Relationship Between Self-reported Apathy and Executive Dysfunction in Nondemented Patients With Parkinson Disease

Zgaljardic, Dennis J.; Borod, Joan C.; Foldi, Nancy S.; Rocco, Mary; Mattis, Paul J.; Gordon, Mark Forrest; Feigin, Andrew; Eidelberg, David

doi:10.1097/wnn.0b013e318145a6f6

Cited by 85 publications

(70 citation statements)

References 40 publications

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“…Apathy is seen in 17-70% of patients with PD, 115,116 and frequently coexists with depression or dementia, although it can occur as the sole major manifestation 116 or can be associated with executive dysfunction. 117 Generalised anxiety, panic attacks, and social phobias are common in PD. 118 About 40% of patients have anxiety, 119,120 although a recent series reported a prevalence of 69% (930 of 1351).…”

Section: Psychiatric Problems In Patients With Early Pdmentioning

confidence: 99%

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Rodriguez-Oroz

Jahanshahi

Krack

et al. 2009

The Lancet Neurology

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500

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A dopaminergic defi ciency in patients with Parkinson's disease (PD) causes abnormalities of movement, behaviour, learning, and emotions. The main motor features (ie, tremor, rigidity, and akinesia) are associated with a defi ciency of dopamine in the posterior putamen and the motor circuit. Hypokinesia and bradykinesia might have a dual anatomo-functional basis: hypokinesia mediated by brainstem mechanisms and bradykinesia by cortical mechanisms. The classic pathophysiological model for PD (ie, hyperactivity in the globus pallidus pars interna and substantia nigra pars reticulata) does not explain rigidity and tremor, which might be caused by changes in primary motor cortex activity. Executive functions (ie, planning and problem solving) are also impaired in early PD, but are usually not clinically noticed. These impairments are associated with dopamine defi ciency in the caudate nucleus and with dysfunction of the associative and other non-motor circuits. Apathy, anxiety, and depression are the main psychiatric manifestations in untreated PD, which might be caused by ventral striatum dopaminergic defi cit and depletion of serotonin and norepinephrine. In this Review we discuss the motor, cognitive, and psychiatric manifestations associated with the dopaminergic defi ciency in the early phase of the parkinsonian state and the diff erent circuits implicated, and we propose distinct mechanisms to explain the wide clinical range of PD symptoms at the time of diagnosis.

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Section: Psychiatric Problems In Patients With Early Pdmentioning

confidence: 99%

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Rodriguez-Oroz

Jahanshahi

Krack

et al. 2009

The Lancet Neurology

745

500

View full text Add to dashboard Cite

show abstract

“…In the literature, it has been demonstrated that apathy is associated with cognitive dysfunction [15,41,[43][44][45][46][47][48][49][50][51][52][53] (See table 2), depression [44-46, 50, 51, 53-56] and anxiety [57]. Although apathy and depression can co-exist in PD, several studies have found that apathy may occur in isolation in the absence of depression [15,45,46,51,53,56,[58][59][60].…”

Section: Apathymentioning

confidence: 99%

“…Although apathy and depression can co-exist in PD, several studies have found that apathy may occur in isolation in the absence of depression [15,45,46,51,53,56,[58][59][60].…”

Section: Apathymentioning

confidence: 99%

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Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

Alzahrani

Venneri

2015

Journal of the Neurological Sciences

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“…According to Stuss et al [3], apathetic syndromes can be divided into three subtypes, depending on the domain in which lack of mo-reason its reported prevalence varies from 14% to 70% (mean: 38%) [19]. PD patients with apathy tends to show more severe cognitive symptoms, and particularly executive dysfunction [14,15,[20][21][22][23], with respect to PD patients without apathy. In a 18-month longitudinal study, Dujardin et al [21] found apathy to be predictive of development of dementia.…”

Section: Introductionmentioning

confidence: 99%

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

Grossi

Santangelo

Barbarulo

et al. 2013

Behavioural Neurology

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Abstract. Apathy is defined as a lack of motivation and has been reported to be common in Alzheimer's disease (AD) and Parkinson's disease (PD). To explore the neuropsychological correlates of apathy in patients with PD related dementia (PDD) and AD and to identify the specific cognitive profile of apathy in the two forms of neurodegenerative disease, 61 non-depressed patients (29 PDD and 32 AD) were selected. Out of these, 29 patients (47.5%) were detected as apathetic (14 PDD-A+ and 15 AD-A+), and 32 patients as non-apathetic (15 PDD-A-and 17 AD-A-). All patients underwent cognitive tasks tapping memory, visuospatial and executive functions, behavioral rating scales and Clinical Judgment for Apathy Syndrome (CJ-AS), an inventory developed to measure severity of apathy. The four subgroups differed significantly on memory and frontal tasks. The PDD-A+ performed significantly worse than PDD-Aon frontal tasks. The AD-A+ had poorer performance than AD-A-on frontal tasks. Last, PDD-A+ achieved significantly higher scores than AD-A+ on memory tasks. The four groups differed significantly on CJ-AS and behavioral rating scales. The results showed that apathetic patients with both forms of dementia showed a common neuropsychological and behavioral picture, characterized by defects on frontal tasks, thus strongly supporting the existence of an 'apathetic syndrome', characterized by specific cognitive and psychological symptoms.

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Relationship Between Self-reported Apathy and Executive Dysfunction in Nondemented Patients With Parkinson Disease

Cited by 85 publications

References 40 publications

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Initial clinical manifestations of Parkinson's disease: features and pathophysiological mechanisms

Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

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

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