Background: Although the item Starkstein Apathy Scale (SAS) is recommended to screen for and measure the severity of apathetic symptoms in Parkinson. Although the item Starkstein Apathy Scale (SAS) is recommended to screen for and measure the severity of apathetic symptoms in Parkinson disease (PD). Items 9 – 14 breviated version of the AES, known as the Apathy Scale. Copyright © SciRes. ..  Starkstein, S.E. and Leentjens, A.F.G. () The noso-.
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Briefly, apathy was diagnosed whenever patients had 1 Poor or no motivation as rated with item 7 on the Apathy Scale2 Poor or no interests as rated with items 1 and 2 or effort as rated with items 4 and 9and 3 Feelings of indifference or lack of emotions most or all of the time as rated with items 10 and Recent studies provided working definitions of apathy that were operationalized into standardized diagnostic criteria.
These diagnostic criteria have been validated for patients with Alzheimer’s disease, but their validity in other neuropsychiatric conditions remains to be established.
Clinical information was obtained from caregivers, who filled the Apathy Scale about the patient. We have recently published the validity and reliability of the Structured Clinical Interview for Apathy Starkstein et al. Recent Developments in Parkinson’s Disease. Attention and memory dysfunction after traumatic brain injury: Am J Psychiatry ; 5: Dement Geriatr Cogn Disord ; 10 2: There are no specific randomized controlled trials of psychoactive compounds to treat apathy in neuropsychiatric disorders.
On the overlap between apathy and depression in dementia. Several treatment studies suggested that anticholinesterase compounds may starkstein apathy scale apathy among patients with dementia.
However, the magnitude and temporal course of their therapeutic effect is still controversial Whyte et al. The authors found a significant improvement on apathy measures over the course of the study, but there were no significant differences between the treatment groups on any of the outcome measures. In a recent study we assessed the longitudinal evolution of apathy in a consecutive series of patients with probable AD attending a memory clinic Starkstein et al. J Head Trauma Rehabil ; 20 4: Int J Geriatr Psychiatry ; 17 Textbook of Traumatic Brain Injury.
Thus, the beneficial effects of cholinergic therapy in AD needs to be replicated in larger, adequately powered clinical trials. Finally, we also found that patients with apathy at baseline or those that developed apathy during the follow-up period had a faster cognitive and functional decline than patients with no apathy at baseline or at follow-up.
Conclusions Although starkstein apathy scale SAS showed fairly good psychometric properties and the exploratory factor analysis suggested a two-factor solution, the results with starkstein apathy scale PD sample indicate scalw item 3 is ambiguous and should be considered removed from the scale.
There are several valid and reliable scales to measure the severity of apathy in adults with neuropsychiatric disorders. In spite of the strong negative impact of apathy in AD, treatment studies for this frequent behavioural condition are surprisingly few. Evidence from case reports and small case series suggest the usefulness of psychostimulants to treat apathy in traumatic brain injury, whereas pharmacological trials for behavioural and psychological problems in dementia suggest that anticholinesterases may have some efficacy.
The authors suggested that testosterone replacement therapy may constitute a helpful treatment of apathy for these patients. Clinical correlates and course of apathy in AD Most studies on apathy in AD have been cross-sectional, and all of them demonstrated a significant association between more severe apathy and more severe dementia.
J Head Trauma Rehabil Aug; 17 4: Furthermore, changes on the Neuropsychiatric Inventory were rather small and may not have been clinically relevant. Starkstein apathy scale on this item are 0: They further suggested that apathy may result from the disruption of prefrontal cortex-basal ganglia circuits, considered to play a critical role in the generation and control of self-generated purposeful behaviour.
The prevalence, clinical correlates and treatment of apathy in Alzheimer’s disease
Recent studies emphasized the potential importance of parallel and segregated cortico-subcortical loops originating from and terminating in the frontal lobes for the mechanism of neuropsychiatric disorders Cummings It is important to stress that the effect of rivastigmine was not specific for apathy, since improvements were also noticed on other neuropsychiatric disturbances.
Recent studies found that apathy in Alzheimer’s disease is significantly associated with older age, relatively more severe cognitive deficits, depression, and more severe impairments in activities of daily living. One of the main diagnostic dilemmas is how to separate apathy from depression.
A short review of cognitive and functional neuroimaging studies of cholinergic drugs: The mechanism of apathy in neuropsychiatric disorders is still unknown, but several studies suggest an important role for frontal lobe and basal ganglia dysfunction.
Treatment of apathy There are few randomized controlled trials of pharmacological or non-pharmacological treatments for apathy in AD. Several treatment studies suggested that anticholinesterase compounds may improve apathy among patients with dementia.
Effects of methylphenidate on attention deficits after traumatic brain injury: This would explain why some patients with orbito-frontal lesions who mostly show disinhibited behaviours, also feature xcale concomitant loss of motivation. Apathy is most frequently associated with depression and severe dementia. Our group and others have also reported a relatively high frequency of apathy among patients with stroke lesions, traumatic brain injury, Parkinson’s disease, and Huntington’s disease Burns et al.
Starkstein Starkstein standardized Marin’s construct into a set of criteria based on the presence of diminished goal-directed behaviour, diminished goal-directed etarkstein, and diminished concomitants of goal-directed behaviour Table I. Athymhormia and disorders of motivation in Basal Ganglia apahty.
Apathy was assessed with the Apathy Scale and diagnosed using the diagnostic criteria shown in Table I.
Starkstein Apathy Scale (SAS)
One of these circuits originates in the anterior cingulate cortex, connects with the ventral globus pallidus and the dorsomedial thalamus, and projects back to the anterior cingulate. Int Psychogeriatr ; 12 Suppl 1: Syndromic validity of apathy in Alzheimer’s disease. Furthermore, changes on the Neuropsychiatric Inventory were rather small and may not have been clinically relevant.
Reliability, validity, and clinical correlates of scaoe in Parkinson’s disease. Apathy following cerebrovascular lesions.
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Subacute methylphenidate treatment for moderate to moderately severe traumatic brain injury: Thirteen of these 29 patients also had major depression, 5 patients had minor depression, and 11 patients were not depressed. About two thirds of the AD patients sczle apathy were also depressed either major or minor depression. Politis and coworkers Politis et al. The authors have no disclosures to report.