Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Grossi, Dario; Santangelo, Gabriella; Barbarulo, Anna Maria; Castaldo, G.; Proto, Maria Grazia; Siano, Pietro; Barone, Paolo; Trojano, Luigi

doi:10.1155/2013/781029

Cited by 31 publications

(21 citation statements)

References 53 publications

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“…Additionally, the current study found a significant association between apathy and letter fluency scores, which is also in line with previous findings in more severe patients [4,13,15]. Moreover, a similar pattern of executive dysfunction has been reported in apathetic patients with PD with dementia and apathetic patients with AD [50]. Taken together, the findings of the present study highlight the presence of a strong association between apathy and the presence of executive deficits.…”

Section: Discussionsupporting

confidence: 93%

Apathy in Mild Parkinson’s Disease: Neuropsychological and Neuroimaging Evidence

Alzahrani

Antonini

Venneri

2016

Journal of Parkinson’s Disease

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Background: Apathy is one of the most common neuropsychiatric symptoms in Parkinson's disease (PD). Few studies have investigated the cognitive and neuroanatomical correlates of apathy in PD, and those which have done so have not controlled for the presence of other neuropsychiatric comorbidities. Objective: To explore the cognitive and neuroanatomical correlates of apathy in PD at a mild disease stage. Methods: Sixty-five PD patients and 24 healthy controls participated in this study. Patients underwent extensive neuropsychological screening, neuropsychiatric assessment using the Neuropsychiatric Inventory, structural MRI scanning, and neurological examination. Voxel-based independent t-test analyses were used to assess the differences in grey and white matter volumes between the sample groups with/without apathy/neuropsychiatric symptoms. Results: Patients with apathy had lower grey matter volume in several brain areas including the left insula, left inferior/middle/medial frontal gyrus, right anterior cingulate, and the left superior temporal gyrus. Significant impairments were found in tests assessing executive functions, and a trend-level significant difference was observed in long term memory tests in patients with apathy, when compared with patients without apathy. Conclusions: Apathy was associated with greater levels of atrophy in the frontal and temporal cortex, and anterior cingulate, as well as overall lower level of cognitive performance, particularly in executive function and memory skills. Apathy appears to be associated with cognitive impairments in PD, therefore, treatment of this symptom might mitigate its effects on cognitive performance in this clinical population.

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Section: Discussionsupporting

confidence: 93%

Apathy in Mild Parkinson’s Disease: Neuropsychological and Neuroimaging Evidence

Alzahrani

Antonini

Venneri

2016

Journal of Parkinson’s Disease

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“…[23]. A similar pattern has been reported in other studies (e.g., 23% depression only, 23% depression + apathy, and 20% apathy only) [66, 67]. This frequent comorbidity suggests shared etiology.…”

Section: Apathysupporting

confidence: 79%

Behavioral and Psychological Symptoms in Alzheimer’s Disease

Tan

et al. 2014

BioMed Research International

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Neuropsychiatric symptoms (NPS) such as depression, apathy, aggression, and psychosis are now recognized as core features of Alzheimer's disease (AD), and there is a general consensus that greater symptom severity is predictive of faster cognitive decline, loss of independence, and even shorter survival. Whether these symptoms result from the same pathogenic processes responsible for cognitive decline or have unique etiologies independent of AD-associated neurodegeneration is unclear. Many structural and metabolic features of the AD brain are associated with individual neuropsychiatric symptoms or symptom clusters. In addition, many genes have been identified and confirmed that are associated with symptom risk in a few cases. However, there are no single genes strongly predictive of individual neuropsychiatric syndromes, while functional and structural brain changes unique to specific symptoms may reflect variability in progression of the same pathological processes. Unfortunately, treatment success for these psychiatric symptoms may be lower when comorbid with AD, underscoring the importance of future research on their pathobiology and treatment. This review summarizes some of the most salient aspects of NPS pathogenesis.

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“…An original research paper by Grossi et al in the present issue [24] verified that this specific relationship holds true in both demented PD patients and patients with Alzheimer's disease. Actually, Grossi et al [24] explored memory, visuospatial and executive functions in patients affected by the two neurodegenerative diseases; the authors also used specific behavioral rating scales and an inventory developed to measure severity of apathy on clinical basis, the newly proposed Clinical Judgment for Apathy Syndrome. The results showed that apathetic patients with both forms of dementia showed a common neuropsychological and behavioral picture, characterized by impairment on frontal tasks, thus strongly supporting the existence of an 'apathetic syndrome', characterized by specific cognitive and psychological symptoms.…”

supporting

confidence: 56%

“…This hypothesis about the neural bases of apathy received support from neuropsychological studies highlighting the presence of frontal/executive disorders in PD patients with "pure apathy" (i.e., non-demented, non-depressed patients with high scores on specific questionnaires for apathy) [22,23]. An original research paper by Grossi et al in the present issue [24] verified that this specific relationship holds true in both demented PD patients and patients with Alzheimer's disease. Actually, Grossi et al [24] explored memory, visuospatial and executive functions in patients affected by the two neurodegenerative diseases; the authors also used specific behavioral rating scales and an inventory developed to measure severity of apathy on clinical basis, the newly proposed Clinical Judgment for Apathy Syndrome.…”

mentioning

confidence: 53%

Towards a Deeper Comprehension of Relationships among Cognitive, Behavioral and Psychiatric Symptoms in Parkinson’s Disease

Trojano

Santangelo

Conson

et al. 2013

Behavioural Neurology

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Parkinson's Disease (PD) is nowadays considered as a complex clinical condition in which motor symptoms coexist with several non-motor symptoms. A growing body of literature has addressed non-motor symptoms in PD [1], that are progressively being recognized as a potential source of distress for patients and their families, even greater than that imposed by the well-known motor impairments [2][3][4].The aim of this special issue was to gather together studies providing new findings about a specific subset of non-motor symptoms in PD: cognitive, behavioural and psychological disturbances, that are likely those with the highest impact on patient's daily life [5,6]. Within this framework we collected papers addressing neuropsychological defects (particularly frontal dysfunctions and dysexecutive syndromes) and neuropsychiatric disorders (such as hallucinations, depression and apathy, compulsive behavior), and highlighting the possible relationships of these symptoms with pharmacological treatment, and, above all, with each other.In the present issue a review by Friedman et al.[7] addressed occurrence of psychosis and hallucinations in PD. Psychotic symptoms are common in drug treated PD patients: visual hallucinations (VH) have been reported to occur in about 30%, whereas delusions, typically paranoid in nature, occur in about 5%. These

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Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Cited by 31 publications

References 53 publications

Apathy in Mild Parkinson’s Disease: Neuropsychological and Neuroimaging Evidence

Apathy in Mild Parkinson’s Disease: Neuropsychological and Neuroimaging Evidence

Behavioral and Psychological Symptoms in Alzheimer’s Disease

Towards a Deeper Comprehension of Relationships among Cognitive, Behavioral and Psychiatric Symptoms in Parkinson’s Disease

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