Abstract

Apathy is pervasive across many neuropsychiatric disorders but is poorly characterized mechanistically, so targeted therapeutic interventions remain elusive. A key impediment has been the lack of validated assessment tools to facilitate translation of promising findings between preclinical disease models and patients. Apathy is a common symptom in Huntington's disease. Due to its established genetic basis and the availability of defined animal models, this disease offers a robust translational framework for linking motivated behavior with underlying neurobiology and an ideal context in which to evaluate a quantitative, translational apathy assessment method. In this study we therefore aimed to demonstrate the validity of using touchscreen-delivered progressive ratio tasks to mirror apathy assessment in Huntington's disease patients and a representative mouse model. To do this we evaluated Huntington's disease patients (n = 23) and age-matched healthy controls (n = 20), and male R6/1 mice (n = 23) and wildtype controls (n = 29) for apathy-like behavior using touchscreen-delivered progressive ratio tasks. The primary outcome measure of the assessment was breakpoint, defined as the highest number of touchscreen responses emitted before task engagement ceased. Patients and R6/1 mice were both found to exhibit significantly reduced breakpoints relative to their respective control groups, consistent with apathy-like behavior. This performance was also not associated with motoric differences in either species. These data demonstrate the utility of touchscreen-delivered progressive ratio tasks in detecting clinically relevant motivational deficits in Huntington's disease. This approach may offer a platform from which clinically relevant mechanistic insights concerning motivation symptoms can be derived and provide an effective route for translation of promising preclinical findings into viable therapeutic interventions.

Highlights

  • Apathy is a multidimensional construct that encompasses a wide range of clinical features, including reductions in goaldirected behavior, cognitive activity, and emotional expression [1,2,3,4]

  • We have demonstrated the potential of a fully quantitative, touchscreen-delivered motivational assessment to detect apathy-like behavior in Huntington’s disease (HD) patients and a wellcharacterized rodent disease model

  • We have shown that manifest HD patients exhibit lower breakpoints relative to healthy controls in a touchscreen progressive ratio (PR) assessment

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Summary

Introduction

Apathy is a multidimensional construct that encompasses a wide range of clinical features, including reductions in goaldirected behavior, cognitive activity, and emotional expression [1,2,3,4]. Despite its prevalence and impact on quality of life for both patients and caregivers, apathy remains a difficult symptom to treat effectively in HD, with no successful HD apathy treatment trial reported to date [17]. This is partly due to the often mixed neuropsychiatric presentation of these patients and concerns around polypharmacy related to medication interactions and side-effects leading to exacerbation of other neuropsychiatric symptoms [14, 18]. Identification of viable neuropharmacological targets and screening of prospective treatments for efficacy is challenging

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