Structural Correlates of Apathy in Alzheimer’s Disease

Apostolova, Liana G.; Akopyan, G.; Partiali, Negar Rachel; Steiner, Claudia; Dutton, Rebecca A.; Hayashi, Kiralee M.; Dinov, Ivo D.; Toga, Arthur W.; Cummings, Jeffrey L.; Thompson, Paul M.

doi:10.1159/000103914

Cited by 170 publications

(124 citation statements)

References 45 publications

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“…Pathological data from Ad patients with severe dementia disclosed correlation between Acc pathology and apathy severity, according to NPI scores 52 . These findings were recently replicated in structural magnetic resonance imaging data 53 . Additionally, a series of studies with single photon emission tomography (sPecT) have shown resting hypometabolism in Acc from Ad apathetic patients when compared to non-apathetic individuals [54][55][56][57][58] .…”

Section: Apathy Alzheimer's Disease and Other Cortical Dementias: Nementioning

confidence: 62%

Neurobiology of apathy in Alzheimer's disease

Guimarães

Lévy²,

Teixeira

et al. 2008

Arq. Neuro-Psiquiatr.

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-Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome is generally deleterious. Apathy can be related to a dysfunction of the anatomical-system that supports the generation of voluntary actions, namely the prefrontal cortex and/or the prefrontal-subcortical circuits. In Alzheimer's disease, pathological and neuroimaging data indicate that apathy is likely due to a dysfunction of the medial prefrontal cortex. Accordingly, in this review article, we propose a pathophysiological model to explain apathetic behavior in Alzheimer's disease, combining data from neuroimaging, neuropathology and experimental research on the role of orbito-frontal cortex, anterior cingulate cortex, basal ganglia and dopamine in decision-making neurobiology.Key words: apathy, Alzheimer's disease, decision-making, orbito-frontal cortex, anterior cingulate cortex, basal ganglia, dopamine. Neurobiologia da apatia na doença de alzheimerResumo -Apatia é considerada a alteração neuropsiquiátrica mais freqüente nas demências e suas conseqüências são habitualmente deletérias. Apatia pode ser relacionada à disfunção do sistema anatômico responsável pela geração de ações voluntárias, conhecido com córtex pré-frontal e/ou circuitos pré-frontais-subcorticais. Na doença de Alzheimer, evidências neuropatológicas e de neuroimagem funcional indicam que a apatia é provavelmente decorrente da disfunção do córtex pré-frontal medial. Assim, neste artigo de revisão, apresentamos uma proposta de um modelo fisiopatológico para explicar o comportamento apático na doença de Alzheimer, combinando dados de neuropatologia, neuroimagem e experimentação animal sobre o papel do córtex órbito-frontal, cíngulo anterior, núcleos da base e dopamina na neurobiologia da tomada de decisão.PAlAvrAs-chAve: apatia, doença de Alzheimer, tomada de decisão, córtex órbito-frontal, córtex cingulado anterior, núcleos da base, dopamina.

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Section: Apathy Alzheimer's Disease and Other Cortical Dementias: Nementioning

confidence: 62%

Neurobiology of apathy in Alzheimer's disease

Guimarães

Lévy²,

Teixeira

et al. 2008

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…More recent PET and resting fMRI studies in PD revealed an association between high apathy scores and abnormalities in several prefrontal regions (including orbitofrontal cortex, cingulated region, dorsolateral cortex, right middle frontal cortex), besides other cortical areas, such as bilateral inferior parietal gyrus, bilateral insula and right precuneus [65][66][67]. Also in AD, apathy severity has been associated with abnormalities in several cortical regions such as the anterior cingulate gyrus [68] and the left medial frontal cortex [69]. Taken together, these results indicated that apathy in neurodegenerative diseases seems to arise from altered functioning of several cortical areas, mainly of prefrontal areas.…”

Section: Discussionmentioning

confidence: 99%

“…Brain imaging studies in AD reported a significant association between apathy and abnormal perfusion in the frontal cortex and in the cingulate area [28][29][30][31][32][33][34][35].…”

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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“…The functional neuroanatomy of apathy has been studied primarily in AD patients, where it was found that bilateral frontal, temporal, and cingulate area hypoperfusion and hypometabolism are associated with apathy severity [8][9][10][11][12]. Several structural neuroimaging studies also demonstrated an association between apathy and loss of integrity of frontal regions in AD [13,14]. Taken together, these results demonstrate that different brain areas are implicated in the pathophysiology of apathy in AD and suggest that circuits, rather than individual structures, may be disrupted in apathetic patients.…”

Section: Introductionmentioning

confidence: 99%

White Matter Microstructure and Apathy Level in Amnestic Mild Cognitive Impairment

Cacciari

Moraschi

Paola

et al. 2010

JAD

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Abstract. In this study, we assessed white matter microstructural deficit correlates of apathy level in 20 patients with amnestic mild cognitive impairment by means of diffusion tensor imaging. Mean diffusivity correlated positively with apathy level in the right temporal portion of the uncinate, middle longitudinal and inferior longitudinal fasciculi and in the parathalamic white matter, the fornix and the posterior cingulum of the right hemisphere. Fractional anisotropy results confirmed evidence of disconnection associated with apathy in all white matter areas except the middle longitudinal fasciculus. These results support the view that alterations in the neural mechanisms underlying apathy level occur in the early phase of degenerative dementias.

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Structural Correlates of Apathy in Alzheimer’s Disease

Cited by 170 publications

References 45 publications

Neurobiology of apathy in Alzheimer's disease

Neurobiology of apathy in Alzheimer's disease

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

White Matter Microstructure and Apathy Level in Amnestic Mild Cognitive Impairment

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