Apathy in patients with Neuromyelitis Optica Spectrum Disorder

Apathy is a common neuropsychiatric complication of neurological diseases, but it has not been investigated in patients with neuromyelitis optica spectrum disorders (NMOSD) until now.

We enrolled 66 patients diagnosed with NMOSD and assessed apathy using the self-reported version of the Apathy Evaluation Scale (AES-S). All the patients also completed the investigations composed of demographic data, disease characteristics, and composite evaluations of life status, including anxiety/depression, fatigue, sleep, and quality of life. Further statistical analysis proceeded.

The mean AES-S score was 36.7 ± 8.3, with 40.9% of patients exhibiting clinically significant apathy (cutoff score: 36). Correlation analysis revealed that higher AES-S scores were significantly correlated with lower education attainment (p = 0.002), more number of attacks (p = 0.008), longer disease duration (p = 0.004), higher disability (p = 0.03), severer anxiety (p < 0.001), severer depression (p < 0.001), severer fatigue (p < 0.001), and severer sleep disturbances (p = 0.001). Depression was revealed to be a significant independent factor of apathy (P < 0.001). The subscales of AES-S and its correlated factors were also analyzed. Further analysis showed that the AES-S score was negatively correlated with the total score of the quality of life scale and all the sub-dimensions' scores (P < 0.05).

These results suggest that apathy is a common neuropsychiatric complication in patients with NMOSD and is closely related to their quality of life. The apathy of NMOSD correlated with various physiological and psychological changes, especially depression. These findings might help us identify patients with a high risk of apathy, highlighting the importance of evaluating and managing apathy is of great significance for improving the quality of life in NMOSD patients.