title: Apathy and cortical atrophy in Alzheimer's disease.
abstract: OBJECTIVE
  Apathy has been reported as the most prevalent behavioural symptom experienced in Alzheimer's disease (AD), associated with greater functional decline and caregiver distress. The aim of the current study was to investigate structural correlates of apathy in AD using magnetic resonance imaging (MRI) regional volume and regional cortical thickness measures.
  
  
  METHODS
  Semi-structured interviews were conducted with 111 AD patients and their caregivers as part of the European multi-centre study AddNeuroMed. Apathy was measured using the apathy domain of the Neuropsychiatric Inventory (NPI). All AD patients were scanned using a 1.5T MRI scanner and the images analysed using an automated analysis pipeline.
  
  
  RESULTS
  We found apathy to be the most prevalent neuropsychiatric symptom occurring in 57% of patients. Apathetic patients had significantly greater cortical thinning in left caudal anterior cingulate cortex (ACC) and left lateral orbitofrontal cortex (OFC), as well as left superior and ventrolateral frontal regions, than those without apathy symptoms.
  
  
  CONCLUSIONS
  Apathy is mediated by frontocortical structures but this is specific to the left hemisphere at least for patients in the mild to moderate stages of AD.
authors.affiliation: MRC Centre for Neurodegeneration, King's College London, Institute of Psychiatry, De Crespigny Park, UK.
authors.forename: C
authors.initials: C
authors.lastname: Tunnard
authors.forename: D
authors.initials: D
authors.lastname: Whitehead
authors.forename: C
authors.initials: C
authors.lastname: Hurt
authors.forename: L O
authors.initials: LO
authors.lastname: Wahlund
authors.forename: P
authors.initials: P
authors.lastname: Mecocci
authors.forename: M
authors.initials: M
authors.lastname: Tsolaki
authors.forename: B
authors.initials: B
authors.lastname: Vellas
authors.forename: C
authors.initials: C
authors.lastname: Spenger
authors.forename: I
authors.initials: I
authors.lastname: Kłoszewska
authors.forename: H
authors.initials: H
authors.lastname: Soininen
authors.forename: S
authors.initials: S
authors.lastname: Lovestone
authors.forename: A
authors.initials: A
authors.lastname: Simmons
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology*; D000704:Analysis of Variance; D057565:Apathy / Q000502:physiology*; D001284:Atrophy / Q000473:pathology / Q000523:psychology; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales