title: Apathy and impaired emotional facial recognition networks overlap in Parkinson's disease: a PET study with conjunction analyses.
abstract: Apathy is a disabling non-motor symptom that is frequently observed in Parkinson's disease (PD). Its description and physiopathology suggest that it is partially mediated by emotional impairment, but this research issue has never been addressed at a clinical and metabolic level. We therefore conducted a metabolic study using (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) in 36 PD patients without depression and dementia. Apathy was assessed on the Apathy Evaluation Scale (AES), and emotional facial recognition (EFR) performances (ie, percentage of correct responses) were calculated for each patient. Confounding factors such as age, antiparkinsonian and antidepressant medication, global cognitive functions and depressive symptoms were controlled for. We found a significant negative correlation between AES scores and performances on the EFR task. The apathy network was characterised by increased metabolism within the left posterior cingulate (PC) cortex (Brodmann area (BA) 31). The impaired EFR network was characterised by decreased metabolism within the bilateral PC gyrus (BA 31), right superior frontal gyrus (BAs 10, 9 and 6) and left superior frontal gyrus (BA 10 and 11). By applying conjunction analyses to both networks, we identified the right premotor cortex (BA 6), right orbitofrontal cortex (BA 10), left middle frontal gyrus (BA 8) and left posterior cingulate gyrus (BA 31) as the structures supporting the association between apathy and impaired EFR. These results confirm that apathy in PD is partially mediated by impaired EFR, opening up new prospects for alleviating apathy in PD, such as emotional rehabilitation.
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Robert
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Nuclear Medicine, Rennes University Hospital, Eugene Marquis Hospital Centre, Rennes, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Le Jeune
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France Department of Neurology, Rennes University Hospital, Rennes, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: Dondaine
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Neurology, Rennes University Hospital, Rennes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.affiliation: Neuroscience of Emotion and Affective Dynamics lab, Swiss Center for Affective Sciences, Geneva, Switzerland.
authors.forename: Julie
authors.initials: J
authors.lastname: Péron
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Lozachmeur
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Neurology, Rennes University Hospital, Rennes, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Sauleau
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Neurology, Rennes University Hospital, Rennes, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Houvenaghel
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France.
authors.forename: David
authors.initials: D
authors.lastname: Travers
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Millet
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Neurology, Rennes University Hospital, Rennes, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Vérin
authors.affiliation: Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
mesh_terms: D000368:Aged; D057565:Apathy / Q000502:physiology*; D001931:Brain Mapping; D005149:Facial Expression; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology* / Q000523:psychology*; D049268:Positron-Emission Tomography; D021641:Recognition, Psychology / Q000502:physiology*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Neuropsychiatry; Parkinson's Disease; Pet, Functional Imaging