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Hedonic and behavioral deficits associated with apathy in Parkinson's disease: Potential treatment implications

Authors

  • Lizabeth L. Jordan MS,

    1. Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
    2. Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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  • Laura B. Zahodne PhD,

    1. Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
    2. Columbia University College of Physicians and Surgeons, Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and The Aging Brain, New York, New York, USA
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  • Michael S. Okun MD,

    1. Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
    2. Department of Neurology, University of Florida, Gainesville, Florida, USA
    3. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
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  • Dawn Bowers PhD

    Corresponding author
    1. Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
    2. Department of Neurology, University of Florida, Gainesville, Florida, USA
    • Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
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  • Funding agencies: This study was supported by the National Institute on Aging (grant T32-AG020499 to Dr. Zahodne), the Bryan W. Robinson Endowment for Neuroscience, the American Psychological Foundation, and the American Psychological Association Divisions 20 and 40. Drs. Bowers and Okun received financial support for the conduction and supervision of this research study through the Michael J. Fox Foundation and grants from the National Institute of Neurological Disorders and Stroke (R01-NS0653 and R21-NS09767).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Correspondence to: Dr. D. Bowers, University of Florida, Department of Clinical and Health Psychology, Health Science Center, PO Box 100165, Gainesville, FL 32610-0165; dawnbowers@phhp.ufl.edu

ABSTRACT

Background

Many individuals with Parkinson's disease (PD) experience apathy independent of depression.

Methods

In this study, we examined hedonic and behavioral deficits related to apathy in 50 patients with PD and 42 healthy older adults who completed standardized measures.

Results

Regression analyses revealed that apathy was associated with anticipatory, but not consummatory, anhedonia and reduced goal-directed behavior, independent of PD diagnosis, age, education, and depressive symptoms.

Conclusions

These findings suggest that apathy is characterized by deficits in anticipatory pleasure and behavioral drive rather than consummatory pleasure or reward responsiveness. Therefore, PD patients with apathy would likely benefit from psychotherapeutic treatment that encourages structured, goal-directed plans for pleasurable events and stimulation that provide adaptive hedonic effects. In addition, given the proposed shared mechanism of dopamine depletion within the ventral striatum in apathy and anticipatory anhedonia, future trials of dopamine-eliciting activities (eg, exercise and other nonpharmacologic methods) appear to be warranted to improve these symptoms in patients with PD. © 2013 Movement Disorder Society

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