Apathy in Parkinson's disease: more than just executive dysfunction
Saül Martínez-Horta1, Javier Pagonabarraga, Ramón Fernández de Bobadilla
1Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain.
Journal of the International Neuropsychological Society : JINS
|February 22, 2013
Summary
Apathy in Parkinson's disease (PD) involves more than executive dysfunction. Our study found that even without cognitive impairment, PD patients with apathy struggle with cortical functions, suggesting additional underlying mechanisms.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- Apathy is a common symptom in Parkinson's disease (PD), often linked to depression, cognitive impairment (CI), and dementia.
- While executive dysfunction is considered a primary cause of apathy in PD, other factors may contribute to its clinical presentation.
Purpose of the Study:
- To investigate the neuropsychological profile of PD patients with apathy as their sole neuropsychiatric symptom.
- To explore potential mechanisms beyond executive dysfunction contributing to apathy in PD, even in the absence of significant cognitive impairment.
Main Methods:
- Neuropsychological testing was used to assess global cognitive functioning, set-shifting, decision-making, and cognitive effort.
- A carefully selected group of PD patients with apathy (and no other neuropsychiatric symptoms or significant CI) was compared to a control group.
Main Results:
- Apathetic PD patients showed executive dysfunction, as expected.
- Significant difficulties were also observed in tasks assessing cortical functioning, such as naming and clock drawing.
- Interestingly, apathetic patients performed better on a decision-making task, and effort levels did not explain these differences.
Conclusions:
- Executive dysfunction alone does not fully explain apathy in Parkinson's disease.
- Additional mechanisms involving cortical functioning may play a role in the development of apathy in PD patients.
- These findings suggest a more complex pathophysiology of apathy in PD than previously understood.
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