Abstract
Apathy is highly prevalent in Parkinson's disease. New findings suggest the syndrome is multifaceted. Here, we investigate whether all aspects of apathy are equally affected in Parkinson's disease and whether different dimensions of apathy were associated with depression and anhedonia. On the Apathy Motivation Index, while behavioral apathy and social apathy were elevated, emotional motivation was relatively preserved in Parkinson's disease, although a few patients did show impaired emotional sensitivity. Behavioral and social, but not emotional, apathy was associated with depression and anhedonia. These findings suggest aspects of motivation can be selectively impaired in Parkinson's disease and may have implications for guiding treatment.
Highlights
Apathy, a disorder of motivation characterized by reduced self-initiated goal-directed behavior,[1] is very common in Parkinson’s disease (PD) and associated with diminished quality of life.[2,3,4] Theoretical accounts[5] and new evidence[6] suggest that rather than being a unitary construct, apathy is multidimensional, involving behavioral, cognitive, executive, social, and emotional domains
Are all domains of apathy are affected in PD? and second, how are different domains of apathy associated with depression and anhedonia? PD patients exhibited greater behavioral and social apathy compared with healthy controls
Studies of anhedonia and apathy in PD are scarce and have produced mixed results of both greater anhedonia in patients with apathy,[25] and no association.[26]. We examined this relationship in a large sample and found that behavioral and social, but crucially not emotional, apathy correlated with anhedonia in PD
Summary
A disorder of motivation characterized by reduced self-initiated goal-directed behavior,[1] is very common in Parkinson’s disease (PD) and associated with diminished quality of life.[2,3,4] Theoretical accounts[5] and new evidence[6] suggest that rather than being a unitary construct, apathy is multidimensional, involving behavioral, cognitive, executive, social, and emotional domains. Apathy appears to have overlapping symptoms with other comorbid states associated with altered motivation, depression[10] and anhedonia.[11] It remains to be established whether different apathy domains in PD relate to these syndromes
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