July 11, 2006

Apathy often a part of Parkinson’s disease

NEW YORK (Reuters Health) - Patients with Parkinson's
disease may exhibit apathetic behavior without being depressed,
a group of clinicians report. They suggest in the medical
journal Neurology that apathy may therefore be a "core" feature
of the disease.

"It's important to screen for both apathy and depression so
patients can be treated appropriately," noted Dr. Lindsey
Kirsch-Darrow in an American Academy of Neurology statement.

"It will also be important to educate family members and
caregivers about apathy to help them understand that it is a
characteristic of Parkinson's disease," she continued.
"Apathetic behavior is not something the patient can
voluntarily control, and it is not laziness or the patient
trying to be difficult -- it is a symptom of Parkinson's

Kirsch-Darrow, of the University of Florida in Gainesville
and colleagues compared 80 patients with Parkinson's disease to
20 patients with dystonia, or impaired muscle control.

The team found observed a "significantly higher severity
and frequency of apathy" in the Parkinson's disease patients
compared to the dystonia patients. Fifty-one percent of
Parkinson's disease patients exhibited apathy compared with 20
percent of those with dystonia.

Apathy in the absence of depression was common in
Parkinson's disease patients (29 percent but was not seen in
any of the dystonia patients. "This was the most dramatic and
potentially important finding of the study," the researchers

In an editorial, Dr. Irene Hegeman Richard from the
University of Rochester in New York notes that the "recognition
that apathy can be present without depression is important so
that we do not inappropriately diagnose and treat a depressive
disorder that is not present."

For patients with apathy, stimulant-type drugs have been
suggested as a possible treatment. "However, it is important to
stop and ask ourselves who we are treating," Richard writes.
"With apathy, it is generally the spouse, family or friends and
not the patient who complain because the patient requires
constant prompting to do anything and does not want to go

SOURCE: Neurology, July 11, 2006.