Affiliations: Department of Psychology, Second University of Naples,
Caserta, Italy | Istituto di Diagnosi e Cura "Hermitage Capodimonte",
Naples, Italy | Neurodegenerative Diseases Center, University of
Salerno, Salerno, Italy | University of Naples "Parthenope", Naples, Italy
Note: [] Corresponding author: Luigi Trojano, MD, Department of
Psychology, Second University of Naples, viale Ellittico Complesso
Universitario, 81100 Caserta, Italy. Tel.: +39 0823274784; E-mail:
[email protected]
Abstract: Apathy has been defined as lack of motivation. It has been
traditionally considered as a symptom of psychiatric disorders, such as major
depression and schizophrenia, but more recently it has been recognized as a
specific neuropsychiatric syndrome associated with neurodegenerative such as
Parkinson's disease (PD). As a consequence the reported prevalence of apathy in
PD ranges from 13.9% to 70%; the mean prevalence is 35%. Prevalence of "pure
apathy" (i.e., of apathy without comorbid depression and dementia) seems to be
substantially lower, from 3 to 47.9%. High levels of apathy in PD are
associated with decreased daily function, specific cognitive deficits and
increased stress for families. Although neuroimaging studies do not provide a
unique anatomic pattern, several data suggest that the ventromedial prefrontal
cortex and the basal ganglia connected through frontal-subcortical circuits,
are particularly involved in the genesis of apathy. At present, there are no
approved medications for the treatment of apathy in and no proof of efficacy
exists for any drug in current use. Further studies and innovative
pharmacologic approaches are thus needed to ameliorate our understanding and
treatment of apathy in PD.
