Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.

<h4>Background</h4>The relationship between apathy, depression and cognitive impairment in Parkinson's disease (PD) is still controversial. The objective of this study is to investigate whether apathy and depression are associated with inefficient cognitive strategies in PD.<h4&g...

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Autores principales:	Sara Varanese, Bernardo Perfetti, Maria Felice Ghilardi, Alessandro Di Rocco
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9d3fbcf6291f44429f7be66ffb3cf9e2
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spelling	oai:doaj.org-article:9d3fbcf6291f44429f7be66ffb3cf9e22021-11-18T06:57:09ZApathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.1932-620310.1371/journal.pone.0017846https://doaj.org/article/9d3fbcf6291f44429f7be66ffb3cf9e22011-03-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21437255/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The relationship between apathy, depression and cognitive impairment in Parkinson's disease (PD) is still controversial. The objective of this study is to investigate whether apathy and depression are associated with inefficient cognitive strategies in PD.<h4>Methods</h4>In this prospective clinical cohort study conducted in a university-based clinical and research movement disorders center we studied 48 PD patients. Based on clinical evaluation, they were classified in two groups: PD with apathy (PD-A group, n = 23) and PD without apathy (PD-NA group, n = 25). Patients received clinical and neuropsychological evaluations. The clinical evaluation included: Apathy Evaluation Scale-patient version, Hamilton Depression Rating Scale-17 items, the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr staging system; the neuropsychological evaluation explored speed information processing, attention, working memory, executive function, learning abilities and memory, which included several measures of recall (immediate free, short delay free, long delay free and cued, and total recall).<h4>Findings</h4>PD-A and PD-NA groups did not differ in age, disease duration, treatment, and motor condition, but differed in recall (p<0.001) and executive tasks (p<0.001). Immediate free recall had the highest predictive value for apathy (F = 10.94; p = 0.002). Depression and apathy had a weak correlation (Pearson index= 0.3; p<0.07), with three items of the depression scale correlating with apathy (Pearson index between .3 and.4; p<0.04). The depressed and non-depressed PD patients within the non-apathetic group did not differ.<h4>Conclusion</h4>Apathy, but not depression, is associated with deficit in implementing efficient cognitive strategies. As the implementation of efficient strategies relies on the fronto-striatal circuit, we conclude that apathy, unlike depression, is an early expression of executive impairment in PD.Sara VaraneseBernardo PerfettiMaria Felice GhilardiAlessandro Di RoccoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 3, p e17846 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sara Varanese Bernardo Perfetti Maria Felice Ghilardi Alessandro Di Rocco Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
description	<h4>Background</h4>The relationship between apathy, depression and cognitive impairment in Parkinson's disease (PD) is still controversial. The objective of this study is to investigate whether apathy and depression are associated with inefficient cognitive strategies in PD.<h4>Methods</h4>In this prospective clinical cohort study conducted in a university-based clinical and research movement disorders center we studied 48 PD patients. Based on clinical evaluation, they were classified in two groups: PD with apathy (PD-A group, n = 23) and PD without apathy (PD-NA group, n = 25). Patients received clinical and neuropsychological evaluations. The clinical evaluation included: Apathy Evaluation Scale-patient version, Hamilton Depression Rating Scale-17 items, the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr staging system; the neuropsychological evaluation explored speed information processing, attention, working memory, executive function, learning abilities and memory, which included several measures of recall (immediate free, short delay free, long delay free and cued, and total recall).<h4>Findings</h4>PD-A and PD-NA groups did not differ in age, disease duration, treatment, and motor condition, but differed in recall (p<0.001) and executive tasks (p<0.001). Immediate free recall had the highest predictive value for apathy (F = 10.94; p = 0.002). Depression and apathy had a weak correlation (Pearson index= 0.3; p<0.07), with three items of the depression scale correlating with apathy (Pearson index between .3 and.4; p<0.04). The depressed and non-depressed PD patients within the non-apathetic group did not differ.<h4>Conclusion</h4>Apathy, but not depression, is associated with deficit in implementing efficient cognitive strategies. As the implementation of efficient strategies relies on the fronto-striatal circuit, we conclude that apathy, unlike depression, is an early expression of executive impairment in PD.
format	article
author	Sara Varanese Bernardo Perfetti Maria Felice Ghilardi Alessandro Di Rocco
author_facet	Sara Varanese Bernardo Perfetti Maria Felice Ghilardi Alessandro Di Rocco
author_sort	Sara Varanese
title	Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
title_short	Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
title_full	Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
title_fullStr	Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
title_full_unstemmed	Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.
title_sort	apathy, but not depression, reflects inefficient cognitive strategies in parkinson's disease.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/9d3fbcf6291f44429f7be66ffb3cf9e2
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Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease.

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