Of course there is apathy after stroke, your doctor knows nothing about 100% recovery and does nothing. The solution is 100% recovery protocols. Your patients wouldn't have time to be apathetic if they knew they had to do 10 million reps of some exercise to get it recovered. Apathy is a secondary problem, Solve the primary problem of 100% recovery and you don't need research on this topic. You danced around the question;'Why are stroke survivors apathetic?' Answer: NO STROKE REHAB PROTOCOLS, thus the survivor doesn't see any way to get back to normal.
EXPRESS: Apathy after stroke: diagnosis, mechanisms, consequences, and treatment
Abstract
Apathy is a reduction in goal-directed activity in the cognitive, behavioural, emotional, or social domains of a patient's life, and occurs in one out of three patients after stroke. Despite this, apathy is clinically under-recognised and poorly understood. This overview provides a contemporary introduction to apathy in stroke for researchers and practitioners, covering topics including diagnosis, neurobiological mechanisms, associated consequences, and potential treatments for apathy. Apathy is often misdiagnosed as other post-stroke conditions such as depression. Accurate differential diagnosis of apathy, which manifests as reductions in initiative, and depression, which manifests as negative emotionality, is important as it informs prognosis. Research on the neurobiology of apathy suggests that there are few consistent associations between stroke lesion location and the development of apathy. These may be resolved by adopting a network neuroscience approach, which conceptualises of apathy as a pathology arising from structural or functional damage to brain networks underlying motivated behaviour. Importantly, networks can be affected by physiological changes related to stroke, including the acute infarct but also diaschisis and neurodegeneration. Aside from neurobiological changes, apathy is also associated with other negative outcome measures such as functional disability, cognitive impairment, and emotional distress, suggesting that apathy is indicative of a worse prognosis following stroke. Unfortunately, high-quality trials aimed at treating apathy are scarce. Antidepressants may have limited effects on apathy. Acetylcholine and dopamine pharmacotherapy, behavioural interventions, and transcranial magnetic stimulation may be more promising avenues for treatment.
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