Abstract
Apathy predicts poor outcomes in older adults, and its underlying neural mechanism needs further investigation. We examined the association between symptoms of apathy and functional connectivity (FC) in older adults without stroke or dementia. Participants included 48 individuals (mean age = 70.90) living independently in the community, who underwent resting-state fMRI and completed the Apathy Evaluation Scale (AES). Seed-to-voxel analysis (cluster-level p-FDR <0.05, voxel threshold p < 0.001) tested the association between AES scores and the whole-brain FC of brain regions involved in reward- and salience-related processing. We found that AES scores were negatively associated with FC of the right insula cortex and right anterior temporal regions (124 voxels, t = −5.10) and FC of the left orbitofrontal cortex and anterior cingulate regions (160 voxels, t = −5.45), and were positively associated with FC of the left orbitofrontal cortex and left lateral prefrontal (282 voxels, t = 4.99) and anterior prefrontal (123 voxels, t = 4.52) regions. These findings suggest that apathy in older adults may reflect disruptions in neural connectivity involved in reward- and salience-related processing.
Highlights
Apathy is a multi-domain syndrome, with motivational deficits and declines in goal-directed behavior as its chief symptoms (Marin, 1991)
Apathy Evaluation Scale (AES) scores were negatively associated with functional connectivity (FC) of the right IC and a cluster in the anterior temporal regions [cluster 1: 124 voxels; peak voxel Montreal Neurological Institute (MNI) coordinates: 52, 14, −28; t(45) = −5.10], including the right temporal pole (84 voxels) and right anterior middle temporal gyrus (25 voxels)
The current study investigated the association between apathy and resting-state FC of the regions of interest (ROIs) derived from the neural correlates of apathy in the context of neurological and psychiatric disorders
Summary
Apathy is a multi-domain syndrome, with motivational deficits and declines in goal-directed behavior as its chief symptoms (Marin, 1991). Reviews integrating structural and functional correlates of apathy across different disorders have identified regions commonly associated with apathy, including the anterior cingulate cortex (ACC), ventral striatum (nucleus accumbens; NAcc), thalamus, orbitofrontal cortex (OFC), and insula (IC) (Kos et al, 2016; Le Heron et al, 2018; Pimontel et al, 2020) These are considered key nodes in networks responsible for decision-making, initiating effortful activities, and reward- and salience-related processing (Kos et al, 2016; Le Heron et al, 2018; Pimontel et al, 2020). We explored brain structures identified by the recent comprehensive reviews (described above) as seed regions of interest (ROIs), as evidence from disorders prevalent in older adults could be informative in studying healthy older individuals
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