title: The neuropsychiatry of hyperkinetic movement disorders: insights from neuroimaging into the neural circuit bases of dysfunction.
abstract: BACKGROUND
  Movement disorders, particularly those associated with basal ganglia disease, have a high rate of comorbid neuropsychiatric illness.
  
  
  METHODS
  We consider the pathophysiological basis of the comorbidity between movement disorders and neuropsychiatric illness by 1) reviewing the epidemiology of neuropsychiatric illness in a range of hyperkinetic movement disorders, and 2) correlating findings to evidence from studies that have utilized modern neuroimaging techniques to investigate these disorders. In addition to diseases classically associated with basal ganglia pathology, such as Huntington disease, Wilson disease, the neuroacanthocytoses, and diseases of brain iron accumulation, we include diseases associated with pathology of subcortical white matter tracts, brain stem nuclei, and the cerebellum, such as metachromatic leukodystrophy, dentatorubropallidoluysian atrophy, and the spinocerebellar ataxias.
  
  
  CONCLUSIONS
  Neuropsychiatric symptoms are integral to a thorough phenomenological account of hyperkinetic movement disorders. Drawing on modern theories of cortico-subcortical circuits, we argue that these disorders can be conceptualized as disorders of complex subcortical networks with distinct functional architectures. Damage to any component of these complex information-processing networks can have variable and often profound consequences for the function of more remote neural structures, creating a diverse but nonetheless rational pattern of clinical symptomatology.
authors.affiliation: Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, Australia ; Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Parkville, Australia.
authors.forename: Bradleigh D
authors.initials: BD
authors.lastname: Hayhow
authors.forename: Islam
authors.initials: I
authors.lastname: Hassan
authors.forename: Jeffrey C L
authors.initials: JC
authors.lastname: Looi
authors.forename: Francesco
authors.initials: F
authors.lastname: Gaillard
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
authors.forename: Mark
authors.initials: M
authors.lastname: Walterfang
keywords: Movement disorders; frontostriatal; neuroimaging; psychopathology
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