The anatomy of apathy: A neurocognitive framework for amotivated behaviour

Research output: Contribution to journalReview articlepeer-review

Authors

Colleges, School and Institutes

External organisations

  • University of Oxford

Abstract

Apathy is a debilitating syndrome associated with many neurological disorders, including several common neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease, and focal lesion syndromes such as stroke. Here, we review neuroimaging studies to identify anatomical correlates of apathy, across brain disorders. Our analysis reveals that apathy is strongly associated with disruption particularly of dorsal anterior cingulate cortex (dACC), ventral striatum (VS) and connected brain regions. Remarkably, these changes are consistent across clinical disorders and imaging modalities. Review of the neuroimaging findings allows us to develop a neurocognitive framework to consider potential mechanisms underlying apathy. According to this perspective, an interconnected group of brain regions - with dACC and VS at its core - plays a crucial role in normal motivated behaviour. Specifically we argue that motivated behaviour requires a willingness to work, to keep working, and to learn what is worth working for. We propose that deficits in any one or more of these processes can lead to the clinical syndrome of apathy, and outline specific approaches to test this hypothesis. A richer neurobiological understanding of the mechanisms underlying apathy should ultimately facilitate development of effective therapies for this disabling condition.

Bibliographic note

Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Details

Original languageEnglish
Pages (from-to)54-67
Number of pages14
JournalNeuropsychologia
Volume118
Issue numberPt B
Publication statusPublished - Sep 2018

Keywords

  • Apathy/physiology, Brain/diagnostic imaging, Brain Mapping, Humans, Motivation/physiology, Neuroimaging