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Apathy in Parkinson's Disease: More Than Just Executive Dysfunction

Published online by Cambridge University Press:  21 February 2013

Saül Martínez-Horta ,
Javier Pagonabarraga ,
Ramón Fernández de Bobadilla ,
Carmen García-Sanchez  and
Jaime Kulisevsky
Saül Martínez-Horta
Affiliation:
Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
Javier Pagonabarraga
Affiliation:
Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
Ramón Fernández de Bobadilla
Affiliation:
Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
Carmen García-Sanchez
Affiliation:
Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain
Jaime Kulisevsky*
Affiliation:
Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain Centro Investigación Biomedica en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
*
Correspondence and reprint requests to: Jaime Kulisevsky, Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Sant Antoni M. Claret 167,08025 Barcelona, Spain. E-mail: jkulisevsky@santpau.cat
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Abstract

Apathy is a frequent syndrome in Parkinson's disease (PD) usually associated with depression, cognitive impairment (CI), and dementia. Whereas executive dysfunction seems to play a major causative role in the development of apathy in PD, recent findings pointed for the possible participation of other underlying mechanisms in the development of clinically meaningful symptoms of apathy. By means of neuropsychological testing focused over global cognitive functioning, set-shifting, decision making, and cognitive effort, we compared to a control group, a carefully selected sample of PD patients presenting apathy as the only neuropsychiatric symptom and without clinically relevant signs of cognitive impairment. In addition to the previously reported executive dysfunction, apathetic patients also exhibited significant difficulties in tasks assessing for cortical functioning, such as naming and clock drawing. Moreover, apathetic patients performed significantly better on a decision-making task, although any of these differences appeared linked to a lack of effort when performing the tasks. On the basis of our findings, we discuss the possible implication of added mechanisms rather than just executive dysfunction in the development of apathy in PD. (JINS, 2013, 19, 1–12.)

Keywords

ApathyParkinson's diseaseCognitionExecutive dysfunctionRewardCognitive impairment
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 5 , May 2013 , pp. 571 - 582
Copyright
Copyright © The International Neuropsychological Society 2013

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