Hedonic and Behavioral Deficits Associated with Apathy in Parkinson’s Disease: Potential Treatment Implications
Identifieur interne : 000331 ( Pmc/Curation ); précédent : 000330; suivant : 000332Hedonic and Behavioral Deficits Associated with Apathy in Parkinson’s Disease: Potential Treatment Implications
Auteurs : Lizabeth L. Jordan [États-Unis] ; Laura B. Zahodne [États-Unis] ; Michael S. Okun [États-Unis] ; Dawn Bowers [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2013.
Abstract
Many individuals with Parkinson’s disease (PD) experience apathy independent of depression. In this study we examined hedonic and behavioral deficits related to apathy in 50 PD patients and 42 healthy older adults who completed standardized measures. Regression analyses revealed that apathy was associated with anticipatory, but not consummatory, anhedonia and reduced goal-directed behavior, independent of PD diagnosis, age, education and depressive symptoms. These findings suggest that apathy is characterized by deficits in anticipatory pleasure and behavioral drive rather than consummatory pleasure or reward responsiveness. Therefore, PD patients with apathy would likely benefit from psychotherapeutic treatment that encourages structured, goal-directed plans for pleasurable events and stimulation which provide adaptive hedonic effects. In addition, given the proposed shared mechanism of dopamine depletion within the ventral striatum in apathy and anticipatory anhedonia, future trials of dopamine-eliciting activities (e.g. exercise and other non-pharmacologic methods) appear warranted to improve these symptoms in PD.
Url:
DOI: 10.1002/mds.25496
PubMed: 23712560
PubMed Central: 3760996
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Lizabeth L. Jordan<affiliation><nlm:aff id="A1">University of Florida, Center for Movement Disorders and Neurorestoration</nlm:aff>
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<affiliation wicri:level="2"><nlm:aff id="A5">Columbia University College of Physicians & Surgeons, Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, New York, NY</nlm:aff>
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<front><div type="abstract" xml:lang="en"><p id="P1">Many individuals with Parkinson’s disease (PD) experience apathy independent of depression. In this study we examined hedonic and behavioral deficits related to apathy in 50 PD patients and 42 healthy older adults who completed standardized measures. Regression analyses revealed that apathy was associated with anticipatory, but not consummatory, anhedonia and reduced goal-directed behavior, independent of PD diagnosis, age, education and depressive symptoms. These findings suggest that apathy is characterized by deficits in anticipatory pleasure and behavioral drive rather than consummatory pleasure or reward responsiveness. Therefore, PD patients with apathy would likely benefit from psychotherapeutic treatment that encourages structured, goal-directed plans for pleasurable events and stimulation which provide adaptive hedonic effects. In addition, given the proposed shared mechanism of dopamine depletion within the ventral striatum in apathy and anticipatory anhedonia, future trials of dopamine-eliciting activities (e.g. exercise and other non-pharmacologic methods) appear warranted to improve these symptoms in PD.</p>
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<contrib-group><contrib contrib-type="author"><name><surname>Jordan</surname>
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University of Florida, Center for Movement Disorders and Neurorestoration</aff>
<aff id="A2"><label>2</label>
University of Florida, Department of Clinical and Health Psychology, Gainesville, FL</aff>
<aff id="A3"><label>3</label>
University of Florida, Department of Neurology, Gainesville, FL</aff>
<aff id="A4"><label>4</label>
University of Florida, Department of Neurosurgery, Gainesville, FL</aff>
<aff id="A5"><label>5</label>
Columbia University College of Physicians & Surgeons, Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, New York, NY</aff>
<author-notes><corresp id="CR1"><label>6</label>
Address correspondence to Dawn Bowers, Ph.D., University of Florida, Department of Clinical and Health Psychology, Health Science Center, PO Box 100165, Gainesville, FL 32610-0165; <email>dawnbowers@phhp.ufl.edu</email>
.
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<issue>9</issue>
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<abstract><p id="P1">Many individuals with Parkinson’s disease (PD) experience apathy independent of depression. In this study we examined hedonic and behavioral deficits related to apathy in 50 PD patients and 42 healthy older adults who completed standardized measures. Regression analyses revealed that apathy was associated with anticipatory, but not consummatory, anhedonia and reduced goal-directed behavior, independent of PD diagnosis, age, education and depressive symptoms. These findings suggest that apathy is characterized by deficits in anticipatory pleasure and behavioral drive rather than consummatory pleasure or reward responsiveness. Therefore, PD patients with apathy would likely benefit from psychotherapeutic treatment that encourages structured, goal-directed plans for pleasurable events and stimulation which provide adaptive hedonic effects. In addition, given the proposed shared mechanism of dopamine depletion within the ventral striatum in apathy and anticipatory anhedonia, future trials of dopamine-eliciting activities (e.g. exercise and other non-pharmacologic methods) appear warranted to improve these symptoms in PD.</p>
</abstract>
<kwd-group><kwd>Parkinson’s disease</kwd>
<kwd>anhedonia</kwd>
<kwd>apathy</kwd>
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