Apathy and Depression: Separate Factors in Parkinson's Disease

Overview

Journal J Int Neuropsychol Soc

Publisher Cambridge University Press

Specialties Neurology
Psychology

Date 2011 Nov 2

PMID 22040900

Citations 51

Authors

Lindsey Kirsch-Darrow

Michael Marsiske

Michael S Okun

Russell Bauer

Dawn Bowers

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to test the hypothesis that apathy and depression are dissociable in Parkinson disease (PD) by conducting a confirmatory factor analysis (CFA) of items from two commonly used mood scales. A total of 161 non-demented PD patients (age = 64.1; ± 8.4 years) were administered the Apathy Scale and the Beck Depression Inventory-II. Items were hypothesized to load onto four factors: (1) an apathy factor representing loss of motivation, (2) dysphoric mood factor representing sadness and negativity, (3) loss of interest/pleasure factor representing the features common to both apathy and depression, and (4) a somatic factor representing bodily complaints. Results indicated a good fit for the overall CFA model, χ² (128, N = 146) = 194.9; p<.01. RMSEA was .060 (p = .16). The four-factor model was significantly better than all alternative nested models at p < .001, including an overarching single factor model, representing "depression." Results support the concept that apathy and depression are discrete constructs. We suggest a "factor based" scoring of the Apathy Scale and Beck Depression Inventory-II that disentangles symptoms related to apathy, depression, overlapping symptoms, and somatic complaints. Such scoring may be important in providing useful information regarding differential treatment options.

Citing Articles

Apathy and Impulsivity Co-Occur in Huntington's Disease.

Morris L, Horne K, Paermentier L, Buchanan C, Macaskill M, Myall D Brain Behav. 2024; 14(10):e70061.

PMID: 39344371 PMC: 11440026. DOI: 10.1002/brb3.70061.

Decision cost hypersensitivity underlies Huntington's disease apathy.

Morris L, Horne K, Manohar S, Paermentier L, Buchanan C, Buchanan C Brain. 2024; 148(3):861-874.

PMID: 39269457 PMC: 11884755. DOI: 10.1093/brain/awae296.

A Cognitive-Behavioral Model of Apathy in Parkinson's Disease.

Plant O, Kienast A, Drew D, Slavkova E, Muhammed K, Kennerley H Parkinsons Dis. 2024; 2024:2820257.

PMID: 39247682 PMC: 11380718. DOI: 10.1155/2024/2820257.

Treatment of Apathy in Parkinson's Disease and Implications for Underlying Pathophysiology.

Maher S, Donlon E, Mullane G, Walsh R, Lynch T, Fearon C J Clin Med. 2024; 13(8).

PMID: 38673489 PMC: 11051068. DOI: 10.3390/jcm13082216.

Apathy scores in Parkinson's disease relate to EEG components in an incentivized motor task.

Lee S, Song E, Zhu M, Appel-Cresswell S, McKeown M Brain Commun. 2024; 6(1):fcae025.

PMID: 38370450 PMC: 10873141. DOI: 10.1093/braincomms/fcae025.

References

Pluck G, Brown R . Apathy in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2002; 73(6):636-42. PMC: 1757348. DOI: 10.1136/jnnp.73.6.636. View

Leentjens A, Dujardin K, Marsh L, Martinez-Martin P, Richard I, Starkstein S . Apathy and anhedonia rating scales in Parkinson's disease: critique and recommendations. Mov Disord. 2008; 23(14):2004-14. DOI: 10.1002/mds.22229. View

Pedersen K, Alves G, Bronnick K, Aarsland D, Tysnes O, Larsen J . Apathy in drug-naïve patients with incident Parkinson's disease: the Norwegian ParkWest study. J Neurol. 2009; 257(2):217-23. DOI: 10.1007/s00415-009-5297-x. View

Groenewegen H, Wright C, Beijer A . The nucleus accumbens: gateway for limbic structures to reach the motor system?. Prog Brain Res. 1996; 107:485-511. DOI: 10.1016/s0079-6123(08)61883-x. View

Hughes A, Ben-Shlomo Y, Daniel S, Lees A . What features improve the accuracy of clinical diagnosis in Parkinson's disease: a clinicopathologic study. Neurology. 1992; 42(6):1142-6. DOI: 10.1212/wnl.42.6.1142. View

Dobkin R, Menza M, Bienfait K . CBT for the treatment of depression in Parkinson's disease: a promising nonpharmacological approach. Expert Rev Neurother. 2007; 8(1):27-35. PMC: 2743417. DOI: 10.1586/14737175.8.1.27. View

Marin R, Biedrzycki R, Firinciogullari S . Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res. 1991; 38(2):143-62. DOI: 10.1016/0165-1781(91)90040-v. View

Hughes A, Daniel S, Kilford L, Lees A . Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992; 55(3):181-4. PMC: 1014720. DOI: 10.1136/jnnp.55.3.181. View

MOGENSON G, Jones D, Yim C . From motivation to action: functional interface between the limbic system and the motor system. Prog Neurobiol. 1980; 14(2-3):69-97. DOI: 10.1016/0301-0082(80)90018-0. View

10.

Visser M, Leentjens A, Marinus J, Stiggelbout A, van Hilten J . Reliability and validity of the Beck depression inventory in patients with Parkinson's disease. Mov Disord. 2006; 21(5):668-72. DOI: 10.1002/mds.20792. View

11.

Dobkin R, Allen L, Menza M . Cognitive-behavioral therapy for depression in Parkinson's disease: a pilot study. Mov Disord. 2007; 22(7):946-52. DOI: 10.1002/mds.21455. View

12.

Levy M, Cummings J, Fairbanks L, Masterman D, Miller B, Craig A . Apathy is not depression. J Neuropsychiatry Clin Neurosci. 1998; 10(3):314-9. DOI: 10.1176/jnp.10.3.314. View

13.

Butterfield L, Cimino C, Oelke L, Hauser R, Sanchez-Ramos J . The independent influence of apathy and depression on cognitive functioning in Parkinson's disease. Neuropsychology. 2010; 24(6):721-30. DOI: 10.1037/a0019650. View

14.

Judd L, Paulus M, Wells K, Rapaport M . Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry. 1996; 153(11):1411-7. DOI: 10.1176/ajp.153.11.1411. View

15.

DAVIDSON , Irwin . The functional neuroanatomy of emotion and affective style. Trends Cogn Sci. 1999; 3(1):11-21. DOI: 10.1016/s1364-6613(98)01265-0. View

16.

Starkstein S, Mayberg H, Preziosi T, Andrezejewski P, Leiguarda R, Robinson R . Reliability, validity, and clinical correlates of apathy in Parkinson's disease. J Neuropsychiatry Clin Neurosci. 1992; 4(2):134-9. DOI: 10.1176/jnp.4.2.134. View

17.

Lyness J, Bruce M, Koenig H, Parmelee P, Schulz R, Lawton M . Depression and medical illness in late life: report of a symposium. J Am Geriatr Soc. 1996; 44(2):198-203. DOI: 10.1111/j.1532-5415.1996.tb02440.x. View

18.

Kirsch-Darrow L, Fernandez H, Fernandez H, Marsiske M, Okun M, Bowers D . Dissociating apathy and depression in Parkinson disease. Neurology. 2006; 67(1):33-8. PMC: 2911155. DOI: 10.1212/01.wnl.0000230572.07791.22. View

19.

Czernecki V, Pillon B, Houeto J, Pochon J, Levy R, Dubois B . Motivation, reward, and Parkinson's disease: influence of dopatherapy. Neuropsychologia. 2002; 40(13):2257-67. DOI: 10.1016/s0028-3932(02)00108-2. View

20.

Kirsch-Darrow L, Zahodne L, Hass C, Mikos A, Okun M, Fernandez H . How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?. Mov Disord. 2009; 24(5):684-8. PMC: 3045863. DOI: 10.1002/mds.22437. View