Dopamine reverses reward insensitivity in apathy following globus pallidus lesions.

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Serval ID
serval:BIB_4FFB75B393A0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dopamine reverses reward insensitivity in apathy following globus pallidus lesions.
Journal
Cortex
Author(s)
Adam R., Leff A., Sinha N., Turner C., Bays P., Draganski B., Husain M.
ISSN
1973-8102 (Electronic)
ISSN-L
0010-9452
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
49
Number
5
Pages
1292-1303
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Open Access article
Abstract
Apathy is a complex, behavioural disorder associated with reduced spontaneous initiation of actions. Although present in mild forms in some healthy people, it is a pathological state in conditions such as Alzheimer's and Parkinson's disease where it can have profoundly devastating effects. Understanding the mechanisms underlying apathy is therefore of urgent concern but this has proven difficult because widespread brain changes in neurodegenerative diseases make interpretation difficult and there is no good animal model. Here we present a very rare case with profound apathy following bilateral, focal lesions of the basal ganglia, with globus pallidus regions that connect with orbitofrontal (OFC) and ventromedial prefrontal cortex (VMPFC) particularly affected. Using two measures of oculomotor decision-making we show that apathy in this individual was associated with reward insensitivity. However, reward sensitivity could be established partially with levodopa and more effectively with a dopamine receptor agonist. Concomitantly, there was an improvement in the patient's clinical state, with reduced apathy, greater motivation and increased social interactions. These findings provide a model system to study a key neuropsychiatric disorder. They demonstrate that reward insensitivity associated with basal ganglia dysfunction might be an important component of apathy that can be reversed by dopaminergic modulation.
Pubmed
Web of science
Open Access
Yes
Create date
28/09/2012 13:55
Last modification date
20/08/2019 14:05
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