title: Microstructural alteration of the anterior cingulum is associated with apathy in Alzheimer disease.
abstract: OBJECTIVE
  To identify regional alterations of white matter integrity associated with apathy in Alzheimer disease (AD).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University Dementia Clinic.
  
  
  METHODS
  Fifty-one very mild or mild probable AD subjects.
  
  
  METHODS
  Volumetric magnetic resonance imaging with diffusion tensor imaging.
  
  
  METHODS
  Volume of interest analyses were performed to compare regional fractional anisotropy (FA) between apathy and apathy-free group, and to test linear relationship between regional FA and apathy severity. Apathy was assessed by the Neuropsychiatric Inventory.
  
  
  RESULTS
  Apathy group showed significantly lower FA values than apathy-free group in the left anterior cingulum (A-C), regardless of concomitant depression and psychotropic medications. Left A-C FA values also had significant linear relationship with apathy-composite scores as a measure of apathy severity, even after controlling gray matter density of the ipsilateral anterior cingulate cortex.
  
  
  CONCLUSIONS
  Our findings support that communication failure between the anterior cingulate cortex and other brain structures via the A-C contributes to the development and aggravation of apathy in AD, additionally supporting the general notion of disconnection syndrome for clinical manifestation of AD.
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jee Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Dong Young
authors.initials: DY
authors.lastname: Lee
authors.forename: Il Han
authors.initials: IH
authors.lastname: Choo
authors.forename: Eun Hyun
authors.initials: EH
authors.lastname: Seo
authors.forename: Shin Gyeom
authors.initials: SG
authors.lastname: Kim
authors.forename: Shin Young
authors.initials: SY
authors.lastname: Park
authors.forename: Jong Inn
authors.initials: JI
authors.lastname: Woo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D057565:Apathy / Q000502:physiology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000033:anatomy & histology* / Q000503:physiopathology; D006801:Humans; D056784:Leukoencephalopathies / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000033:anatomy & histology / Q000503:physiopathology