Apathy as a feature of prodromal Alzheimer's disease: an FDG-PET ADNI study

Int J Geriatr Psychiatry. 2015 May;30(5):470-7. doi: 10.1002/gps.4161. Epub 2014 Jun 20.

Abstract

Objective: The goal of this study is to evaluate brain metabolism in mild cognitive impairment (MCI) patients with and without apathy (as determined by the Neuropsychiatric Inventory Questionnaire).

Methods: Baseline data from 65 MCI participants (11 with apathy and 54 without) from the Alzheimer's Disease (AD) Neuroimaging Initiative study were analyzed. All participants underwent a comprehensive cognitive and neuropsychiatric assessment, volumetric MRI and measures of cerebral glucose metabolism applying (18)F-fluorodeoxyglucose positron emission tomography at baseline. The presence of apathy at baseline was determined by the Neuropsychiatric Inventory Questionnaire.

Results: There was no difference between apathy and apathy-free MCI patients regarding cognitive assessment and neuropsychiatric measures when apathy-specific items were removed. Cerebrovascular disease load and cerebral atrophy were equivalent in both groups. Compared with the apathy-free MCI patients, MCI patients with apathy had significantly decreased metabolism in the posterior cingulate cortex.

Conclusion: The presence of apathy in MCI patients is associated with AD-specific pattern of brain metabolic defect. These results could suggest that apathy belongs to the spectrum of prodromal AD symptoms.

Keywords: Alzheimer's disease; Alzheimer's disease neuroimaging initiative (ADNI); FDG-PET; apathy; biomarker; mild cognitive impairment.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / metabolism*
  • Alzheimer Disease / physiopathology*
  • Apathy / physiology*
  • Atrophy / pathology
  • Brain / metabolism*
  • Cognitive Dysfunction / diagnostic imaging
  • Cognitive Dysfunction / metabolism*
  • Cognitive Dysfunction / physiopathology*
  • Disease Progression
  • Female
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroimaging / methods*
  • Positron-Emission Tomography / methods

Substances

  • Fluorodeoxyglucose F18