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REGULAR ARTICLES   |    
Apathy Is Associated With Increased Amyloid Burden in Mild Cognitive Impairment
Gad A. Marshall, M.D.; Nancy J. Donovan, M.D.; Natacha Lorius, B.A.; Christopher M. Gidicsin, B.A.; Jacqueline Maye, B.S.; Lesley C. Pepin, B.A.; J. Alex Becker, Ph.D.; Rebecca E. Amariglio, Ph.D.; Dorene M. Rentz, Psy.D.; Reisa A. Sperling, M.D.; Keith A. Johnson, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:302-307. doi:10.1176/appi.neuropsych.12060156
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From the Center for Alzheimer Research and Treatment (GAM, NL, REA, DMR, RAS, KAJ), Dept. of Neurology (GAM, NL, REA, DMR, RAS, KAJ), and Dept. of Psychiatry (NL, REA, DMR), Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, and the Dept. of Neurology (GAM, REA, DMR, RAS) and Dept. of Radiology (KAJ), Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Send correspondence to Gad A. Marshall, M.D.; e-mail: gamarshall@partners.org

Copyright © 2013 by the American Psychiatric Association

Received June 25, 2012; Accepted October 02, 2012.

Abstract

Apathy is the most common neuropsychiatric symptom in mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. The authors sought to determine whether apathy is associated with cortical amyloid burden, as measured by Pittsburgh Compound B (PiB) positron emission tomography (PET), and regional hypometabolism, measured by 18F-fluorodeoxyglocuse (FDG) PET in MCI. The authors found a significant association between increased apathy (lower Apathy Evaluation Scale score) and greater cortical PiB retention independent of age, but no significant association between apathy and regional FDG metabolism. These results suggest that increased apathy is associated with greater amyloid burden but not regional hypometabolism in MCI.

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FIGURE 1. Scatterplot of Cortical PiB DVR by AES

Unadjusted Spearman’s correlation coefficient and p value are reported here, whereas the main analyses used partial Spearman’s correlations adjusted for age. Lower scores on the AES indicate greater apathy.

AES: Apathy Evaluation Scale; PiB DVR: Pittsburgh Compound B distribution volume ratio.

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TABLE 1.Demographics and Characteristics of Subjects
Table Footer Note

All values (except N and sex) represent mean±standard deviation (range).

Table Footer Note

MCI: mild cognitive impairment; RAVLT: Rey Auditory Verbal Learning Test; MMSE: Mini-Mental State Exam; CDR: Clinical Dementia Rating; AES: Apathy Evaluation Scale.

Table Footer Note

*Significantly correlated with AES, p <0.05.

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References

Apostolova  LG;  Cummings  JL:  Neuropsychiatric manifestations in mild cognitive impairment: a systematic review of the literature.  Dement Geriatr Cogn Disord 2008; 25:115–126
[CrossRef] | [PubMed]
 
Mega  MS;  Cummings  JL;  Fiorello  T  et al:  The spectrum of behavioral changes in Alzheimer’s disease.  Neurology 1996; 46:130–135
[CrossRef] | [PubMed]
 
Peters  ME;  Rosenberg  PB;  Steinberg  M  et al; Cache County Investigators:  prevalence of neuropsychiatric symptoms in CIND and its subtypes: the Cache County Study.  Am J Geriatr Psychiatry 2012; 20:416–424
[CrossRef] | [PubMed]
 
Boyle  PA;  Malloy  PF;  Salloway  S  et al:  Executive dysfunction and apathy predict functional impairment in Alzheimer disease.  Am J Geriatr Psychiatry 2003; 11:214–221
[PubMed]
 
Marshall  GA;  Rentz  DM;  Frey  MT  et al; Alzheimer’s Disease Neuroimaging Initiative:  executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease.  Alzheimers Dement 2011; 7:300–308
[CrossRef] | [PubMed]
 
McPherson  S;  Fairbanks  L;  Tiken  S  et al:  Apathy and executive function in Alzheimer’s disease.  J Int Neuropsychol Soc 2002; 8:373–381
[CrossRef] | [PubMed]
 
Palmer  K;  Di Iulio  F;  Varsi  AE  et al:  Neuropsychiatric predictors of progression from amnestic mild cognitive impairment to Alzheimer’s disease: the role of depression and apathy.  J Alzheimers Dis 2010; 20:175–183
[PubMed]
 
Robert  PH;  Berr  C;  Volteau  M  et al; PréAL study:  apathy in patients with mild cognitive impairment and the risk of developing dementia of Alzheimer’s disease: a one-year follow-up study.  Clin Neurol Neurosurg 2006; 108:733–736
[CrossRef] | [PubMed]
 
Cummings  JL:  Frontal-subcortical circuits and human behavior.  Arch Neurol 1993; 50:873–880
[CrossRef] | [PubMed]
 
Mega  MS;  Cummings  JL;  Salloway  S  et al:  The limbic system: an anatomic, phylogenetic, and clinical perspective.  J Neuropsychiatry Clin Neurosci 1997; 9:315–330
[PubMed]
 
Benoit  M;  Clairet  S;  Koulibaly  PM  et al:  Brain perfusion correlates of the apathy inventory dimensions of Alzheimer’s disease.  Int J Geriatr Psychiatry 2004; 19:864–869
[CrossRef] | [PubMed]
 
Marshall  GA;  Monserratt  L;  Harwood  D  et al:  Positron emission tomography metabolic correlates of apathy in Alzheimer disease.  Arch Neurol 2007; 64:1015–1020
[CrossRef] | [PubMed]
 
Marshall  GA;  Fairbanks  LA;  Tekin  S  et al:  Neuropathologic correlates of apathy in Alzheimer’s disease.  Dement Geriatr Cogn Disord 2006; 21:144–147
[CrossRef] | [PubMed]
 
Skogseth  R;  Mulugeta  E;  Jones  E  et al:  Neuropsychiatric correlates of cerebrospinal fluid biomarkers in Alzheimer’s disease.  Dement Geriatr Cogn Disord 2008; 25:559–563
[CrossRef] | [PubMed]
 
Klunk  WE;  Engler  H;  Nordberg  A  et al:  Imaging brain amyloid in Alzheimer’s disease with Pittsburgh Compound-B.  Ann Neurol 2004; 55:306–319
[CrossRef] | [PubMed]
 
Rowe  CC;  Ng  S;  Ackermann  U  et al:  Imaging beta-amyloid burden in aging and dementia.  Neurology 2007; 68:1718–1725
[CrossRef] | [PubMed]
 
Sperling  RA;  Laviolette  PS;  O’Keefe  K  et al:  Amyloid deposition is associated with impaired default network function in older persons without dementia.  Neuron 2009; 63:178–188
[CrossRef] | [PubMed]
 
Wolk  DA;  Price  JC;  Saxton  JA  et al:  Amyloid imaging in mild cognitive impairment subtypes.  Ann Neurol 2009; 65:557–568
[CrossRef] | [PubMed]
 
Jack  CR  Jr;  Lowe  VJ;  Senjem  ML  et al:  11C PiB and structural MRI provide complementary information in imaging of Alzheimer’s disease and amnestic mild cognitive impairment.  Brain 2008; 131:665–680
[CrossRef] | [PubMed]
 
Bennett  DA;  Schneider  JA;  Bienias  JL  et al:  Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions.  Neurology 2005; 64:834–841
[CrossRef] | [PubMed]
 
Petersen  RC;  Parisi  JE;  Dickson  DW  et al:  Neuropathologic features of amnestic mild cognitive impairment.  Arch Neurol 2006; 63:665–672
[CrossRef] | [PubMed]
 
Rosen  WG;  Terry  RD;  Fuld  PA  et al:  Pathological verification of ischemic score in differentiation of dementias.  Ann Neurol 1980; 7:486–488
[CrossRef] | [PubMed]
 
Yesavage  JA;  Brink  TL;  Rose  TL  et al:  Development and validation of a geriatric depression screening scale: a preliminary report.  J Psychiatr Res 1982-1983; 17:37–49
[CrossRef]
 
Petersen  RC:  Mild cognitive impairment as a diagnostic entity.  J Intern Med 2004; 256:183–194
[CrossRef] | [PubMed]
 
Folstein  MF;  Folstein  SE;  McHugh  PR:  “Mini-Mental State:” a practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res 1975; 12:189–198
[CrossRef] | [PubMed]
 
Morris  JC:  The Clinical Dementia Rating (CDR): current version and scoring rules.  Neurology 1993; 43:2412–2414
[CrossRef] | [PubMed]
 
Marin  RS;  Biedrzycki  RC;  Firinciogullari  S:  Reliability and validity of the Apathy Evaluation Scale.  Psychiatry Res 1991; 38:143–162
[CrossRef] | [PubMed]
 
Cummings  JL:  The Neuropsychiatric Inventory: assessing psychopathology in dementia patients.  Neurology 1997; 48(Suppl 6):S10–S16
[CrossRef] | [PubMed]
 
Cummings  JL;  Mega  M;  Gray  K  et al:  The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia.  Neurology 1994; 44:2308–2314
[CrossRef] | [PubMed]
 
Mathis  CA;  Wang  Y;  Holt  DP  et al:  Synthesis and evaluation of 11C-labeled 6-substituted 2-arylbenzothiazoles as amyloid imaging agents.  J Med Chem 2003; 46:2740–2754
[CrossRef] | [PubMed]
 
Johnson  KA;  Gregas  M;  Becker  JA  et al:  Imaging of amyloid burden and distribution in cerebral amyloid angiopathy.  Ann Neurol 2007; 62:229–234
[CrossRef] | [PubMed]
 
Gomperts  SN;  Rentz  DM;  Moran  E  et al:  Imaging amyloid deposition in Lewy body diseases.  Neurology 2008; 71:903–910
[CrossRef] | [PubMed]
 
Marshall  GA;  Olson  LE;  Frey  MT  et al:  Instrumental activities of daily living impairment is associated with increased amyloid burden.  Dement Geriatr Cogn Disord 2011; 31:443–450
[CrossRef] | [PubMed]
 
Becker  JA;  Hedden  T;  Carmasin  J  et al:  Amyloid-β associated cortical thinning in clinically normal elderly.  Ann Neurol 2011; 69:1032–1042
[CrossRef] | [PubMed]
 
Price  JC;  Klunk  WE;  Lopresti  BJ  et al:  Kinetic modeling of amyloid binding in humans using PET imaging and Pittsburgh Compound-B.  J Cereb Blood Flow Metab 2005; 25:1528–1547
[CrossRef] | [PubMed]
 
Rentz  DM;  Locascio  JJ;  Becker  JA  et al:  Cognition, reserve, and amyloid deposition in normal aging.  Ann Neurol 2010; 67:353–364
[PubMed]
 
Tzourio-Mazoyer  N;  Landeau  B;  Papathanassiou  D  et al:  Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain.  Neuroimage 2002; 15:273–289
[CrossRef] | [PubMed]
 
Landau  SM;  Harvey  D;  Madison  CM  et al; Alzheimer’s Disease Neuroimaging Initiative:  Associations between cognitive, functional, and FDG-PET measures of decline in AD and MCI.  Neurobiol Aging 2011; 32:1207–1218
[CrossRef] | [PubMed]
 
Rey  A:  L'examen clinique en psychologie .  Paris, France,  Presses Universitaires de France, 1964
 
Albert  MS;  DeKosky  ST;  Dickson  D  et al:  The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease.  Alzheimers Dement 2011; 7:270–279
[CrossRef] | [PubMed]
 
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