IRCCS Santa Lucia Foundation, University "Tor Vergata", Rome, Italy.
Alzheimer Dis Assoc Disord. 2013 Apr-Jun;27(2):192-4. doi: 10.1097/WAD.0b013e318260ab97.
Apathy is a common clinical feature of stroke patients and it is often correlated with cognitive deficits, functional impairment and depression. Here we report the case of a 70-year-old woman with no history of neuropsychiatric disorders who showed abrupt onset of pure apathy after the onset of a right brain vascular lesion located in the head of the caudate nucleus, the anterior part of the putamen, and the genu and the anterior limb of the internal capsule. A complete neuropsychological and neurological examination did not show deficits. A comprehensive neuropsychiatric assessment focusing on the post-stroke hospitalization period showed severe motor, cognitive and affective apathy with no depression or other neuropsychiatric symptoms. This case highlights the key role of the dorsal striatum in the development of pure apathy, possibly due to its function in regulating approach-attachment behavior, affect and initiative, which are the emotional, cognitive and motor dimensions of apathy.
淡漠是脑卒中患者的常见临床特征，常与认知障碍、功能障碍和抑郁相关。我们在此报告一例 70 岁女性病例，无神经精神疾病病史，在右侧尾状核头部、壳核前部和内囊膝部及前肢的血管病变发作后突然出现单纯淡漠。全面的神经心理学和神经系统检查未发现缺陷。在脑卒中住院期间进行的全面神经精神病学评估显示严重的运动、认知和情感淡漠，无抑郁或其他神经精神症状。本例强调了背侧纹状体在单纯淡漠发展中的关键作用，可能是由于其在调节趋近-依恋行为、情感和主动性方面的作用，而这些是淡漠的情感、认知和运动维度。
