Neural correlates of apathy in patients with neurodegenerative disorders, acquired brain injury, and psychiatric disorders
Open accessAbstract
Apathy can be described as a loss of goal-directed purposeful behavior and is common in a variety of neurological and psychiatric disorders. Although previous studies investigated associations between abnormal brain functioning and apathy, it is unclear whether the neural basis of apathy is similar across different pathological conditions. The purpose of this systematic review was to provide an extensive overview of the neuroimaging literature on apathy including studies of various patient populations, and evaluate whether the current state of affairs suggest disorder specific or shared neural correlates of apathy. Results suggest that abnormalities within fronto-striatal circuits are most consistently associated with apathy across the different pathological conditions. Of note, abnormalities within the inferior parietal cortex were also linked to apathy, a region previously not included in neuroanatomical models of apathy. The variance in brain regions implicated in apathy may suggest that different routes towards apathy are possible. Future research should investigate possible alterations in different processes underlying goal-directed behavior, ranging from intention and goal-selection to action planning and execution.
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Limbic-frontal-subcortical circuits are frequently implicated in the pathophysiology of apathy in clinical populations.
“Concerning apathy, it is the case that limbic-frontal-subcortical circuits are frequently implicated in the pathophysiology of this condition in clinical populations (van Reekum et al., 2005; Kos et al., 2016).”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Kos et al., 2016
The indexed Abstract reports that abnormalities in fronto-striatal circuits are most consistently associated with apathy across neurological and psychiatric conditions. This supports the frontal-subcortical and clinical-population portions of the claim, but the passage does not identify a limbic component of those circuits. (LLM, conf=0.82)
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Voxel-Based Analysis of Fractional Anisotropy in Post-Stroke Apathy
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Apathy Is Not Associated with Basal Ganglia Atrophy in Frontotemporal Dementia
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The cingulum bundle: Anatomy, function, and dysfunction
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“Concerning apathy, it is the case that limbic-frontal-subcortical circuits are frequently implicated in the pathophysiology of this condition in clinical populations (van Reekum et al., 2005; Kos et al., 2016).”
The anatomy of apathy: a neurocognitive framework for amotivated behaviour
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Brain mechanisms underlying apathy
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Neural Correlates for Apathy: Frontal-Prefrontal and Parietal Cortical- Subcortical Circuits
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Apathy in Parkinson’s Disease: Clinical Patterns and Neurobiological Basis
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Dysfunctional effort-based decision-making underlies apathy in genetic cerebral small vessel disease
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The neuroimaging basis of apathy: Empirical findings and conceptual challenges
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Neuropsychiatric symptoms in spinocerebellar ataxias and Friedreich ataxia.
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Lateral parietal cortex in the generation of behavior: Implications for apathy
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Network neuroscience of apathy in cerebrovascular disease
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From apathy to addiction: Insights from neurology and psychiatry.
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Functional network topology associated with apathy in Alzheimer's disease
Tumati, S., Marsman, J.-B. C., Deyn, P. P. D., Martens, S., & Aleman, A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.158 · Cited by 31 · see citing works
Self-citationCommon neural deficits across reward functions in major depression: a meta-analysis of fMRI studies
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Apathy is Associated with Critical Psychological Determinants of Medication Adherence in HIV Disease
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Apathy and brain alterations in Parkinson's disease: a multimodal imaging study
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Setiadi, T. M., Martens, S., Opmeer, E. M., Marsman, J.-B. C., Tumati, S., Reesink, F. E., Deyn, P. P. D., Aleman, A., & Ćurĉić‐Blake, B. (2021) · NeuroImage Clinical · doi:10.1016/j.nicl.2021.102567 · Cited by 23 · see citing works
Self-citationApathy is associated with parietal cortical-subcortical dysfunction in ALS.
Caga, J., Tu, S.-C., Dharmadasa, T., Tse, N. Y., Zoing, M. C., Huynh, W., Mahoney, C. J., Ahmed, R., & Kiernan, M. (2021) · Cortex; a journal devoted to the study of the nervous system and behavior · doi:10.1016/j.cortex.2021.02.029 · Cited by 23 · see citing works
Lower Choline and Myo-Inositol in Temporo-Parietal Cortex Is Associated With Apathy in Amnestic MCI
Tumati, S., Opmeer, E. M., Marsman, J.-B. C., Martens, S., Reesink, F. E., Deyn, P. P. D., & Aleman, A. (2018) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2018.00106 · Cited by 24 · see citing works
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Apathy Is Related to Cognitive Control and Striatum Volumes in Prodromal Huntington’s Disease
Misiura, M. B., Ciarochi, J., Vaidya, J. G., Bockholt, J. H., Johnson, H. J., Calhoun, V. D., Paulsen, J. S., Turner, J. A., & the PREDICT-HD Investigators and Working Group (2019) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617719000067 · Cited by 21 · see citing works
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Brain gray matter abnormalities in progressive supranuclear palsy revisited
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Structural Brain Differences Between Cognitively Impaired Patients With and Without Apathy
Chan, N. K., Gerretsen, P., Chakravarty, M. M., Blumberger, D. M., Caravaggio, F., Brown, E. E., & Graff‐Guerrero, A. (2020) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2020.12.008 · Cited by 19 · see citing works
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Gray Matter Vulnerabilities Predict Longitudinal Development of Apathy in Huntington's Disease
Paepe, A. E. D., Ara, A., García-Gorro, C., Martínez-Horta, S., Pèrez-Pèrez, J., Kulisevsky, J., Rodríguez-Dechicha, N., Vaquer, I., Subirà, S., Calopa, M., et al. (2021) · Movement Disorders · doi:10.1002/mds.28638 · Cited by 14 · see citing works
Behavioural changes in frontotemporal dementia and their cognitive and neuroanatomical correlates
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Self-citationStrengths and Weaknesses of the Vascular Apathy Hypothesis: A Narrative Review
Wouts, L., Marijnissen, R. M., Voshaar, R. C. O., & Beekman, A. T. F. (2022) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2022.09.016 · Cited by 18 · see citing works
Apathy in Patients With Cerebral Amyloid Angiopathy
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Apathy is related to reduced activation in cognitive control regions during set‐shifting
Klaasen, N. G., Kos, C., Aleman, A., & Opmeer, E. M. (2017) · Human Brain Mapping · doi:10.1002/hbm.23556 · Cited by 15 · see citing works
Self-citationNeural basis of self-initiative in relation to apathy in a student sample
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Spirituality as a Therapeutic Approach for Severe Mental Illness: Insights from Neural Networks
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Self-citationResting-State Functional Connectivity Signatures of Apathy in Community-Living Older Adults
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The neural correlates of apathy in schizophrenia: An exploratory investigation
Caravaggio, F., Fervaha, G., Menon, M., Remington, G., Graff-Guerrero, A., & Gerretsen, P. (2017) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2017.10.027 · Cited by 11 · see citing works
The Neural Correlates of Negative Symptoms in Schizophrenia: Examples From MRI Literature
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Cortical Thickness in Alcohol Dependent Patients With Apathy
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Planning in amnestic mild cognitive impairment: an fMRI study
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Self-citationApathy is not associated with reduced ventral striatal volume in patients with schizophrenia
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White matter microstructural associates of apathy-avolition in schizophrenia
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Specific mechanisms underlying executive and emotional apathy: A phenotyping study
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Apathy in corticobasal degeneration: possible parietal involvement
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Apathy in depression: An arterial spin labeling perfusion MRI study
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Apathy is not associated with a panel of biomarkers in older adults with HIV disease
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Fu, X., Yang, X.-L., Cui, X.-L., Liu, F., Li, H.-B., Yan, M.-Q., Xie, G.-R., & Guo, W.-B. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.07.043 · Cited by 6 · see citing works
Jackson, M. G., & Robinson, E. S. J. (2022) · Emerging Topics in Life Sciences · doi:10.1042/etls20220004 · Cited by 6 · see citing works
Motomura, K., Kawamura, A., Ohka, F., Aoki, K., Nishikawa, T., Yamaguchi, J., Kibe, Y., Shimizu, H., Maeda, S., & Saito, R. (2023) · Journal of Neuropsychology · doi:10.1111/jnp.12345 · Cited by 6 · see citing works
Post-stroke apathy: A case series investigation of neuropsychological and lesion characteristics.
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Caudate volume and symptoms of apathy in older adults with multiple sclerosis
Cote, S. E., Wagshul, M. E., Foley, F. W., Lipton, M. L., & Holtzer, R. (2023) · Multiple Sclerosis Journal · doi:10.1177/13524585231188096 · Cited by 5 · see citing works
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[Apathy in depression: a morphometric analysis].
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Apathetic symptoms and white matter integrity after traumatic brain injury
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Apathy as a failure of active inference
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Apathy in persons with neurocognitive disorders: Moving the field forward.
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An Exploratory Comparison of Alpha and Beta Network Connectivity Across Four Depression Subtypes
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Apathy in Parkinson’s Disease: EEG Microstate Characteristics
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Apathy as a Loss of Prior Precision on Action OutcomesPreprint
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Preserved reward sensitivity following acquired brain injury: A pilot study in acute rehabilitationPreprint
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Emotional and volitional disorders after stroke
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Rethinking apathy assessment in neurological disorders: conceptual and clinical challenges
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Apathy and resting state functional connectivity across the Alzheimer's disease continuum
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- Authors
- Kos, C., van Tol, M.-J., Marsman, J.-B. C., Knegtering, H., & Aleman, A.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Kos, Claire
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 69
- Pages
- 381-401
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W2514186414
- Cited by
- 101
- References
- 130
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 6 · 2023: 10 · 2022: 8 · 2021: 11 · 2020: 15 · 2019: 5 · 2018: 15 · 2017: 12 · 2016: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (312787, 453-11-004, 016156077)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- apathy, neural correlates, neurodegenerative diseases, acquired brain injury, mental illness, frontostriatal circuits, inferior parietal cortex, goal-directed behavior, intention, goal selection, action planning
- MeSH terms
- Mental Disorders, Brain, Brain Injuries, Humans, Neurodegenerative Diseases, Apathy
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