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Apathy in drug-naïve patients with incident Parkinson’s disease: the Norwegian ParkWest study

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Abstract

Apathy is a common behavioural problem in Parkinson’s disease (PD), with important clinical consequences for patients and their families. However, little is known about apathy in early PD. We examined the frequency and clinical characteristics of apathy in 175 nondemented, drug-naïve patients with newly diagnosed PD and 165 control subjects matched for age, sex and education level in Western and Southern Norway. All participants underwent a comprehensive neurological, psychiatric and neuropsychological evaluation. Apathy was diagnosed based on Neuropsychiatric Inventory assessment and recently proposed consensus criteria. Apathy was found in 22.9% of the PD patients, of whom 37.5% had significant depressive symptoms, whereas none of the control subjects were apathetic. Apathy was significantly associated with male gender, higher depression scores and more severe motor symptoms, but was not associated with greater cognitive impairment. When excluding patients with significant depressive symptoms, apathy remained significantly associated with motor severity. Approximately 50% of the caregivers of patients with apathy reported the apathetic behaviour to be at least moderately distressing. The association between apathy and motor severity in our PD cohort suggests a common underlying pathophysiological mechanism. Future studies should explore the longitudinal effect of dopamine replacement therapy on apathetic behaviour in early PD. The relationship between apathy and male gender needs further study to be fully evaluated.

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Acknowledgments

The authors are grateful to all patients and control subjects for their willingness to participate in this study. We also thank all personnel who contributed to planning and conducting this study.

The Norwegian ParkWest study was funded by the Western Norway Regional Health Authority (grant# 911218) and the Research Council of Norway (grant# 177966).

Author information

Authors and Affiliations

  1. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway

    Kenn Freddy Pedersen, Guido Alves, Kolbjørn Brønnick, Dag Aarsland & Jan Petter Larsen

  2. Department of Neurology, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway

    Kenn Freddy Pedersen, Guido Alves & Jan Petter Larsen

  3. Department of Psychiatry, Stavanger University Hospital, PO Box 1163, Hillevaag, 4095, Stavanger, Norway

    Dag Aarsland

  4. Department of Neurology, Haukeland University Hospital, 5021, Bergen, Norway

    Ole-Bjørn Tysnes

  5. Institute of Clinical Medicine, School of Medicine, University of Bergen, PO Box 7800, 5020, Bergen, Norway

    Dag Aarsland, Ole-Bjørn Tysnes & Jan Petter Larsen

Authors
  1. Kenn Freddy Pedersen
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  2. Guido Alves
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  3. Kolbjørn Brønnick
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  4. Dag Aarsland
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  5. Ole-Bjørn Tysnes
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  6. Jan Petter Larsen
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Corresponding author

Correspondence to Kenn Freddy Pedersen.

Additional information

For the Norwegian ParkWest Study Group.

Appendix

Appendix

The Norwegian ParkWest Study Group consists of: Study neurologists—Guido Alves, Elin Bjelland Forsaa, Michaela Dreetz Gjerstad, Karen Herlofsen, Ineke HogenEsch, Jan Petter Larsen, Bernd Müeller, Kenn Freddy Pedersen, Geir Olve Skeie, Wenche Telstad, Ole-Bjørn Tysnes, and Corinna Vossius. Study nurses—Britt Bruland, Siri Bruun, Marit Ellefseth, Liv Kari Haaland, Janet Kastet, Marianne Kjærandsen, Anita Laugland, Ingrid Leiknes, Kirsten Lode, Kristina Rasmussen, Marit Arnevik Renså, and Gro Tønnesen.

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Pedersen, K.F., Alves, G., Brønnick, K. et al. Apathy in drug-naïve patients with incident Parkinson’s disease: the Norwegian ParkWest study. J Neurol 257, 217–223 (2010). https://doi.org/10.1007/s00415-009-5297-x

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  • DOI: https://doi.org/10.1007/s00415-009-5297-x

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