Apathy following traumatic brain injury: A review

Abstract

Apathy is a common problem after traumatic brain injury (TBI) and can have a major impact on cognitive function, psychosocial outcome and engagement in rehabilitation. For scientists and clinicians it remains one of the least understood aspects of brain-behaviour relationships encompassing disturbances of cognition, motivation, emotion and action, and is variously an indication of organic brain disease or psychiatric disorder. Apathy can be both sign and symptom and has been proposed as a diagnosis in its own right as well as a secondary feature of other conditions. This review considers previous approaches to apathy in terms of relevant psychological constructs and those neural counterparts most likely to be implicated after TBI. Neurobehavioural disorders of apathy are characterised chiefly by dysfunction of executive control of goal-oriented behaviour or the neural substrates of reward-based and emotional learning. We argue that it is possible to distinguish a primary disorder of apathy as an organic neurobehavioural state from secondary presentations due to an impoverished environment or psychological disturbance which has implications for treatment.

Can we predict amyloid deposition by objective cognition and regional cerebral blood flow in patients with subjective cognitive decline?

“…Apathy can be defined as a ‘lack of motivation that is not attributable to diminished level of consciousness, cognitive impairment, or emotional distress’ . The association between apathy and cognitive function has been reported in various neuropsychiatric diseases including schizophrenia, major depressive disorder and traumatic brain injury . In addition to our result, these findings suggest that this relationship may exist in the trans‐diagnostic populations.…”

“…35 The association between apathy and cognitive function has been reported in various neuropsychiatric diseases including schizophrenia, major depressive disorder and traumatic brain injury. [36][37][38] In addition to…”

Neurobehavioral Initiation and Motivation Problems After Acquired Brain Injury

“…There is no obvious relationship between the brain injury severity and the appearance of apathy. Moreover, apathy is generally unrelated to time since injury and has no significant association with either age at injury or educational level (22). Prigatano (23) described the psychosocial problems associated with lack of motivation, also termed amotivation or adynamia, in patients with ABI.…”

Apathy Is Related to Cognitive Control and Striatum Volumes in Prodromal Huntington’s Disease

“…The regions of the brain associated with these functions are the prefrontal cortex, the caudate, and the putamen, such that individuals with lesions or atrophy in these regions often experience impairment in planning and cognitive control (Bhatia & Marsden, 1994; Mendez et al, 1989; Monchi, Petrides, Strafella, Worsley, & Doyon, 2006; Pauli, O’Reilly, Yarkoni, & Wager, 2016; Robertson, Hiebert, Seergobin, Owen, & MacDonald, 2015). In a variety of neurodegenerative diseases and states of neuronal injury, such as Parkinson’s disease, stroke, and traumatic brain injuries, caudate and putamen atrophy correlate with apathy such that as striatum volume decreases, apathy increases (Carriere et al, 2014; Kos, van Tol, Marsman, Knegtering, & Aleman, 2016; Pagonabarraga, Kulisevsky, Strafella, & Krack, 2015; Worthington & Wood, 2018).…”