Apathy and the Functional Anatomy of the Prefrontal Cortex–Basal Ganglia Circuits
Open accessAbstract
The clinical signs grouped under the concept of apathy are a common feature of prefrontal and basal ganglia lesions or dysfunctions and can therefore help to improve our understanding of the functional anatomy of the prefrontal-basal ganglia system. Apathy is here defined as a quantitative reduction of voluntary, goal-directed behaviors. The underlying mechanisms responsible for apathy can be divided into three subtypes of disrupted processing: 'emotional-affective', 'cognitive' and 'auto-activation'. Apathy due to the disruption of 'emotional-affective' processing refers to the inability to establish the necessary linkage between emotional-affective signals and the ongoing or forthcoming behavior. It may be related to lesions of the orbital-medial prefrontal cortex or to the related subregions (limbic territory) within the basal ganglia (e.g. ventral striatum, ventral pallidum). Apathy due to the disruption of 'cognitive' processing refers to difficulties in elaborating the plan of actions necessary for the ongoing or forthcoming behavior. It may be related to lesions of the dorsolateral prefrontal cortex and the related subregions (associative territory) within the basal ganglia (e.g. dorsal caudate nucleus). The disruption of 'auto-activation' processing refers to the inability to self-activate thoughts or self-initiate actions contrasting with a relatively spared ability to generate externally driven behavior. It is responsible for the most severe form of apathy and in most cases the lesions affect bilaterally the associative and limbic territories of the internal portion of the globus pallidus. It characterizes the syndrome of 'auto-activation deficit' (also known as 'psychic akinesia' or 'athymormia'). This syndrome implies that direct lesions of the basal ganglia output result in a loss of amplification of the relevant signal, consequently leading to a diminished extraction of this signal within the frontal cortex. Likewise, apathy occurring in Parkinson's disease could be interpreted as secondary to the loss of spatial and temporal focalization of the signals transferred to the frontal cortex. In both situations (direct basal ganglia lesions and nigro-striatal dopaminergic loss), the capacity of the frontal cortex to select, initiate, maintain and shift programs of actions is impaired.
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Previous studies have implicated the role of the dorsomedial striatum, a known site of impairment in PD, in mediating goal-directed behaviors, such as the online monitoring and adjustment of vocal intensity in the LSVT LOUD program.
“Previous studies have implicated the role of the dorsomedial striatum, a known site of impairment in PD, in mediating goal-directed behaviors (Haruno & Kawato, 2006; Levy & Dubois, 2006), such as the online monitoring and adjustment of vocal intensity in the LSVT LOUD program.”
From Respiratory Responses to Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Levy & Dubois, 2006
In “Role of Dopamine” (page not provided), the paper links dorsal-striatal signaling to action selection and discusses striatal dopamine depletion in PD. It also proposes a role for the dorsolateral PFC–dorsal caudate circuit in PD-related cognitive dysfunction. It does not specifically identify the dorsomedial striatum as the impaired site or examine online adjustment of vocal intensity in LSVT LOUD; the latter appears after the citation as the citing authors’ example. (LLM, conf=0.83)
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- Authors
- Levy, R., & Dubois, B.
- Affiliations
- Inserm (FR)
- ORCID
- Dubois, Bruno
- Venue
- Cerebral Cortex
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-10-05
- Volume
- 16
- Issue
- 7
- Pages
- 916-928
- ISSN
- 1047-3211 (ISSN-L)
- 1460-2199
- OpenAlex
- W1997659839
- Cited by
- 1,285
- References
- 11
- Citations by year
- 2026: 71 · 2025: 67 · 2024: 81 · 2023: 61 · 2022: 92 · 2021: 103 · 2020: 81 · 2019: 51 · 2018: 90 · 2017: 77 · 2016: 77 · 2015: 66 · 2014: 72 · 2013: 69 · 2012: 47
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Cerebral Cortex (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- apathy, prefrontal cortex, basal ganglia, goal-directed behavior, cognitive processes, globus pallidus, dorsolateral prefrontal cortex, ventral striatum, ventral pallidum, caudate nucleus, Parkinson's disease, frontal lobe lesions
- MeSH terms
- Animals, Basal Ganglia, Mental Disorders, Humans, Models, Neurological, Neural Pathways, Volition, Prefrontal Cortex, Mood Disorders
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