Abstract
Apathy is defined as reduction of goal-directed behaviors and a common nuisance syndrome of neurodegenerative and psychiatric disease. The underlying mechanism of apathy implicates changes of the front-striatal circuit, but its precise alteration is unclear for apathy in healthy aged people. The aim of our study is to investigate how the frontal-striatal circuit is changed in elderly with apathy using resting-state functional MRI. Eighteen subjects with apathy (7 female, 63.7 ± 3.0 years) and eighteen subjects without apathy (10 female, 64.8 ± 3.0 years) who underwent neuropsychological assessment and MRI measurement were recruited. We compared functional connectivity with/within the striatum between the apathy and non-apathy groups. The seed-to-voxel group analysis for functional connectivity between the striatum and other brain regions showed that the connectivity was decreased between the ventral rostral putamen and the right dorsal anterior cingulate cortex/supplementary motor area in the apathy group compared to the non-apathy group while the connectivity was increased between the dorsal caudate and the left sensorimotor area. Moreover, the ROI-to-ROI analysis within the striatum indicated reduction of functional connectivity between the ventral regions and dorsal regions of the striatum in the apathy group. Our findings suggest that the changes in functional connectivity balance among different frontal-striatum circuits contribute to apathy in elderly.
Highlights
There were no significant differences between the apathy and non-apathy group in age, sex, educational status, and cognitive test scores
We found that people with apathy showed decreased functional connectivity between the ventral rostral putamen (VRP) and dorsal anterior cingulate cortex (dACC)/pre supplementary motor area (SMA), along with increased functional connectivity between the dorsal caudate (DC) and left sensorimotor area compared with people without apathy
The projections of the striatum are topographically organized, such that the ventromedial area of striatum is connected to the limbic frontal area, the dorsolateral area of striatum is connected to the motor-related frontal area, and the intermediate area of striatum, to the dACC and dorsolateral prefrontal cortex (DLPFC), which is related to cognitive process
Summary
Apathy is defined as a state of diminished motivation and goal-directed behavior, not attributable to decreased level of consciousness, cognitive impairment or emotional distress [1] Apathy occurs frequently in several neurodegenerative and neuropsychiatric disorders, and affects global cognitive function and clinical outcome [2]. Investigations of apathy mainly in neuropsychiatric diseases have been tried to explain its neural substrate with anatomical and functional alterations of brain circuits using different.
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