{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:45:57Z","timestamp":1791380757320,"version":"4.3.3"},"reference-count":8,"publisher":"MedWorks Media","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Akinetic mutism is a rare but important clinical syndrome characterised by a profound decrease in goal-directed behaviour and speech output, yet with preservation of consciousness. This report describes the case of a 58-year-old male with a background of hypertension, alcohol use disorder, smoking, and MTHFR C677T homozygosity who experienced two ischaemic strokes within weeks of each other. The initial infarct involved the right thalamus, posterior putamen, external capsule, and subcortical anterior frontal lobe. Approximately five weeks later, he developed a second stroke in the left hemisphere, eventually leading to the identification of a mitral valve mass consistent with a papillary fibroelastoma. Following surgical resection of this mass, the patient demonstrated severe reductions in spontaneous movement and speech in a pattern consistent with akinetic mutism. He ultimately improved with rehabilitative measures and the initiation of a stimulant medication. This case highlights the intricate relationship between bilateral frontal\u2013subcortical network injuries and the development of akinetic mutism.<\/jats:p>","DOI":"10.64719\/pb.4533","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:23:34Z","timestamp":1761045814000},"page":"37-43","source":"Crossref","is-referenced-by-count":0,"title":["Akinetic Mutism Following Bilateral Infarcts Associated with a Mitral Valve Papillary Fibroelastoma"],"prefix":"10.64719","volume":"55","author":[{"given":"Stanley","family":"Lyndon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Arnts H, van Erp WS, Lavrijsen JCM, van Gaal S, Groenewegen HJ, van den Munckhof P. On the pathophysiology and treatment of akinetic mutism. Neurosci Biobehav Rev. 2020;112:270\u2013278.","DOI":"10.1016\/j.neubiorev.2020.02.006"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Ackermann H, Ziegler W. [Akinetic mutism\u2013a review of the literature] Fortschr Neurol Psychiatr. 1995;63:59\u201367.","DOI":"10.1055\/s-2007-996603"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Nagaratnam N, Nagaratnam K, Ng K, Diu P. Akinetic mutism following stroke. J Clin Neurosci. 2004;11:25\u201330.","DOI":"10.1016\/j.jocn.2003.04.002"},{"key":"ref4","unstructured":"Mega MS, Cohenour RC. Akinetic mutism: disconnection of frontal-subcortical circuits. Neuropsychiatry Neuropsychol Behav Neurol. 1997;10:254\u2013259."},{"key":"ref5","unstructured":"Zoltowska DM, Sadic E, Becoats K et al. Cardiac papillary fibroelastoma. J Geriatr Cardiol. 2021;18:346\u2013351."},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Mkalaluh S, Szczechowicz M, Torabi S et al. Surgery for Cardiac Papillary Fibroelastoma: A 12-Year Single Institution Experience. Med Sci Monit Basic Res. 2017;23:258\u2013263.","DOI":"10.12659\/MSMBR.904881"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Comanducci A, Casarotto S, Rosanova M et al. Unconsciousness or unresponsiveness in akinetic mutism? Insights from a multimodal longitudinal exploration. Eur J Neurosci. 2024;59:860\u2013873.","DOI":"10.1111\/ejn.15994"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Ross ED, Stewart RM. Akinetic mutism from hypothalamic damage: successful treatment with dopamine agonists. Neurology. 1981;31:1435\u20131439.","DOI":"10.1212\/WNL.31.11.1435"}],"container-title":["Psychopharmacology Bulletin"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:33:34Z","timestamp":1791315214000},"score":1,"resource":{"primary":{"URL":"https:\/\/medworksmedia.com\/pb-article\/akinetic-mutism-following-bilateral-infarcts-associated-with-a-mitral-valve-papillary-fibroelastoma\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,8,12]]}},"URL":"https:\/\/doi.org\/10.64719\/pb.4533","relation":{},"ISSN":["2472-2448"],"issn-type":[{"value":"2472-2448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}