Apathy often a part of Parkinson’s disease
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 disease.”
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 write.
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 anywhere.”
SOURCE: Neurology, July 11, 2006.
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