Connectivity patterns of the core resting-state networks associated with apathy in late-life depression
Jean-Charles Roy1, Thomas Desmidt2, Sébastien Dam2
1From the Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France (Roy, Mirea-Grivel, Louise, Drapier, Batail, Robert); the Centre d'investigation clinique (CIC) de Rennes 1414, CHU de Rennes, Institut national de la santé et de la recherche médicale (INSERM), Rennes, France (Roy, Drapier, Batail, Robert); l'Université de Rennes, Inria Centre, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France (Roy, Dam, Bannier, Coloigner, Robert); the Service de Radiologie, CHU Rennes, Rennes, France (Bannier); the CHU de Tours, Tours, France (Desmidt, Barantin); the UMR 1253, iBrain, Université de Tours, INSERM, Tours, France (Desmidt, Barantin); the CIC 1415, CHU de Tours, INSERM, Tours, France (Desmidt); the CoBTeK (Cognition Behaviour Technology) Lab, University Côte d'Azur, Nice, France (David) jc.roy@ch-guillaumeregnier.fr.
Background:
Apathy is associated with reduced antidepressant response and dementia in late-life depression (LLD). However, the functional cerebral basis of apathy is understudied in LLD. We investigated the functional connectivity of 5 resting-state networks (RSN) hypothesized to underlie apathy in LLD.
Methods:
Resting-state functional MRI data were collected from individuals with LLD who did not have dementia as well as healthy older adults between October 2019 and April 2022. Apathy was evaluated using the diagnostic criteria for apathy (DCA), the Apathy Evaluation Scale (AES) and the Apathy Motivation Index (AMI). Subnetworks whose connectivity was significantly associated with each apathy measure were identified via the threshold-free network-based statistics. Regions that were consistently associated with apathy across the measures were reported as robust findings.
Results:
Our sample included 39 individuals with LLD who did not have dementia and 26 healthy older adults. Compared with healthy controls, individuals with LLD had an altered intra-RSN and inter-RNS connectivity in the default mode, the cingulo-opercular and the frontoparietal networks. All 3 apathy measurements showed associations with modified intra-RSN connectivity in these networks, except for the DCA in the cingulo-opercular network. The AMI scores showed stronger associations with the cingulo-opercular and frontoparietal networks, whereas the AES had stronger associations with the default mode network and the goal-oriented behaviour network.
Limitations:
The study was limited by the small number of participants without apathy according to the DCA, which may have reduced the statistical power of between-group comparisons. Additionally, the reliance on specific apathy measures may have influenced the observed overlap in brain regions.
Conclusion:
Our findings indicate that apathy in LLD is consistently associated with changes in both intra-RSN and inter-RSN connectivity of brain regions implicated in goal-oriented behaviours. These results corroborate previous findings of altered functional RSN connectivity in severe LLD.
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