Delineating apathy profiles in Huntington's disease with the short-Lille Apathy Rating Scale

Audrey E De Paepe; Clara Garcia-Gorro; Saül Martinez-Horta; Jesus Perez Perez; Jaime Kulisevsky; Nadia Rodriguez-Dechicha; Irene Vaquer; Susana Subira; Matilde Calopa; Pilar Santacruz; Esteban Muñoz; Celia Mareca; Jesus Ruiz-Idiago; Ruth de Diego-Balaguer; Estela Camara

doi:10.1016/j.parkreldis.2022.10.025

Delineating apathy profiles in Huntington's disease with the short-Lille Apathy Rating Scale

Parkinsonism Relat Disord. 2022 Dec:105:83-89. doi: 10.1016/j.parkreldis.2022.10.025. Epub 2022 Oct 28.

Authors

Affiliations

¹ Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain.
² European Huntington's Disease Network; Movement Disorders Unit, Dept of Neurology, Biomedical Research Institute Sant Pau IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autonoma de Barcelona (U.A.B.), Medicine Department, Barcelona, Spain.
³ European Huntington's Disease Network; Movement Disorders Unit, Dept of Neurology, Biomedical Research Institute Sant Pau IIB-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERNED Center for Networked Biomedical Research on Neurodegenerative Diseases, Carlos III Institute, Madrid, Spain; Universitat Autonoma de Barcelona (U.A.B.), Medicine Department, Barcelona, Spain.
⁴ Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat Barcelona, Spain.
⁵ Hestia Duran i Reynals. Hospital Duran i Reynals, Hospitalet de Llobregat Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
⁶ Movement Disorders Unit, Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Spain.
⁷ Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.
⁸ Movement Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain; IDIBAPS Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Facultat de Medicina, University of Barcelona, Barcelona, Spain.
⁹ Hospital Mare de Deu de la Mercè, Barcelona, Spain.
¹⁰ Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain; Hospital Mare de Deu de la Mercè, Barcelona, Spain; FIDMAG Research Foundation, Barcelona, Spain.
¹¹ Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain; ICREA Catalan Institution for Research and Advanced Studies, Barcelona, Spain.
¹² Cognition and Brain Plasticity Unit Bellvitge Biomedical Research Institute - IDIBELL, 08097 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain. Electronic address: ecamara@idibell.cat.

PMID: 36395542
DOI: 10.1016/j.parkreldis.2022.10.025

Abstract

Introduction: Apathy, a prevalent feature in neurological disorders including Huntington's disease (HD), is characterized by a reduction in goal-directed behavior across cognitive, auto-activation (i.e., self-activating thoughts/behavior), and emotional domains. Nonetheless, current diagnostic criteria are incapable of distinguishing multidimensional apathy profiles. Meanwhile, the short-Lille Apathy Rating Scale (LARS-s) bears potential as an operative diagnostic tool to disentangle apathy dimensions in clinical practice. The present study thereby examines the psychometric properties and factor structure of the LARS-s to tap into apathy profiles and their underlying neural correlates in HD.

Methods: Forty HD individuals were scanned and evaluated for apathy using the LARS-s, assessed for reliability and validity in HD, and the short-Problem Behavior Assessment (PBA-s). To study the dimensional structure of apathy, principal component analysis (PCA) of the LARS-s was implemented. Resulting factors were associated with gray matter volume through whole-brain voxel-based morphometry.

Results: The LARS-s demonstrated satisfactory psychometric properties, sharing convergent validity with PBA-s apathy and discriminant validity against depression. PCA resulted in three factors representative of apathy profiles across cognitive, auto-activation, and emotional domains. Anatomically, global apathy was significantly related with large-scale motor, cognitive, and limbic networks. Exploratory analyses of apathy profiles revealed correspondence between each factor and distinct cortical and subcortical nodes.

Conclusion: The LARS-s is capable of capturing the multidimensional spectrum of apathy. At the same time, apathy profiles in HD are underpinned by functionally diverse neural networks. Such findings promote the continued study of apathy domains to pinpoint personalized therapeutic targets in neurologic disorders in addition to HD.

Keywords: Apathy profiles; Huntington's disease; Individual differences; Psychometric properties; Structural MRI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Apathy*
Brain
Emotions
Humans
Huntington Disease* / diagnostic imaging
Reproducibility of Results