Objective: The aim of this study is to determine the prevalence, clinical and brain MRI morphological characteristics in patients with co-occurring apathy and impulse control disorders (ICDs).

Background: Apathy and ICDs are classically conceptualized as the two extremes of the spectrum of hyper- and hypo-dopaminergic behaviors in Parkinson’s disease.

Method: Patients with Parkinson’s disease from the French prospective multicentric PREDISTIM cohort (NCT02360683) were assessed for the severity of motor and non-motor symptoms, apathy (Lille Apathy Rating Scale, LARS ≥ 21), and ICDs (Ardouin Scale of Behavior in Parkinson’s disease, ASBPD ≥ 2 for hypersexuality, eating, pathological gambling, or shopping). Voxel-based morphometry and surface-based morphometry were performed using CAT12 in SPM12.

Results: Among 642 patients, 18 (2.8%) patients presented with co-occurring apathy and ICDs, with greater severity of depressive and anxious symptoms, greater complexity of motor fluctuations and lower quality of life (PDQ-39). Atrophy of the superior temporal, middle temporal, superior frontal, and anterior insular gyri was specific to patients presenting with co-occurring apathy and ICD, and distinct from the atrophy patterns associated with ICDs (75/642, 11.8%) and apathy (61/642, 9.5%).

Conclusion: Co-occurring apathy and ICDs are associated with greater clinical severity and specific atrophy involving the fronto-temporo-insular networks.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-brain-morphological-characteristics-of-patients-with-parkinsons-disease-and-co-occurring-apathy-and-impulse-control-disorders/