dopaminergic transmission is a transdiagnostic substrate for psychomotor retardation underlying the motor features of conditions such as Parkinson\u2019s disease, drug-induced parkinsonism, neuroleptic malignant syndrome, catatonia and depression. We examine the evidence across clinical, epidemiological, neuroimaging, laboratory and therapeutic studies.<\/jats:p>\n                  <jats:p>Parkinsonian disorders share slowed movement and a reduction in verbal output with catatonia and depression. Bradyphrenia, slowed cognitive processing, also occurs in Parkinson\u2019s disease and depression. In addition, there are close epidemiological relationships between depression and Parkinson\u2019s disease, and between catatonia and neuroleptic malignant syndrome.<\/jats:p>\n                  <jats:p>Neuroimaging studies also generally support the association of psychomotor retardation with reduced dopaminergic transmission, particularly in the dorsal striatum. CSF measurement of homovanillic acid (a dopamine catabolite) yields inconsistent results and is non-specific. Parkinson\u2019s disease and catatonia generally respond well to dopaminergic medication. In contrast, dopamine antagonists can induce both parkinsonism and catatonia.<\/jats:p>\n                  <jats:p>Our review is limited by the variability in measurement of psychomotor retardation and difficulty distinguishing between cognitive and motor slowing. It is also likely that other neurotransmitters, such as GABA and serotonin, play an important role in psychomotor speed.<\/jats:p>\n                  <jats:p>It is possible that dopaminergic deficits in psychiatric disorders represent functional disruptions, in contrast to the structural damage to the substantia nigra in Parkinson\u2019s disease. We propose further research be conducted into the effects of levodopa and dopamine agonists in depression with psychomotor retardation. Alternative neuroimaging methods such as PET sequences with shorter imaging protocols and neuromelanin-MRI should also be explored.<\/jats:p>","DOI":"10.1093\/brain\/awaf335","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T11:59:32Z","timestamp":1757591972000},"page":"18-36","source":"Crossref","is-referenced-by-count":10,"title":["Reduced striatal dopamine transmission as a transdiagnostic substrate of psychomotor retardation"],"prefix":"10.1093","volume":"149","author":[{"given":"Ian Lam","family":"Leong","sequence":"first","affiliation":[{"name":"Division of Psychology and Language Sciences, University College London , London WC1H 0AP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz Huen","family":"Ng","sequence":"additional","affiliation":[{"name":"Faculty of Education, University of Hong Kong , 999077 \u00a0","place":["Hong 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College London , London SE5 8AF ,","place":["UK"]},{"name":"South London and Maudsley NHS Foundation Trust , London SE5 8AZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Coebergh","sequence":"additional","affiliation":[{"name":"Ashford St Peter\u2019s Hospital and St George\u2019s Hospitals , Ashford TW15 3AA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"McCutcheon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford , Oxford OX3 7JX ,","place":["UK"]},{"name":"Oxford Health NHS Foundation Trust , Oxford OX3 7JH ,","place":["UK"]},{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King\u2019s College London , London SE5 8AF ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. George\u2019s University Hospitals NHS Foundation Trust , London SW17 0QT ,","place":["UK"]},{"name":"Department of Neurology, City St George\u2019s University of London , London SW17 0RE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Browning","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford , Oxford OX3 7JX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin J M","family":"Huys","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London , London WC1H 0AL ,","place":["UK"]},{"name":"Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Department of Imaging Neuroscience, Queen Square Institute of Neurology, University College London , London WC1N 3BG 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