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Behavioural Neurology
Volume 27 (2013), Issue 4, Pages 501-513

Apathy in Parkinson’s Disease: Diagnosis, Neuropsychological Correlates, Pathophysiology and Treatment

Gabriella Santangelo,1,2 Luigi Trojano,1 Paolo Barone,2,3 Domenico Errico,1 Dario Grossi,1 and Carmine Vitale2,4

1Department of Psychology, Second University of Naples, Caserta, Italy
2Istituto di Diagnosi e Cura “Hermitage Capodimonte”, Naples, Italy
3Neurodegenerative Diseases Center, University of Salerno, Salerno, Italy
4University of Naples “Parthenope”, Naples, Italy

Received 10 December 2012; Accepted 10 December 2012

Copyright © 2013 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Apathy has been defined as lack of motivation. It has been traditionally considered as a symptom of psychiatric disorders, such as major depression and schizophrenia, but more recently it has been recognized as a specific neuropsychiatric syndrome associated with neurodegenerative such as Parkinson’s disease (PD). As a consequence the reported prevalence of apathy in PD ranges from 13.9% to 70%; the mean prevalence is 35%. Prevalence of “pure apathy” (i.e., of apathy without comorbid depression and dementia) seems to be substantially lower, from 3 to 47.9%. High levels of apathy in PD are associated with decreased daily function, specific cognitive deficits and increased stress for families. Although neuroimaging studies do not provide a unique anatomic pattern, several data suggest that the ventromedial prefrontal cortex and the basal ganglia connected through frontal-subcortical circuits, are particularly involved in the genesis of apathy. At present, there are no approved medications for the treatment of apathy in and no proof of efficacy exists for any drug in current use. Further studies and innovative pharmacologic approaches are thus needed to ameliorate our understanding and treatment of apathy in PD.