%0 Journal Article
%T An Exploration of Apathy and Impulsivity in Parkinson Disease
%A David J. Ahearn
%A Kathryn McDonald
%A Michelle Barraclough
%A Iracema Leroi
%J Current Gerontology and Geriatrics Research
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/390701
%X Background. Apathy and impulsivity in Parkinson disease (PD) are associated with clinically significant behavioral disorders. Aim. To explore the phenomenology, distribution, and clinical correlates of these two behaviors. Methods. In PD participants ( ) without dementia we explored the distribution of measures of motivation and impulsivity using univariate methods. We then undertook factor analysis to define specific underlying dimensions of apathy and impulsivity. Regression models were developed to determine the associated demographic and clinical features of the derived dimensions. Results. The factor analysis of apathy (AES-C) revealed a two-factor solution: ¡°cognitive-behavior¡± and ¡°social indifference¡±. The factor analysis of impulsivity (BIS-11) revealed a five-factor solution: ¡°inattention¡±; ¡°impetuosity¡±; ¡°personal security¡±; ¡°planning¡±; and ¡°future orientation¡±. Apathy was significantly associated with: age, age of motor symptom onset (positive correlation), disease stage, motor symptom severity, and depression. Impulsivity was significantly associated with: age of motor symptom onset (negative correlation), gambling and anxiety scores, and motor complications. We observed an overlap of apathy and impulsivity in some participants. Conclusion. In PD, apathy and impulsivity have specific phenomenological profiles and are associated with particular clinical phenotypes. In spite of this, there is some overlap of behaviors which may suggests common aspects in the pathology underlying motivation and reward processes. 1. Introduction The non-motor symptoms of Parkinson disease (PD) are increasingly recognised as being important factors in determining the quality of life of people living with the condition [1]. The psychiatric and cognitive aspects of these non-motor symptoms are generally well recognized; however, the behavioural syndromes of apathy and impulse control disorders (ICDs), and the symptoms that comprise them, have received much less attention and are less well understood. Apathy is a multidimensional construct and has been defined as a lack of goal-directed behavior, cognition, or emotion [2]. It can be assessed using rating scales such as the Apathy Evaluation Scale (AES-C) [3], which is one of the most widely used in PD. Impulsivity can be defined as ¡°actions that are poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation and that often result in undesirable outcomes¡± [4]. Impulsivity or ¡°impulsiveness¡± may underlie a broad range of psychiatric disorders in addition to the ICDs, including personality
%U http://www.hindawi.com/journals/cggr/2012/390701/