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Apathy: a major symptom in CADASIL.

S Reyes1, A Viswanathan, O Godin

  • 1Department of Neurology, CHU Lariboisière, Assistance Publique des Hôpitaux de Paris, France.

Neurology
|March 11, 2009
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Summary

Apathy is common in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), impacting quality of life. This study explored apathy

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Area of Science:

  • Neurology
  • Neuropsychiatry
  • Genetics

Background:

  • Subcortical ischemic vascular dementia (SIVD) is a significant cause of cognitive decline.
  • The prevalence and impact of apathy in SIVD, particularly in genetic forms like CADASIL, are not well understood.

Purpose of the Study:

  • To determine the frequency of apathy in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).
  • To investigate the clinical, neuropsychological, and neuroimaging correlates of apathy in this population.

Main Methods:

  • Apathy diagnosed using the Neuropsychiatric Inventory.
  • Disability, cognitive function, autonomy, and quality of life assessed using validated scales (mRS, MDRS, MMSE, IADL, SEP-59).
  • Cerebral lesion burden evaluated using neuroimaging techniques.

Main Results:

  • Apathy was present in 41% of 132 CADASIL patients.
  • Apathetic patients exhibited older age, lower cognitive scores (MMSE, MDRS), greater disability (mRS, IADL), and more neuropsychiatric symptoms.
  • Apathy independently correlated with reduced quality of life and increased white matter and lacunar lesions.

Conclusions:

  • Apathy is a frequent symptom in CADASIL, associated with cognitive impairment and functional decline.
  • Apathy impacts quality of life independently of depression in CADASIL patients.
  • Findings highlight apathy as a key target for intervention in CADASIL.