Objective: We aimed to explore the neuroanatomical correlates of isolated apathy in PD by means of voxel-based morphometry (VBM) analysis and its correlates with other clinical measures of interest.

Background: Apathy is a common and debilitating behavioral disturbance that could be early identified in Parkinson’s disease (PD). However, little is known about the neuroanatomical correlates of this entity, specifically when focusing on non-demented and non-depressed patients.

Methods: We compared the grey matter (GM) changes between a sample of eighteen non-demented and non-depressed PD patients with apathy and eighteen well matched non-apathetic patients. We assessed anxiety, depression and cognitive performance and the identified regions of interest were used in a regression analysis with all the captured variables.

Results: Whereas no differences appeared for any of the assessed clinical and socio-demographic variables, apathetic patients showed a significant loss of GM volume involving the left nucleus accumbens (NAcc), left inferior parietal lobule (BA40), left superior parietal gyrus (BA7), left inferior orbital prefrontal cortex (BA47), right postcentral gyrus (BA 3), right insular cortex and right supplementary motor area. GM loss at NAcc significantly correlated with measures of cognitive performance whereas BA47 appeared related to depressive symptoms.

Conclusions: In non-demented and non-depressed PD patients, apathy is linked to a significant reduction of GM volume in a set of brain regions revealing a critical role of the mesocortico-limbic system. Volumetric changes in posterior-cortical structures and the relation of apathy with cognitive performance reinforce the concept on the possible prodromal significance of apathy heralding future cognitive deterioration.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuroanatomical-correlates-of-apathy-in-non-demented-and-non-depressed-parkinsons-disease/