Imagine three different flavors of ice cream: vanilla, chocolate, and strawberry. Each flavor has its own unique characteristics and ingredients that make it distinct. In a similar way, researchers wanted to understand how apathy presents itself in three neurodegenerative motor disorders: amyotrophic lateral sclerosis (ALS), Parkinson’s disease (PD), and Huntington’s disease (HD). They carefully observed and compared apathy in patients with these disorders and explored what factors may contribute to its development. By using a specialized assessment tool called the Dimensional Apathy Scale (DAS), they were able to measure and analyze the levels of apathy in each group. What they found was fascinating! PD and HD patients were more apathetic than healthy controls, with HD patients showing particular difficulties in initiating actions and planning. Education seemed to protect against apathy in ALS, while anxiety was a risk factor for apathy across all three disorders. Cognitive inefficiency and depression also played a role in certain types of apathy. These new insights into the semiology and determinants of apathy in neurodegenerative disorders could greatly impact clinical practice and inform future research. To delve deeper into this intriguing topic, check out the full article!

BackgroundThe semiology and determinants of apathy are largely unknown across amyotrophic lateral sclerosis (ALS), Parkinson’s disease (PD), and Huntington’s disease (HD), due to both motor and non-motor confounders. This study thus aimed at (1) profiling apathy in ALS, PD, and HD and (2) exploring its clinical determinants.MaterialsConsecutive ALS (N = 99), PD (N = 73), and HD (N = 25) patients underwent a motor-free assessment of apathy (Dimensional Apathy Scale, DAS), global cognition, anxiety and depression. Function was assessed through disease-specific scales. The DAS was also completed by N = 101 healthy controls (HCs). Between-group comparisons on DAS scores were implemented by covarying for all applicable confounders. Predictive models on DAS scores were built through multiple, stepwise regressions.ResultsParkinson’s disease and HD, but not ALS, patients were more apathetic than HCs—with HD patients also selectively showing lower initiation and poorer goal-directed planning than HCs. Higher apathetic features were detected in PD and HD as compared to ALS. Education was a protective factor against apathy in ALS. Anxiety was a risk factor for global apathy in ALS, HD, and to a lesser extent, in PD, whereas, protective only toward affective disintegration in PD and ALS. Cognitive inefficiency was a risk factor toward apathy in both PD and ALS. Depression was a risk factor for executive-related apathy in PD.DiscussionThis study provides unprecedented insights into the heterogeneous semiology and determinants of apathy across ALS, PD, and HD via the DAS, in turn informing clinical practice and research.

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