Apathy and Anhedonia: Clinical and Neurophysiological Assessment of a Romanian Cohort

Abstract

Background: Patients with Parkinson’s disease (PD) often have, besides the characteristic motor manifestations, a wide variety of non-motor symptoms. These include apathy and anhedonia, common issues in PD, which can be quantified with the help of evaluation scales recommended by the literature. There are sensory non-motor manifestations of PD, some of which are easy to detect through electrophysiological studies. Our aim was to investigate the possible association of apathy and anhedonia with the severity of the motor status in a sample of PD patients in Romania. We also examined the prevalence of latency changes in the P100 wave of visual evoked potentials (VEPs) and how they correlated with motor status, apathy, and anhedonia in PD patients. Methods: Thirty-four patients with PD participated in this study. All were assessed for motor status using the Unified Parkinson’s Disease Rating Scale (UPDRS) and were rated on the Hoehn and Yahr scales. The presence and severity of apathy and anhedonia were assessed using the Apathy Evaluation Scale (AES), the Dimensional Apathy Scale (DAS), the Lille Apathy Rating Scale (LARS), and the Snaith–Hamilton Pleasure Scale (SHAPS). The latency of the P100 wave of the VEP was measured in all the patients. Results: Apathy and anhedonia were common among the patients with PD (35% and 58.8%, respectively). The presence of apathy/anhedonia was correlated with the severity of motor symptoms, as assessed using the UPDRS scale (p < 0.001), and with the stage of the disease according to the Hoehn and Yahr scale (p < 0.001). A prolonged latency of the P100 wave of the VEP was observed among apathetic (p < 0.001)/anhedonic (p < 0.01) patients and those with increased disease severity (p < 0.001). Conclusion: Apathy and anhedonia are common in PD and may correlate with the severity of motor symptoms. There may be visual impairment in these patients, evidenced by a prolonged P100 latency, which correlates with the severity of disease. Significance: Scales for assessing apathy and anhedonia, as well as measuring VEP latency, could be useful in assessing the severity of disease.

Neurological update: non-motor symptoms in atypical parkinsonian syndromes

“…Apathy (defined as a lack of feeling, emotion, interest or concern) is considered by some to be a separate syndrome in patients with PD, as half of the patients with apathy do not suffer from concomitant depression or cognitive impairments [ 109 ]. We found the prevalence of apathy was significantly higher in MSA (48%) [ 2 , 15 , 65 ] and DLB (56%) [ 2 , 66 ] compared to PD (35%) [ 110 ] ( p < 0.001). Apathy prevalence was similar among CBD (43%) [ 2 , 8 ] ( p = 0.479) and PSP (37%) [ 12 , 15 , 16 , 19 ] ( p = 0.914) compared to PD [ 110 ].…”

“…We found the prevalence of apathy was significantly higher in MSA (48%) [ 2 , 15 , 65 ] and DLB (56%) [ 2 , 66 ] compared to PD (35%) [ 110 ] ( p < 0.001). Apathy prevalence was similar among CBD (43%) [ 2 , 8 ] ( p = 0.479) and PSP (37%) [ 12 , 15 , 16 , 19 ] ( p = 0.914) compared to PD [ 110 ]. We found anxiety symptoms were more prevalent in MSA (45.3%) [ 2 , 65 ] compared to PD (20%) [ 107 ] ( p < 0.001), while there were no significant differences between PSP (17.3%) [ 12 , 16 ] ( p = 0.659) or DLB (26.5%) [ 66 ] ( p = 0.419) when compared to PD [ 107 ].…”