Apathy is associated with large-scale white matter network disruption in small vessel disease.
Tuladhar, Anil M
Brookes, Rebecca L
de Leeuw, Frank-Erik
Wolters Kluwer Health
MetadataShow full item record
Tay, J., Tuladhar, A. M., Hollocks, M. J., Brookes, R. L., Tozer, D., Barrick, T. R., Husain, M., et al. (2019). Apathy is associated with large-scale white matter network disruption in small vessel disease.. Neurology, 92 (11), e1157-e1167. https://doi.org/10.1212/wnl.0000000000007095
Objective: To investigate whether white matter network disruption underlies the pathogenesis of apathy, but not depression, in cerebral small vessel disease (SVD). Methods: 331 SVD patients from the RUN DMC study completed measures of apathy and depression, and underwent structural magnetic resonance imaging. Streamlines reflecting underlying white matter fibres were reconstructed using diffusion tensor tractography. First, path analysis was used to determine if network measures mediated associations between apathy and radiological markers of SVD. Next, we examined differences in whole-brain network measures between participants with only apathy, only depression, comorbid apathy and depression, and a control group free of neuropsychiatric symptoms. Finally, we examined regional network differences associated with apathy. Results: Path analysis demonstrated that network disruption mediated the relationship between apathy and SVD markers. Patients with apathy, compared to all other groups, were impaired on whole-brain measures of network density and efficiency. Regional network analyses in both the apathy subgroup and the entire sample revealed that apathy was associated with impaired connectivity in premotor and cingulate regions. Conclusions: Our results suggest that apathy, but not depression, is associated with white matter tract disconnection in SVD. The subnetworks delineated suggest that apathy may be driven by damage to white matter networks underlying action initiation and effort-based decision making.
Neural Pathways, Humans, Magnetic Resonance Imaging, Depression, Aged, Middle Aged, Female, Male, Diffusion Tensor Imaging, Apathy, Cerebral Small Vessel Diseases, White Matter
Stroke Association (PPA 2015/02)
Embargo Lift Date
External DOI: https://doi.org/10.1212/wnl.0000000000007095
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288100
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/