title: Apathy in drug-naïve patients with incident Parkinson's disease: the Norwegian ParkWest study.
abstract: Apathy is a common behavioural problem in Parkinson's disease (PD), with important clinical consequences for patients and their families. However, little is known about apathy in early PD. We examined the frequency and clinical characteristics of apathy in 175 nondemented, drug-naïve patients with newly diagnosed PD and 165 control subjects matched for age, sex and education level in Western and Southern Norway. All participants underwent a comprehensive neurological, psychiatric and neuropsychological evaluation. Apathy was diagnosed based on Neuropsychiatric Inventory assessment and recently proposed consensus criteria. Apathy was found in 22.9% of the PD patients, of whom 37.5% had significant depressive symptoms, whereas none of the control subjects were apathetic. Apathy was significantly associated with male gender, higher depression scores and more severe motor symptoms, but was not associated with greater cognitive impairment. When excluding patients with significant depressive symptoms, apathy remained significantly associated with motor severity. Approximately 50% of the caregivers of patients with apathy reported the apathetic behaviour to be at least moderately distressing. The association between apathy and motor severity in our PD cohort suggests a common underlying pathophysiological mechanism. Future studies should explore the longitudinal effect of dopamine replacement therapy on apathetic behaviour in early PD. The relationship between apathy and male gender needs further study to be fully evaluated.
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway. kenfrp@online.no
authors.forename: Kenn Freddy
authors.initials: KF
authors.lastname: Pedersen
authors.forename: Guido
authors.initials: G
authors.lastname: Alves
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Brønnick
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
authors.forename: Ole-Bjørn
authors.initials: OB
authors.lastname: Tysnes
authors.forename: Jan Petter
authors.initials: JP
authors.lastname: Larsen
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D020820:Dyskinesias / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology*; D009483:Neuropsychological Tests; D009664:Norway; D010300:Parkinson Disease / Q000453:epidemiology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors
references.citation: J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):851-7
references.pmid: 19246476
references.citation: Neuropsychologia. 2002;40(13):2257-67
references.pmid: 12417456
references.citation: J Neurol Neurosurg Psychiatry. 2009 Nov;80(11):1279-82
references.pmid: 19864662
references.citation: Mov Disord. 2006 Feb;21(2):148-58
references.pmid: 16211591
references.citation: Neurobiol Aging. 2003 Mar-Apr;24(2):197-211
references.pmid: 12498954
references.citation: Mov Disord. 2007 Apr 30;22(6):778-84
references.pmid: 17290451
references.citation: Mov Disord. 2008 Mar 15;23(4):538-46
references.pmid: 18074376
references.citation: J Neurol Neurosurg Psychiatry. 1999 Oct;67(4):492-6
references.pmid: 10486397
references.citation: Trends Neurosci. 2000 Sep;23(9):412-7
references.pmid: 10941190
references.citation: J Head Trauma Rehabil. 2005 Jul-Aug;20(4):377-88
references.pmid: 16030444
references.citation: Int Psychogeriatr. 2004 Sep;16(3):275-93
references.pmid: 15559753
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Neuropsychiatry Clin Neurosci. 1992 Spring;4(2):134-9
references.pmid: 1627973
references.citation: Mov Disord. 2008 Jan 30;23(2):183-9; quiz 313
references.pmid: 17987654
references.citation: J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):636-42
references.pmid: 12438462
references.citation: J Neurol Neurosurg Psychiatry. 2004 Sep;75(9):1323-6
references.pmid: 15314124
references.citation: J Neurol Neurosurg Psychiatry. 2007 Jan;78(1):36-42
references.pmid: 16820421
references.citation: Neurology. 2006 Jul 11;67(1):33-8
references.pmid: 16832074
references.citation: Arch Neurol. 1999 Jan;56(1):33-9
references.pmid: 9923759
references.citation: Neurology. 1967 May;17(5):427-42
references.pmid: 6067254
references.citation: Mov Disord. 2008 Oct 30;23(14):2004-14
references.pmid: 18709683
references.citation: J Neuropsychiatry Clin Neurosci. 1991 Summer;3(3):243-54
references.pmid: 1821241
references.citation: Br J Psychiatry. 1979 Apr;134:382-9
references.pmid: 444788
references.citation: Parkinsonism Relat Disord. 2009 May;15(4):295-9
references.pmid: 18801696
references.citation: Clin Neurol Neurosurg. 2009 Jun;111(5):412-4
references.pmid: 19131155
references.citation: Psychol Med. 2001 Jan;31(1):65-73
references.pmid: 11200961
references.citation: Eur Psychiatry. 2009 Mar;24(2):98-104
references.pmid: 19201579
references.citation: J Am Geriatr Soc. 1998 Feb;46(2):210-5
references.pmid: 9475452
references.citation: Neurology. 1994 Dec;44(12):2308-14
references.pmid: 7991117
references.citation: J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):928-30
references.pmid: 19608786
references.citation: Neurology. 2009 Mar 31;72(13):1121-6
references.pmid: 19020293
references.citation: Mov Disord. 2002 Mar;17(2):366-71
references.pmid: 11921125
references.citation: J Neural Transm (Vienna). 1996;103(3):349-54
references.pmid: 8739846
references.citation: Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837
references.pmid: 17542011
references.citation: Mov Disord. 2007 Jun 15;22(8):1077-92
references.pmid: 17394234
references.citation: Mov Disord. 2008 Oct 15;23(13):1889-96
references.pmid: 18709682