title: Neuropsychiatric symptoms in Alzheimer's disease: What might be associated brain circuits?
abstract: Neuropsychiatric symptoms (NPS) are very common in Alzheimer's disease (AD), particularly agitation, apathy, depression, and delusions. Brain networks or circuits underlying these symptoms are just starting to be understood, and there is a growing imaging and neurochemical evidence base for understanding potential mechanisms for NPS. We offer a synthetic review of the recent literature and offer hypotheses for potential networks/circuits underlying these NPS, particularly agitation, apathy, and delusions. Agitation in AD appears to be associated with deficits in structure and function of frontal cortex, anterior cingulate cortex, posterior cingulate cortex, amygdala, and hippocampus, and may be associated with mechanisms underlying misinterpretation of threats and affective regulation. Apathy in AD is associated with frontal cortex, anterior cingulate cortex, posterior cingulate cortex, as well as orbitofrontal cortex, and inferior temporal cortex, and may be associated with mechanisms underlying avoidance behaviors.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins School of Medicine, USA. Electronic address: prosenb9@jhmi.edu.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Rosenberg
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins School of Medicine, USA.
authors.forename: Milap A
authors.initials: MA
authors.lastname: Nowrangi
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins School of Medicine, USA.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D000544:Alzheimer Disease / Q000150:complications / Q000503:physiopathology*; D000679:Amygdala / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology*; D003702:Delusions / Q000209:etiology / Q000503:physiopathology*; D003863:Depression / Q000209:etiology / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D059906:Neuroimaging
keywords: Agitation; Alzheimer's disease; Amygdala; Anterior cingulate cortex; Apathy; Delusions; Depression; Functional imaging; Inferior temporal cortex; Insula; Neuroimaging; Neuropsychiatric symptoms; Orbitrofrontal cortex; Posterior cingulate cortex