Apathy is one of the most common behavioral symptoms of dementia; it is one of the salient features of behavioral variant of frontotemporal dementia (bvFTD) but is also very frequent in Alzheimer's disease. This preliminary investigation was aimed at assessing the type of apathy-related symptoms in a population of bvFTD and AD subjects showing comparable apathy severity. Each patient underwent a comprehensive neuropsychological assessment; behavioral changes were investigated by the neuropsychiatric inventory (NPI), using the NPI-apathy subscale to detect apathetic symptoms. At univariate analysis, bvFTD subjects showed lack of initiation ( , ), reduced emotional output ( , ), and reduced interest toward friends and family members ( , ), more frequently than AD subjects. BvFTD displayed higher scores than AD on NPI total score ( ) and on subscales assessing agitation ( ), disinhibition ( ) and sleep disturbances ( ); conversely, AD subjects were more impaired on memory, constructional abilities, and attention. On multivariate logistic regression, reduced emotional output was highly predictive of bvFTD ( ; ). Our preliminary findings support the hypothesis that apathy is a complex phenomenon, whose clinical expression is conditioned by the site of anatomical damage. Furthermore, apathy profile may help in differentiating bvFTD from AD. 1. Introduction Apathy has been repeatedly reported to be one of the most common noncognitive symptoms of dementia [1–3]. Frequency and severity of apathy vary across different dementia subtypes; it is the most common behavioral symptom of behavioral variant of frontotemporal dementia (bvFTD), with reported prevalence ranging from 62 to 89% of patients [4]; the prevalence of apathy in AD ranges from 25 to 88% [5, 6] with a trend to increase with disease severity [7]. When severity was directly compared, higher levels of apathy have been reported in bvFTD than in AD [8–11]. The functional and neuroanatomical substrates of apathy seem to differ between AD and bvFTD. In bvFTD, apathy severity has been associated with orbitofrontal abnormalities, both in MRI [12] and PET [13] studies, and with volume loss in the dorsal anterior cingulate and dorsolateral prefrontal cortex [14]. On the other hand, in AD apathy severity has been connected to neurofibrillary tangles density in the anterior cingulate gyrus [15] and to grey matter atrophy in the anterior cingulate and in the left medial frontal cortex [16]. These findings were confirmed by a PET study showing the association of apathy with hypometabolism in the bilateral anterior
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