Skip main navigation
Close Drawer MenuOpen Drawer Menu

The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. As described in the Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences.

Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

×
Back to table of contents
Special ArticlesFull Access

Frequency and Pathophysiology of Apathy in Huntington Disease: A Systematic Review and Meta-Analysis

Published Online:10 Nov 2022https://doi.org/10.1176/appi.neuropsych.20220033

Abstract

Objective:

Apathy is a common behavioral symptom of Huntington disease (HD). This systematic review describes current evidence on the pathophysiology, assessment, and frequency of apathy in HD.

Methods:

This systematic review was conducted in accordance with PRISMA guidelines. Using a comprehensive search strategy, the investigators searched the MEDLINE, Embase, and PsycINFO databases. All studies that evaluated apathy in HD patients with a valid scale and reported apathy frequency or scores were included. Apathy scores were analyzed by mean or standardized mean differences in accordance with Cochrane guidelines.

Results:

A total of 1,085 records were screened and 80 studies were ultimately included. The Problem Behaviors Assessment—Short was the most frequently used apathy assessment tool. Apathy frequency generally ranged from 10%–33% in premanifest HD to 24%–76% in manifest HD. A meta-analysis of 5,311 records of patients with premanifest HD showed significantly higher apathy scores, with a standardized mean difference of 0.41 (CI=0.29–0.52; p<0.001). A comparison of 1,247 patients showed significantly higher apathy scores in manifest than premanifest HD, with a mean difference of 1.87 (CI=1.48–2.26; p<0.001). There was evidence of involvement of various cortical and subcortical brain regions in HD patients with apathy.

Conclusions:

Apathy was more frequent among individuals with premanifest HD compared with those in a control group and among individuals with manifest HD compared with those with premanifest HD. Considering the complexity and unique pattern of development in neurodegenerative disease, further studies are required to explore the pathophysiology of apathy in HD.