Characteristics of apathy in treatment-naïve patients with Parkinson’s disease

Terashi, Hiroo; Ueta, Yuki; Kato, Haruhisa; Mitoma, Hiroshi; Aizawa, Hitoshi

doi:10.1080/00207454.2018.1503184

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…An additional common prodromal PD sign is hyposmia; idiopathic anosmia has a lower PD conversion rate than RBD, with reports of 10% at ten years [ 61 ]. Apathy may be more prevalent in hyposmic PD patients, possibly associated with a higher odour threshold and decreased discrimination and identification of odours [ 8 , 62 , 63 , 64 ]. It was not related to subjective changes in smell [ 4 ].…”

Section: Prevalence Of Apathy During the Disease Coursementioning

confidence: 99%

“…The Park apathy subtype has been associated with more severe motor symptoms, confirmed in observational studies [ 3 ]. Apathetic patients score higher on the UPDRS motor scale than their non-apathetic peers, excluding confounding factors such as disease duration or age [ 8 , 9 , 22 , 130 , 131 ]. This difference is already manifest at diagnosis, before the introduction of DRT [ 4 , 7 , 8 , 22 , 37 ].…”

Section: Park Apathymentioning

confidence: 99%

“…Apathetic patients score higher on the UPDRS motor scale than their non-apathetic peers, excluding confounding factors such as disease duration or age [ 8 , 9 , 22 , 130 , 131 ]. This difference is already manifest at diagnosis, before the introduction of DRT [ 4 , 7 , 8 , 22 , 37 ]. As discussed above, apathy may fluctuate during the disease course [ 14 , 19 ].…”

Section: Park Apathymentioning

confidence: 99%

“…They have increased body sway in a quiet stance compared to non-apathetic patients, reflecting a more pronounced underlying postural instability [ 132 ]. Even in early PD, axial symptoms are more frequent and pronounced in this group [ 8 , 22 , 37 , 133 ]. Freezing of gait in ON state is linked to a higher grade of apathy and was less responsive to medication in this group [ 134 ].…”

Section: Park Apathymentioning

confidence: 99%

“…In the past, it was considered a late-stage symptom occurring predominantly in elderly patients [ 6 ]. Research has shown however that apathy manifests itself in all disease stages, and may serve as a prodromal symptom in some [ 6 , 7 , 8 , 9 ]. Presence of apathy in PD patients has been linked to increased motor burden, reduced quality of life (QoL) and has been identified as a risk factor for motor complications and cognitive decline [ 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Apathy in Parkinson’s Disease: Defining the Park Apathy Subtype

2022

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Apathy is a neurobehavioural symptom affecting Parkinson’s disease patients of all disease stages. Apathy seems to be associated with a specific underlying non-motor disease subtype and reflects dysfunction of separate neural networks with distinct neurotransmitter systems. Due to the complicated neuropsychiatric aetiology of apathy, clinical assessment of this invalidating non-motor symptom remains challenging. We aim to summarize the current findings on apathy in Parkinson’s disease and highlight knowledge gaps. We will discuss the prevalence rates across the different disease stages and suggest screening tools for clinically relevant apathetic symptoms. We will approach the fundamental knowledge on the neural networks implicated in apathy in a practical manner and formulate recommendations on patient-tailored treatment. We will discuss the Park apathy phenotype in detail, shedding light on different clinical manifestations and implications for prognosis. With this review, we strive to distil the vast available theoretical knowledge into a clinical and patient-oriented perspective.

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