The relationships between apathy and executive dysfunction in multiple sclerosis

Neuropsychology. 2016 Sep;30(6):767-74. doi: 10.1037/neu0000279. Epub 2016 Apr 7.

Abstract

Background: Neuropsychiatric symptoms are common in multiple sclerosis (MS). Among these, apathy is relatively frequent but its relationships with cognitive dysfunctions have been poorly investigated.

Objective: To explore cognitive correlates of apathy with or without depression ("pure apathy") in MS patients.

Material and method: Nondemented MS patients (n = 125), consecutively referred to the Multiple Sclerosis Center of Moscati Hospital, in Avellino, Italy, underwent the Apathy Evaluation Scale Self-Rated (AES-S), the Hamilton Depression Rating Scale (HDRS), and a comprehensive neuropsychological battery.

Results: According to cut-off scores of AES-S (≥36), of HDRS (≥15) and criteria for diagnosis of apathy and major depression, the sample was divided into 4 subgroups: 49 patients without apathy or depression (A-D-), 20 patients with "pure" apathy (A+D-), 29 patients with depression only (A-D+), and 27 patients with apathy and depression (A+D+). Cognitive performance significantly differed in the 4 groups: in particular MS patients with apathy (A+D- and A+D+) performed significantly worse on executive tasks than patients without apathy, whereas patients with "pure" apathy (A+D-) performed significantly worse than patients without apathy only on executive tasks tapping cognitive control abilities.

Conclusions: We found a significant relationship between apathy and dysexecutive defects in MS, consistent with the hypothesis that dysfunctions of prefrontal cortico-subcortical circuits contribute to specific neuropsychiatric syndromes in MS patients. (PsycINFO Database Record

MeSH terms

  • Adult
  • Aged
  • Apathy / physiology*
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology*
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / physiopathology*
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / physiopathology*
  • Young Adult