title: Apathy in untreated early-stage Parkinson disease: relationship with other non-motor symptoms.
abstract: Apathy is a frequent and disabling behavioral disorder in patients with Parkinson's disease (PD). Its prevalence in treatment-naive patients with early-stage PD has not been extensively investigated. Moreover, whether apathy is related to other non-motor symptoms in early-stage PD is unknown. Our objective was to determine the prevalence and features of apathy and associated factors in a group of treatment-naive patients with early-stage PD. Ninety-five treatment-naive patients with early-stage PD participated in the study. Apathy, depression, motor symptoms, and overall cognitive efficiency were assessed. The presence of the main non-motor symptoms was checked during a detailed clinical interview. Group comparisons were carried out to investigate the association with apathy. Eighteen patients (18.95%) were diagnosed as apathetic, and five of the latter had concomitant depression. Apathetic patients had significantly more severe motor symptoms (P < 0.001) and a lower cognitive status (P = 0.032) than non-apathetic patients. When considering non-motor symptoms, apathy was significantly associated only with fatigue (P = 0.007) and anhedonia (P = 0.010), both of which were more prevalent in apathetic patients than in non-apathetic patients. In treatment-naive patients with early-stage PD, apathy was significantly associated with more severe motor symptoms and a lower cognitive status. After adjustment for these factors, apathy appeared to be a relatively isolated, independent symptom because the only other associated non-motor symptoms were fatigue and anhedonia.
authors.affiliation: Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France.
authors.forename: Kathy
authors.initials: K
authors.lastname: Dujardin
authors.forename: Carole
authors.initials: C
authors.lastname: Langlois
authors.forename: Lucie
authors.initials: L
authors.lastname: Plomhause
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Carette
authors.forename: Marie
authors.initials: M
authors.lastname: Delliaux
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Luc
authors.initials: L
authors.lastname: Defebvre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057565:Apathy / Q000502:physiology*; D003863:Depression / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology*; D018450:Disease Progression; D005221:Fatigue / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence
keywords: apathy; early untreated Parkinson's disease; fatigue; non-motor symptoms