The February International Psychogeriatrics Article of the Month is entitled ‘A review of neuroimaging findings of apathy in Alzheimer’s disease’ by Christos Theleritis, Antonios Politis, Kostas Siarkos and Costantine G. Lyketsos.

Apathy is one of the most frequent “behavioral and psychological signs and symptoms of dementia” (BPSD) encountered in Alzheimer’s disease (AD). There is a growing interest in the early diagnosis of apathetic elderly patients in the community since apathy has been associated with reduced daily functioning, caregiver distress, and poor outcome. The generalization of neuroimaging techniques might be able to offer help in this domain.

Within this context the authors conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for neuroimaging findings of apathy in AD.

They found that neuroimaging findings lend support to the notion that frontal-subcortical networks are involved in the occurrence of apathy in AD. Apathy seems to be prevalent both in AD and Mild Cognitive Impairment (MCI). It is of great importance to assess and diagnose apathetic elderly patients within the community as soon as possible since it is proposed that the wider recognition of apathy and its association with mild cognitive syndromes could facilitate earlier diagnosis of dementia.

The authors concluded that Longitudinal studies comparing patients and normal individuals might allow us to infer on the association between apathy and neurodegenerative diseases and what brain imaging markers can tell us about the characterization of this association, thus revealing disease patterns, helping to distinguish clinically distinct cognitive syndromes, and allowing predictions.

The commentary paper author, Sergio E. Starkstein, observed, “Theleritis and co-workers should be commended for producing the most comprehensive review on the neuroimaging correlates of apathy in Alzheimer’s disease. The authors assessed studies using different imaging modalities such as structural neuroimaging with three-dimensional magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), single photon emission tomography (SPECT), and positron emission tomography (PET). This scholarly review will be an excellent resource for future publications on neuroimaging in apathy.”

The full paper “A review of neuroimaging findings of apathy in Alzheimer’s disease” is available free of charge for one month here.

The commentary on the paper “Imaging apathy in Alzheimer’s disease” is also available free of charge for one month here.