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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Frontal-subcortical circuits provide a comprehensive framework for understanding the anatomy, biochemistry, and pharmacology of behavior. The three principal behaviorally relevant circuits originate in the dorsolateral prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex, respectively. Circuit-specific marker behaviors associated with each circuit are executive dysfunction (dorsolateral prefrontal-subcortical circuit), disinhibition and OCD (orbitofrontal-subcortical circuit), and apathy (medial frontal-subcortical circuit). Environmental dependency is common to all prefrontal-subcortical syndromes and may reflect disruption of working memory. Depression, mania, and psychosis are mediated by structures involved in prefrontal-subcortical circuits and are circuit-related but not circuit-specific behaviors. The actions of PCP, LSD, serotonergic antidepressants, anxiolytics, sedative-hypnotics, antipsychotic agents, and ethanol may all be partially or primarily mediated through transmitter systems and receptor effects expressed through frontal-subcortical circuits.
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PMID:Anatomic and behavioral aspects of frontal-subcortical circuits. 859 19

Noncognitive symptoms contribute prominently to the morbidity of demeting illnesses. CT, MRI, SPECT, and PET are powerful tools used to examine cerbral structure and function and can be utilized to help advance understanding of brain-behavior relationships. Recently, investigators have used neurimaging techniques to study the relationship between structural or functional cerebral deficits and noncognitive symptoms such as depressed mood, delusions, hallucinations, and agitated or disinhibited behaviors that occur in patients with dementia. Although the methodology and subsequent results of studies have varied, three tentative conclusions emerge: (1) Disinhibited and inappropriate social behaviors are most prominent among patients with neuorimaging evidence of frontal cortical dysfunction, across diagnostic categories of dementia syndromes; (2) Depressed mood, apathy, and blunted affect are associated with structural lesions in subcortical nuclei. Frontal cortical dysfunction may be crucial to the development of mood symptoms that result from subcortical lesions; (3) Delusions are associated with dysgunction of paralimbic or heteromodal association areas in the frontal or temporal cortex in patients wtih dementia. The collective neuroimaging evidence suggests that psychiatric and behavioral symptoms in dementia are not random consequences of diffuse brain illness, but are fundamental expressions of regional cerebral pathology. Further development of neuroimaging techniques, more focused neurimaging study designs, and corroboration with neuropathologic studies will help to clarify the pathophysiologic mechanisms involved in neuropsychiatric symptoms and will suggest opportunities for therapeutic intervention.
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PMID:Behavioral Syndrome in Dementia: Neuroimaging Insights. 1032 Apr 29

Positron emission tomography was used to evaluate 3 Alzheimer's disease (AD) patients: 1 with major depression, 1 with emotional lability, and 1 with apathy. Compared with 5 non-mood-disordered AD patients, the patient with depression had diminished relative regional cerebral blood flow (rel-CBF) in the anterior cingulate and superior temporal cortices, bilaterally. This patient also showed diminished rel-CBF in the left dorsolateral prefrontal and right medial temporal and parietal cortices. The patient with emotional lability had diminished rel-CBF in the anterior cingulate and dorsolateral prefrontal cortices, bilaterally, and left basal ganglia. The patient with apathy had diminished rel-CBF in the basal ganglia and dorsolateral prefrontal cortex, bilaterally. Results are consistent with the hypothesis of a common frontal-temporal-subcortical substrate (e.g., involving aminergic nuclei) in the etiology of depression in AD. Frontal-subcortical dysfunction may also be associated with emotional lability and apathy in AD, although these may be related to a greater involvement of frontal-basal ganglia circuits.
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PMID:Psychiatric symptoms associated with cortical-subcortical dysfunction in Alzheimer's disease. 1120 30

Frontal-subcortical circuits form the principal network, which mediate motor activity and behavior in humans. Five parallel frontal-subcortical circuits link the specific areas of the frontal cortex to the striatum, basal ganglia and thalamus. These frontal-subcortical circuits originate from the supplementary motor area, frontal eye field, dorsolateral prefrontal region, lateral orbitofrontal region and anterior cingulate portion of the frontal cortex. The open afferent and efferent connections to the frontal-subcortical circuits mediate coordination between functionally similar areas of the brain. Specific chemoarchitecture and multiple neurotransmitter interactions modulate the functional activity of each circuit. Dorsolateral prefrontal circuit lesions cause executive dysfunction, orbitofrontal circuit lesions lead to personality changes characterized by disinhibition and anterior cingulate circuit lesions present with apathy. The neurobiological correlates of neuropsychiatric disorders including depression, obsessive-compulsive disorder, schizophrenia and substance abuse, imply involvement of frontal-subcortical circuits.
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PMID:Frontal-subcortical neuronal circuits and clinical neuropsychiatry: an update. 1216 39

Schizophrenia patients often exhibit impairments in executive functioning on formal testing and exhibit behaviors consistent with executive/frontal impairment in daily life. The Frontal Systems Behavior Scale (FrSBe) assesses behaviors associated with frontal lobe damage including executive dysfunction, apathy and disinhibition. We examined the reliability and validity of the FrSBe in 131 schizophrenia outpatients. Subjects were rated on the FrSBe and received symptom, cognitive and functional assessments. Statistical tests were corrected for multiple comparisons. The FrSBe was found to have good internal consistency and test-retest reliability. All three dimensions of the FrSBe (i.e. executive dysfunction, apathy and disinhibition) were significantly correlated with poor adaptive functioning as measured by the Social and Occupational Functioning Scale and the Functional Needs Assessment. In addition, differential relationships were found for apathy and disinhibition with symptoms as rated from the Brief Psychiatric Rating Scale and with cognitive variables including Trails B and verbal fluency scores. A multivariate analysis of variance examined differences on the FrSBe between patients and a group of 51 education-matched controls. Patients had significantly greater impairment on the FrSBe than controls. These differences were found for all FrSBe subscales. Results support the use of the FrSBe to characterize goal-directed behavior in schizophrenia patients.
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PMID:Frontal Systems Behavior Scale in schizophrenia: relationships with psychiatric symptomatology, cognition and adaptive function. 1255 79

The Frontal Systems Behavior Scale (FrSBe), formerly called the Frontal Lobe Personality Scale (FLOPS), is a brief behavior rating scale with demonstrated validity for the assessment of behavior disturbances associated with damage to the frontal-subcortical brain circuits. The authors report an exploratory principal factor analysis of the FrSBe-Family Version in a sample including 324 neurological patients and research participants, of which about 63% were diagnosed with neurodegenerative diseases (Huntington's, Parkinson's, and Alzheimer's diseases). The three-factor solution accounted for a modest level of variance (41%) and confirmed a factor structure consistent with the three subscales proposed on the theoretical basis of the frontal systems. Most items (83%)from the FrSBe subscales of Apathy, Disinhibition, and Executive Dysfunction loaded saliently on three corresponding factors. The FrSBe factor structure supports its utility for assessing both the severity of the three frontal syndromes in aggregate and separately.
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PMID:Factor analysis of the frontal systems behavior scale (FrSBe). 1267 87

Credit card use often involves a disadvantageous allocation of finances because they allow for spending beyond means and buying on impulse. Accordingly they are associated with increased bankruptcy, anxiety, stress, and health problems. Mounting evidence from functional neuroimaging and clinical studies implicates prefrontal-subcortical systems in processing financial information. This study examined the relationship of credit card debt and executive functions using the Frontal System Behavior Scale (FRSBE). After removing the influences of demographic variables (age, sex, education, and income), credit card debt was associated with the Executive Dysfunction scale, but not the Apathy or Disinhibition scales. This suggests that processes of conceptualizing and organizing finances are most relevant to credit card debt, and implicates dorsolateral prefrontal dysfunction.
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PMID:Prefrontal system dysfunction and credit card debt. 1537 Jan 89

This review presents data showing that apathy is common across a number of disorders. Apathy is not only common, but is also associated with significant problems: reduced functional level, decreased response to treatment, poor illness outcome, caregiver distress, and chronicity. Preliminary evidence of treatment efficacy exists for dopaminergic drugs and for amphetamines. Strong evidence of efficacy exists for acetylcholinesterase inhibitors in Alzheimer's disease, and for atypical antipsychotics in schizophrenia. Frontal-subcortical system(s) dysfunction is implicated in the causation of apathy; apathy subtypes based on the various frontal-subcortical loops may thus exist. Further research involving diagnosis, pathophysiology, and treatment is suggested.
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PMID:Apathy: why care? 1574 78

We compared the performance of 40 patients with frontal lobe dementia to that of 40 patients with subcortical vascular dementia (80 patients including, 46 men and 34 women) in a set of tasks assessing attentional, executive, and behavioural tasks. The frontal lobe dementia represents an important cause for degenerative disruption and is increasingly recognised as an important form (up to 25%) of degenerative dementia among individuals of late-middle-age. The main involvement is the frontal-subcortical pathway, which is the final target of impairment even in subcortical vascular dementia. A wider involvement of the cortical (decisional) layers in frontal dementia, in contrast with the prominent and widespread involvement of the subcortical pathways (refinement and corrections programs) creates the different profiles of the two groups. Frontal patients have more difficulties in abstract reasoning, focusing attention, and implementing strategies to solve problems. They exhibit more profound behavioural alterations in personality and social conduct and show only moderate depression, and a total lack of insight concerning their dinical condition. In contrast, the patients with subcortical vascular dementia have poor general cognitive functions, high insight, and important depression and apathy as the principal and most salient characteristic of their behavioral conduct.
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PMID:Frontal lobe dementia and subcortical vascular dementia: a neuropsychological comparison. 1582 17

Increasing evidence indicates that substance abusers are impaired in cognitive-executive control tasks relying on different functional systems converging in the prefrontal cortex (PFC). Different PFC functional systems relevant to addiction have been described: the dorsolateral (DLC), orbitofrontal (OFC), and anterior cingulate (ACC) circuits. Each system is associated with different behavioral, cognitive, and emotional deficits, including apathy, disinhibition, and executive dysfunction. In this study, we examined the effects of severity of use of different drugs on apathy, disinhibition and executive dysfunction behavioral deficits as measured by the Frontal Systems Behavior Scale (FrSBe). The FrSBe, and a severity of substance use interview were administered to 32 poly-substance abusers. Multiple regression analyses showed that severity of cannabis use significantly predicted greater apathy and executive dysfunction behavior; and that severity of cocaine use significantly predicted greater disinhibition behavior. These results are consistent with previous studies using cognitive measures and support the notion that severity of substance use significantly affects behavioral symptoms associated with PFC systems functioning. These clinical symptoms should be specifically addressed during rehabilitation.
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PMID:Differential impact of severity of drug use on frontal behavioral symptoms. 1632 22


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