Abstract
BackgroundApathy is one of the most common non-motor symptoms of Parkinson’s disease (PD). However, its pathophysiology remains unclear.MethodsWe analyzed resting-state functional magnetic resonance imaging (MRI) data acquired at a 3.0T MRI scanner using the amplitude of low-frequency fluctuation (ALFF) metric in 20 de novo, drug-naïve, non-demented PD patients with apathy (PD-A), 26 PD patients without apathy (PD-NA) without comorbidity of depressive or anxious symptoms, and 23 matched healthy control (HC) subjects.ResultsWe found that the ALFF decreased significantly in the bilateral nucleus accumbens, dorsal anterior cingulate cortex (ACC), and left dorsolateral prefrontal cortex in patients with PD-A compared to patients with PD-NA and HC subjects. Furthermore, apathy severity was negatively correlated with the ALFF in the bilateral nucleus accumbens and dorsal ACC in the pooled patients with PD.ConclusionThe present study characterized the functional pattern of changes in spontaneous neural activity in patients with PD-A. With the aim to better elucidate the pathophysiological mechanisms responsible for these changes, this study controlled for the potentially confounding effects of dopaminergic medication, depression, anxiety, and global cognitive impairment. The findings of the current study add to the literature by highlighting potential abnormalities in mesocorticolimbic pathways involved in the development of apathy in PD.
Highlights
Apathy is one of the most common non-motor symptoms of Parkinson’s disease (PD), with a prevalence of almost 40% (Den Brok et al, 2015)
The pathophysiology of apathy in PD remains unclear, it has been hypothesized that disruptions of the basal ganglia circuits of the prefrontal cortex are heavily involved (Levy and Dubois, 2006; Pagonabarraga et al, 2015)
Using the amplitude of lowfrequency fluctuations (ALFF) approach, via rs-fMRI, we demonstrated that altered spontaneous, regional neural activity is associated with apathy in drug-naïve PD patients with “pure” apathy
Summary
Apathy is one of the most common non-motor symptoms of Parkinson’s disease (PD), with a prevalence of almost 40% (Den Brok et al, 2015). Apathy is defined as a syndrome of diminished motivation (reduced goal-directed behavior, goal-directed cognitive activity, and emotional expression) that persists over time (Robert et al, 2009). The pathophysiology of apathy in PD remains unclear, it has been hypothesized that disruptions of the basal ganglia circuits of the prefrontal cortex are heavily involved (Levy and Dubois, 2006; Pagonabarraga et al, 2015). The degeneration of dopaminergic and serotonergic pathways has been proposed as a possible pathophysiological mechanism for apathy in PD (Maillet et al, 2016). Apathy is one of the most common non-motor symptoms of Parkinson’s disease (PD).
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