Dopamine agonists can improve pure apathy associated with lesions of the prefrontal-basal ganglia functional system

Apathy is a common neurobehavioral symptom of other syndromes or a syndrome per se which occurs in a variety of neuropsychiatric disorders. Apathy depends on disruption of emotional, cognitive, and behavioral functions. Six brain-damaged patients were assessed, including five patients with unilateral or bilateral focal lesions of the basal ganglia or the thalamus (showing apathy due to an auto-activation deficit) and one patient with bilateral lesions in the limbic temporomesial cortex associated with a form of emotional-affective apathy. A significant and persistent improvement of apathy was observed in all patients after treatment with dopamine agonists such as pramipexole, ropinirole, and rotigotine. These results confirm preliminary reports on the beneficial effects of dopamine agonist agents on apathy and suggest that this syndrome can be treatable in many cases.