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P1–434: Apathy and depressive symptoms in Alzheimer's disease. Results from the European Alzheimer's Disease Consortium
Author(s) -
Robert Philippe H.,
Byrne Jane,
Aalten Pauline,
Nobili Flavio,
deDeyn Peter P.,
Bullock Roger,
Costa-Tsolaki Magdalini,
Salmon Eric,
Frisoni Giovanni,
Holmes Clive,
Mecocci Patricia
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.813
Subject(s) - apathy , depression (economics) , dementia , psychiatry , medicine , disease , anxiety , psychology , clinical psychology , economics , macroeconomics
in AD. Methods: 41 subjects with probable AD underwent FDG-PET imaging, and behavioral and cognitive assessments. The Scale for the Assessment of Negative Symptoms in Alzheimer’s Disease (SANS-AD) was administered to all subjects. Two groups were designated based on absence or presence of clinically meaningful apathy derived from SANS-AD global subscale scores. Subjects who had questionable or no avolition/apathy and social/emotional withdrawal were designated as not having apathy, while subjects who had mild-severe avolition/apathy or social/emotional withdrawal were designated as having apathy. Wholebrain voxel-wise analyses were performed using statistical parametric mapping (SPM2), yielding significance maps comparing the two groups. Results: 27 subjects did not have apathy, while 14 subjects had apathy. Mean age was 75.3 8.2 years, cognitive symptom duration 2.7 2.3 years, education 13.7 3.8 years, gender (88% male, 12% female), and MiniMental State Examination (MMSE) 19.6 6.1. SPM analysis revealed significant hypometabolism in the bilateral anterior cingulate region extending inferiorly to the medial orbitofrontal region (cluster level p 0.001), as well as in the bilateral medial thalamus (p 0.042) in subjects with apathy. Subjects with apathy had lower MMSE scores when compared to subjects without apathy (16.8 5.0 vs. 21.1 6.2, respectively, t 2.24, p 0.031). The results of the SPM analysis remained the same after covarying for the effect of MMSE score on metabolic rate. Conclusions: Apathy in AD is associated with bilateral anterior cingulate, medial orbitofrontal, and medial thalamic hypometabolism. This is one of the few PET studies to address apathy in AD, and these results reinforce the confluence of evidence from other investigational modalities in implicating medial frontal dysfunction in the neurobiology of apathy in AD and other neuropsychiatric diseases.