Functional Neuro-imaging in Apathy

  • O. Migneco
  • P. M. Koulibaly
  • M. Benoit
  • J. Darcourt
  • Philippe Robert


There is little research in the literature on functional neuro-imaging in apathy. However, the reported studies show that apathy is related to a decreased function of the anterior cingulate and connected fronto-subcortical structures. Research data and implications are presented in this chapter.


Brain SPECT Thalamic Infarction Statistical Parametric Mapping Analysis Perfusion Brain SPECT Dementia Subtype 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Alexander GE, DeLong MR, Strick PL (1986) Parallel organization of functional segregation circuits linking basal ganglia and cortex. Annu Rev Neurosci 9:357–381PubMedCrossRefGoogle Scholar
  2. Benoit M, Dygai I, Migneco O, Robert PH, Bertogliati C, Darcourt J et al (1999) Behavioral and psychological symptoms in Alzheimer’s disease. Dement Geriatr Cogn Dis 10:511–517CrossRefGoogle Scholar
  3. Benoit M, Koulibaly PM, Migneco O, Darcourt J, Pringuey DJ, Robert PH (2002) Brain perfusion in Alzheimers disease with and without apathy: a SPECT study with statistical parametric mapping analysis. Psychiatry Res Neuroimaging 114:103–111CrossRefGoogle Scholar
  4. Berrios GE, Gili M (1995) Abulia and impulsiveness revisited: a conceptual history. Acta Psychiatr Scand 92:161–167PubMedCrossRefGoogle Scholar
  5. Brown RG, Pluck G (2000) Negative symptoms: the pathology of motivation and goal-directed behavior. Trends Neurosci 23:412–417PubMedCrossRefGoogle Scholar
  6. Brunei H, Michel B, Pasquier J, Gastaut J (2003) Value of single photon emission computed tomography in the characterization of fronto-temporal dementia subtypes. J Neuroradiol 30: 37–45Google Scholar
  7. Burns A, Jacoby R, Levy R (1990) Psychiatric phenomena in Alzheimers disease II: disorders of perception. Br J Psychiatry 157:76–81PubMedCrossRefGoogle Scholar
  8. Craig AH, Cummings JL, Fairbanks L, Itti L, Miller B, Li J et al (1996) Cerebral blood flow correlates of apathy in Alzheimer disease. Arch Neuro 53:1116–1120CrossRefGoogle Scholar
  9. Cummings JL, Mega MS, Gray K, Rosemberg-Thompson S, Gornbein T (1994) The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 44: 2308–2314PubMedCrossRefGoogle Scholar
  10. Cummings JL, Diaz C, Levy M (1996) Behavioral syndromes in neurodegenerative diseases: frequency and significance. Semin Neuropsychiatry 1:241–247Google Scholar
  11. Cummings JL, Nadel A, Masterman D, Cyrus P (2001) Efficacy of metrifonate in improving the psychiatric and behavioral disturbances of patients with Alzheimers disease. J Geriatr Psychiatry Neurol 14:101–108PubMedCrossRefGoogle Scholar
  12. Engelborgsh S, Marien P, Pickut B, Verstraeten S, de Deyn P (2000) Loss of psychic self-activation after paramedian bithalamic infarction. Stroke 31:1762–1765CrossRefGoogle Scholar
  13. Kaufer D (1998) Beyond the cholinergic hypothesis: the effect of metrifonate and other cholinesterase inhibitors on neuropsychiatric symptoms in Alzheimers disease. Dement Geriatr Cogn Dis 9[Suppl 2]:8–14CrossRefGoogle Scholar
  14. Kuzis G, Sabe L, Tiberti C, Dorrego F, Starkstein SE (1999) Neuropsychological correlates of apathy and depression in patients with dementia. Neurology 52:1403–1407PubMedCrossRefGoogle Scholar
  15. Levy ML, Cummings JL, Fairbanks LA, Masterman D, Miller BL, Craig AH, et al. (1998) Apathy is not depression. J Neuropsy Clin N 10:314–319Google Scholar
  16. Marin RS (1996) Apathy: concept, syndrome, neural mechanisms and treatment. Semin Clin Neuropsychiatry 1:304–314PubMedGoogle Scholar
  17. Marin RS, Biedrzycki RC, Firinciogullari S (1991) Reliability and validity of the apathy evaluation scale. Psychiatry Res 38:143–162PubMedCrossRefGoogle Scholar
  18. Mesulam MM, Geula C (1988) Nucleus basalis (Ch4) and cortical cholinergic innervation in the human brain. J Comp Neurol 275:216–240PubMedCrossRefGoogle Scholar
  19. Mesulam MM, Mufson EJ, Levey AI, Wainer BH (1983) Cholinergic innervation of cortex by the basal forebrain: cytochemistry and cortical connections of the septal area, diagonal band nuclei, nucleus basalis and hypothalamus in the rhesus monkey. J Comp Neurol 214:170–197PubMedCrossRefGoogle Scholar
  20. Migneco O, Benoit M, Koulibaly PM, Dygai I, Bertogliati C, Desvignes P, Robert PH, Malandain G, Bussiere F, Darcourt J (2001) Perfusion brain SPECT and statistical parametric mapping analysis indicate that apathy is a cingulate syndrome: a study in Alzheimers disease and non-demented patients. Neuroimage 13:896–902PubMedCrossRefGoogle Scholar
  21. Nordberg A (1994) Use of PET technique to monitor effect of drugs in Alzheimer disease treatment. In: Giacobini E, Becker R (eds) Alzheimer disease: therapeutic strategies. Birkhauser, Boston, pp 405–412CrossRefGoogle Scholar
  22. Robert PH, Clairet S, Benoit M, Koutaich J, Bertogliati C, Tible O et al (2002) The Apathy Inventory: assessment of apathy and awareness in Alzheimers disease, Parkinsons disease and mild cognitive impairment. Int J Geriatr Psychiatry 17:1099–1105PubMedCrossRefGoogle Scholar
  23. Robert PH, Migneco O, Koulibaly M, Bertogliati C, Dygai C, Benoit M et al (2001) Cingulate and attentional correlates of apathy in Alzheimers disease. Brain Cogn 47:300–303Google Scholar
  24. Starkstein SE, Mayberg HS, Preziosi TJ, Andrezejewski P, Leiguarda R, Robinson RG (1992) Reliability, validity and clinical correlates of apathy in Parkinsons disease. J Neuropsychiatry Clin Neurosci 4:134–139PubMedGoogle Scholar
  25. Starkstein SE, Petracca G, Chemerinski E, Kremer J (2001) Syndromic validity of apathy in Alzheimers disease. Am J Psychiatry 158:872–877PubMedGoogle Scholar
  26. Stuss DT, Van Reekum R, Murphy KJ (2000) Differentiation of states and causes of apathy. Oxford University Press, New YorkGoogle Scholar
  27. Van der Werf Y, Weerts J, Jolles J, Witter M, Lindeboom J, Scheltens P (1999) Neuropsychological correlates of a right unilateral lacunar thalamic infarction. J Neurol Neurosurg Psychiatry 66:36–42CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • O. Migneco
    • 1
  • P. M. Koulibaly
    • 2
  • M. Benoit
    • 3
  • J. Darcourt
    • 4
  • Philippe Robert
    • 3
  1. 1.Service de Médecine Nucleáire de la DOUAVilleurbanneFrance
  2. 2.Service de Médecine NucléaireCentre Antoine LacassagneNice Cedex 2France
  3. 3.Service de Psychiatrie et de Psychologie MédicalePavillon J, Hôpital PasteurNice Cedex 1France
  4. 4.Laboratoire de Biophysique et de Traitement de l’ImageNice Cedex 2France

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