Does apathy in stroke have the same basis? Whom is going to research the answer? Or is this another thing our stroke medical world is punting on?
http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00350/full?
Antonia Meyer1,
Ronan Zimmermann
1,
Ute Gschwandtner
1,
Florian Hatz1,
Habib Bousleiman1,2,
Nadine Schwarz
1 and
Peter Fuhr1*
- 1Clinical Neurophysiology, Department of Neurology, Hospital of the University of Basel, Basel, Switzerland
- 2Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
Deficits in executive functions occur in up to 93% of patients with
Parkinson's disease (PD). Apathy, a reduction of motivation and
goal-directed behavior is an important part of the syndrome; affecting
both the patients as well as their social environment.
Executive
functions can be subdivided into three different processes: initiation,
shifting and inhibition. We examined the hypotheses, (1) that apathy in
patients with Parkinson's disease is only related to initiation and not
to shifting and inhibition, and (2) that depression and severity of
motor signs correlate with apathy. Fifty-one non-demented patients (19 =
female) with PD were evaluated for apathy, depression and executive
functions. Executive function variables were summarized with an index
variable according to the defined executive processes. Linear regression
with stepwise elimination procedure was used to select significant
predictors. The significant model (
R2 = 0.41;
p < 0.01) revealed influences of initiation (
b = −0.79;
p < 0.01), gender (
b = −7.75;
p < 0.01), age (
b = −0.07;
p < 0.05) and an age by gender interaction (
b = 0.12;
p
< 0.01) on apathy in Parkinson's disease. Motor signs, depression
and level of education did not influence the relation. These results
support an association of apathy and deficits of executive function in
PD. Initiation strongly correlates with apathy, whereas depression does
not. We conclude, that initiation dysfunction in a patient with
Parkinson's disease heralds apathy. Apathy and depression can be
dissociated. Additionally, apathy is influenced by age and gender: older
age correlates with apathy in men, whereas in women it seems to protect
against it.
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