Insensitivity to loss predicts apathy in huntington's disease

被引:16
作者
McLauchlan, Duncan J. [1 ,2 ,3 ]
Lancaster, Thomas [1 ,2 ,3 ]
Craufurd, David [4 ,5 ]
Linden, David E. J. [1 ,2 ,3 ,6 ]
Rosser, Anne E. [1 ,2 ,7 ]
机构
[1] Cardiff Univ, Div Psychol Med & Clin Neurosci, Cardiff, S Glam, Wales
[2] Cardiff Univ, MRC Ctr Neuropsychiat Genet & Genom, Cardiff, S Glam, Wales
[3] Cardiff Univ, Brain Res Imaging Ctr, Cardiff, S Glam, Wales
[4] Univ Manchester, Manchester Acad Hlth Sci Ctr, Div Evolut & Genom Sci,Sch Biol Sci, Manchester Ctr Genom Med,Fac Biol Med & Hlth, Manchester, Lancs, England
[5] Manchester Univ NHS Fdn Trust, Manchester Acad Hlth Sci Ctr, St Marys Hosp, Manchester, Lancs, England
[6] Maastricht Univ, Sch Mental Hlth & Neurosci, Fac Hlth Med & Life Sci, Maastricht, Netherlands
[7] Cardiff Univ, Sch Biosci, Brain Repair Grp, Cardiff, S Glam, Wales
关键词
apathy; Huntington's disease; neurodegeneration; neuropsychology; QUALITY-OF-LIFE; GOAL-DIRECTED BEHAVIOR; RISKY DECISION-MAKING; FRONTOTEMPORAL DEMENTIA; LEARNING-DEFICITS; DOSE EQUIVALENTS; TRACK-HD; REWARD; PUNISHMENT; IMPACT;
D O I
10.1002/mds.27787
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Apathy is a deficit in goal-directed behavior that significantly affects quality of life and function. It is common in Huntington's disease and other disorders affecting corticostriatal pathways. Deficits in processing of reward, altered effort, and executive dysfunction are associated with apathy in other disorders, but the cognitive processes leading to apathy in Huntington's disease remain largely unknown. A previously reported deficit in learning from losses in Huntington's disease raises the possibility of a hitherto unrecognized mechanism leading to apathy. This study's objective was to delineate the cognitive processes associated with apathy in HD. Methods We tested 51 Huntington's disease participants and 26 controls on a battery of novel and established measures to assess the contribution to apathy in Huntington's disease of executive function, reward value, reward-effort calculations, instrumental learning, and response to reward and loss. Results Huntington's disase participants had deficits in instrumental learning with impaired response to loss, but no evidence to suggest altered reward-related behavior or effort. We also saw an executive dysfunction contribution to apathy in Huntington's disease. Discussion We report the novel finding that apathy in Huntington's disease is associated with blunted responses to losses and impaired instrumental learning. This association is consistent with the known early degeneration of the indirect pathway and amygdala involvement in apathy in Huntington's disease, but is previously unreported in any disorder. In keeping with the comparative preservation of the ventral striatum and orbitofrontal cortex in Huntington's disease, reward valuation and reward-effort calculations did not contribute to apathy. (c) 2019 International Parkinson and Movement Disorder Society
引用
收藏
页码:1381 / 1391
页数:11
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