Deniz Büyükgök1, Zübeyir Bayraktaroğlu2, H Seda Buker3, M Işın Baral Kulaksızoğlu1, İ Hakan Gurvit4. 1. Department of Psychiatry, Geriatric Psychiatry Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey. 2. Department of Physiology, İstanbul Medipol University International School of Medicine, İstanbul, Turkey;Regenerative and Restorative Medicine Research Center (REMER), Istanbul University, İstanbul, Turkey. 3. Department of Neurology, Behavioral Neurology and Movement Disorders Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey. 4. Department of Neurology, Behavioral Neurology and Movement Disorders Unit, İstanbul University İstanbul School of Medicine, İstanbul, Turkey;Hulusi Behcet Life Sciences Laboratory, Istanbul University, İstanbul, Turkey.
Abstract
PURPOSE: Diagnosis of comorbid psychiatric conditions are a significant determinant for the prognosis of neurodegenerative diseases. Apathy, which is a behavioral executive dysfunction, frequently accompanies Alzheimer's disease (AD) and leads to higher daily functional loss. We assume that frontal lobe hypofunction in apathetic AD patients are more apparent than the AD patients without apathy. This study aims to address the neuroanatomical correlates of apathy in the early stage of AD using task-free functional magnetic resonance imaging (MRI). METHODS: Patients (n=20) were recruited from the Neurology and Psychiatry Departments of İstanbul University, İstanbul School of Medicine whose first referrals were 6- to 12-month history of progressive cognitive decline. Patients with clinical dementia rating 0.5 and 1 were included in the study. The patient group was divided into two subgroups as apathetic and non-apathetic AD according to their psychiatric examination and assessment scores. A healthy control group was also included (n=10). All subjects underwent structural and functional MRI. The resting-state condition was recorded eyes open for 5 minutes. RESULTS: The difference between the three groups came up in the pregenual anterior cingulate cortex (pgACC) at the trend level (P = 0.056). Apathetic AD group showed the most constricted activation area at pgACC. CONCLUSION: The region in and around anterior default mode network (pgACC) seems to mediate motivation to initiate behavior, and this function appears to weaken as the apathy becomes more severe in AD.
PURPOSE: Diagnosis of comorbid psychiatric conditions are a significant determinant for the prognosis of neurodegenerative diseases. Apathy, which is a behavioral executive dysfunction, frequently accompanies Alzheimer's disease (AD) and leads to higher daily functional loss. We assume that frontal lobe hypofunction in apathetic ADpatients are more apparent than the AD patients without apathy. This study aims to address the neuroanatomical correlates of apathy in the early stage of AD using task-free functional magnetic resonance imaging (MRI). METHODS:Patients (n=20) were recruited from the Neurology and Psychiatry Departments of İstanbul University, İstanbul School of Medicine whose first referrals were 6- to 12-month history of progressive cognitive decline. Patients with clinical dementia rating 0.5 and 1 were included in the study. The patient group was divided into two subgroups as apathetic and non-apathetic AD according to their psychiatric examination and assessment scores. A healthy control group was also included (n=10). All subjects underwent structural and functional MRI. The resting-state condition was recorded eyes open for 5 minutes. RESULTS: The difference between the three groups came up in the pregenual anterior cingulate cortex (pgACC) at the trend level (P = 0.056). Apathetic AD group showed the most constricted activation area at pgACC. CONCLUSION: The region in and around anterior default mode network (pgACC) seems to mediate motivation to initiate behavior, and this function appears to weaken as the apathy becomes more severe in AD.
Authors: O Migneco; M Benoit; P M Koulibaly; I Dygai; C Bertogliati; P Desvignes; P H Robert; G Malandain; F Bussiere; J Darcourt Journal: Neuroimage Date: 2001-05 Impact factor: 6.556