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Multidimensional apathy and executive dysfunction in amyotrophic lateral sclerosis.

Ratko Radakovic1, Laura Stephenson2, Judith Newton2

  • 1Human Cognitive Neuroscience Unit - School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK; Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Euan MacDonald Centre for MND Research, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.

Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
|August 1, 2017
PubMed
Summary

Amyotrophic lateral sclerosis (ALS) patients show increased Initiation apathy, linked to verbal fluency deficits. Emotional apathy is associated with impaired emotional recognition, suggesting distinct cognitive mechanisms for these motivational symptoms.

Keywords:
Amyotrophic lateral sclerosisApathyDimensional apathy scaleEmotional processingExecutive dysfunction

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Psychology

Background:

  • Apathy and cognitive dysfunction are key symptoms in Amyotrophic lateral sclerosis (ALS).
  • Specifically, ALS patients exhibit increased Initiation apathy, a deficit in self-motivated thought generation.
  • Understanding the cognitive basis of apathy subtypes in ALS is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the cognitive underpinnings of apathy subtypes in Amyotrophic lateral sclerosis.
  • To explore the association between Initiation apathy and deficits in intrinsic response generation, like verbal fluency.
  • To examine the relationship of Emotional and Executive apathy with emotional, social cognition, and planning deficits, respectively.

Main Methods:

  • Recruited ALS patients (N=30) and healthy controls (N=29), with carer/informant ratings.
  • Administered self- and informant-rated Dimensional Apathy Scale to assess apathy subtypes (Executive, Emotional, Initiation).
  • Conducted comprehensive neuropsychological testing, including emotional recognition, social cognition, verbal fluency, random number generation, and planning tasks.

Main Results:

  • Initiation apathy was the only significantly elevated apathy subtype in ALS patients.
  • Increased Initiation apathy correlated significantly with verbal fluency deficits.
  • Emotional apathy showed a significant association with deficits in emotional recognition.

Conclusions:

  • This study reveals specific associations between apathy subtypes (Initiation and Emotional) and distinct cognitive deficits in ALS.
  • Findings suggest potentially different underlying neural mechanisms for various apathy presentations in ALS.
  • These results highlight the importance of differentiating apathy subtypes for understanding and managing motivational impairments in neurodegenerative diseases.