title: Apathy in Parkinson's disease: more than just executive dysfunction.
abstract: Apathy is a frequent syndrome in Parkinson's disease (PD) usually associated with depression, cognitive impairment (CI), and dementia. Whereas executive dysfunction seems to play a major causative role in the development of apathy in PD, recent findings pointed for the possible participation of other underlying mechanisms in the development of clinically meaningful symptoms of apathy. By means of neuropsychological testing focused over global cognitive functioning, set-shifting, decision making, and cognitive effort, we compared to a control group, a carefully selected sample of PD patients presenting apathy as the only neuropsychiatric symptom and without clinically relevant signs of cognitive impairment. In addition to the previously reported executive dysfunction, apathetic patients also exhibited significant difficulties in tasks assessing for cortical functioning, such as naming and clock drawing. Moreover, apathetic patients performed significantly better on a decision-making task, although any of these differences appeared linked to a lack of effort when performing the tasks. On the basis of our findings, we discuss the possible implication of added mechanisms rather than just executive dysfunction in the development of apathy in PD.
authors: Neurology Department, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona. Barcelona, Spain.
authors: Saül
authors: S
authors: Martínez-Horta
authors: Javier
authors: J
authors: Pagonabarraga
authors: Ramón
authors: R
authors: Fernández de Bobadilla
authors: Carmen
authors: C
authors: García-Sanchez
authors: Jaime
authors: J
authors: Kulisevsky
mesh_terms: D000368:Aged; D057565:Apathy; D001288:Attention; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000209:etiology*; D003657:Decision Making; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D012044:Regression Analysis