Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease

Lohner, Valerie; Brookes, Rebecca L.; Hollocks, Matthew J.; Morris, Robin G.; Markus, Hugh S.

doi:10.1371/journal.pone.0176943

Cited by 51 publications

(45 citation statements)

References 42 publications

(63 reference statements)

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“…[50][51][52] In addition, apathy may mediate the influence of cognitive function on QoL, which suggests that the reduction of apathy could lead to better cognitive performance or vice versa. 53 Depression and fatigue are the core predictors of psychological and physical QoL in patients with muscular diseases. 54,55 In addition, apathy, in conjunction with fatigue and depression, could promote social inhibition and the avoidance of social interactions, 56 leading to the deterioration of QoL.…”

Section: Relationships Among Cognitive Function Psychologicalmentioning

confidence: 99%

Cognitive impairment and quality of life in patients with myotonic dystrophy type 1

et al. 2017

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Section: Relationships Among Cognitive Function Psychologicalmentioning

confidence: 99%

Cognitive impairment and quality of life in patients with myotonic dystrophy type 1

et al. 2017

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“…Early evidence for the vascular apathy hypothesis was reported in studies in clinical samples with established cerebrovascular disease (eg, vascular dementia and stroke), where apathy appeared related to the general effect (or severity) of cerebrovascular damage, given that associations with specific cerebral circuitries and regions were inconsistent . Particularly, the stroke subtype of SVD (lacunar infarcts and white matter hyperintensities [WMH]) was found to be related to apathy in several other studies, independent of depression …”

Section: Introductionmentioning

confidence: 99%

Empirical support for the vascular apathy hypothesis: A structured review

Wouts

Kessel

Beekman

et al. 2019

Int J Geriat Psychiatry

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ObjectivesA systematic review of the relationship between subclinical small vessel disease (SSVD) in the general population and apathy to examine the hypothesis that apathy has a vascular basis.MethodsWe searched for studies on associations between apathy and SSVD, operationalized as white matter hyperintensities (WMH) or white matter diffusivity changes, lacunar infarcts, cerebral microbleeds, decreasing cortical thickness, and perivascular spaces, while also peripheral proxies for SSVD were considered, operationalized as ankle brachial pressure index (ABI), intima media thickness, arterial stiffness, cardio‐femoral pulse wave velocity, hypertension, or cardiovascular disease. Only eligible retrospective and prospective observational studies conducted in the general population were included.ResultsThe 14 studies eligible for review examined the associations between apathy and hypertension (3), ABI (1), arterial stiffness (1), cardiovascular disease (2), WMH (3), white matter diffusivity (2), cerebral microbleeds (1), or cortical thickness (3). Arterial stiffness and white matter diffusivity were not related to apathy, while the associations with cortical thickness were contradictory. Cross‐sectional studies in the general population did find evidence of apathy being associated with WMH, CM, cardiovascular disease, hypertension, and ABI, and cardiovascular disease was prospectively associated with apathy. The methodologies of the studies reviewed were too heterogeneous to perform meta‐analyses.ConclusionsAlthough more prospective evidence is needed and vascular depression needs to be controlled for, cardiovascular disease, hypertension, and ABI as proxies for SSVD, and WMH and cerebral microbleeds as direct measures of SSVD have been found to be associated with apathy in the general population, supporting the hypothesis of vascular apathy.

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“…Again, this hypothesis fails to explain the different involvement of the four MSCEIT scores. Typical cognitive emotional consequences of SVD include apathy, depression, executive dysfunction and memory decline, but not the impairment of perception (Brookes, Herbert, Lawrence, Morris, & Markus, ; Dobrynina et al, ; Lohner, Brookes, Hollocks, Morris, & Markus, ), and thus, from this biological point of view, an association with emotional regulation rather than with the understanding of emotions would be more expected. Third, in the current study we took a general measure of white matter integrity derived from the regions most commonly involved in SVD, and did not investigate the integrity of the tracts originating from the insula.…”

Section: Discussionmentioning

confidence: 99%

The ability to understand emotions is associated with interoception‐related insular activation and white matter integrity during aging

et al. 2020

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Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in elderly people. While most research focuses on the role of the classical vascular risk factors in SVD, a description of the psychophysiological mechanisms leading to the age-related brain damage may open new possibilities for prophylaxis. In the current study, we evaluated the associations between emotional abilities, interoception, and age-related vascular white matter degeneration. The work was influenced, first, by multiple studies recognizing alexithymia as a cardiovascular risk factor; second, by theories of emotions linking body's allostasis and emotional regulation; and third, by neuroimaging data highlighting the shared role of the insular cortex in interoceptive and emotional processing. In a sample of older female adults (N = 30), we performed the Mayer-Salovey-Caruso Emotional Intelligence Test, functional MRI using the heartbeat detection task, and evaluation of white matter microstructural integrity using diffusion weighted imaging. The ability to understand and analyze emotions-one of the four components of emotional intelligence-was found to be associated with higher interoception-related activation of the right anterior insula and preserved white matter microstructure. We interpret these results in light of the concept of Embodied Predictive Interoception Coding, which proposes that emotional processing, interoception, and allostasis (antecedent top-down regulation of the body's internal milieu) may rely on the shared neural mechanisms of predictive coding. The study demonstrates feasibility of the investigation of cerebrovascular diseases form a psychophysiological perspective and calls for future research.

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Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease

Cited by 51 publications

References 42 publications

Cognitive impairment and quality of life in patients with myotonic dystrophy type 1

Cognitive impairment and quality of life in patients with myotonic dystrophy type 1

Empirical support for the vascular apathy hypothesis: A structured review

The ability to understand emotions is associated with interoception‐related insular activation and white matter integrity during aging

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