Clinical and radiological correlates of apathy in multiple sclerosis

Author:

Tazza Francesco12ORCID,Schiavi Simona12,Leveraro Elisa3,Cellerino Maria12,Boffa Giacomo12,Ballerini Stefania4,Dighero Mara12,Uccelli Antonio123ORCID,Sbragia Elvira12ORCID,Aluan Kenda12ORCID,Inglese Matilde123,Lapucci Caterina3

Affiliation:

1. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy

2. IRCCS Ospedale Policlinico San Martino, Genoa, Italy

3. Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

4. Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Abstract

Background: Although apathy has been associated with fronto-striatal dysfunction in several neurological disorders, its clinical and magnetic resonance imaging (MRI) correlates have been poorly investigated in people with multiple sclerosis (PwMS). Objectives: To evaluate clinical variables and investigate microstructural integrity of fronto-striatal grey matter (GM) and white matter (WM) structures using diffusion tensor imaging (DTI). Methods: A total of 123 PwMS (age: 40.25 ± 11.5; female: 60.9%; relapsing–remitting multiple sclerosis: 75.6%) were prospectively enrolled and underwent neurological and neuropsychological evaluation, including Expanded Disability Status Scale (EDSS), Apathy Evaluation Scale (AES-S), Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS) and brain 3T-MRI volumes of whole brain, frontal/prefrontal cortex (PFC) and subcortical regions were calculated. DTI-derived metrics were evaluated in the same GM regions and in connecting WM tracts. Results: Apathetic PwMS (32.5%) showed lower education levels, higher HADS, MFIS scores and WM lesions volume than nonapathetic PwMS. Significant differences in DTI metrics were found in middle frontal, anterior cingulate and superior frontal PFC subregions and in caudate nuclei. Significant alterations were found in the right cingulum and left striatal-frontorbital tracts. Conclusions: Apathy in PwMS is associated with higher levels of physical disability, depression, anxiety and fatigue together with lower educational backgrounds. Microstructural damage within frontal cortex, caudate and fronto-striatal WM bundles is a significant pathological substrate of apathy in multiple sclerosis (MS).

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Behavioral disorders in multiple sclerosis: a comprehensive review;Journal of Neural Transmission;2024-09-04

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