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重新审视阿尔茨海默病中的淡漠:从概念化到治疗方法。

Revisiting Apathy in Alzheimer's Disease: From Conceptualization to Therapeutic Approaches.

机构信息

Neuropsychiatry Program, UT Health Science Center at Houston, USA.

Instituto Ensino e Pesquisa, Santa Casa BH, Belo Horizonte, Brazil.

出版信息

Behav Neurol. 2021 Aug 3;2021:6319826. doi: 10.1155/2021/6319826. eCollection 2021.

Abstract

Apathy is a neurobehavioral syndrome characterized by impaired motivation for goal-directed behaviors and cognitive activity, alongside blunted affect. Apathy is a common neuropsychiatric syndrome in Alzheimer's disease (AD), with a 5-year prevalence over 70%. Apathy also serves as a prognostic indicator, correlating with the progression of AD. Despite advances in its conceptualization and understanding of its neural basis, there is very limited empirical evidence to support the available strategies for the treatment of apathy in AD. Given its complex pathophysiology, including distinct substrates for different apathy dimensions (affective, cognitive, and behavioral), it is unlikely that a single pharmacological or nonpharmacological strategy will be effective for all cases of apathy in AD. High-quality evidence research is needed to better understand the role of specific strategies aiming at a personalized approach.

摘要

淡漠是一种神经行为综合征,其特征为目标导向行为和认知活动的动机受损,同时情感迟钝。淡漠是阿尔茨海默病(AD)中常见的神经精神综合征,5 年内的患病率超过 70%。淡漠也是一个预后指标,与 AD 的进展相关。尽管在其概念化及其神经基础的理解方面取得了进展,但几乎没有支持 AD 中淡漠可用治疗策略的经验证据。鉴于其复杂的病理生理学,包括不同淡漠维度(情感、认知和行为)的不同基础,不太可能有一种单一的药物或非药物策略对 AD 中所有淡漠病例都有效。需要高质量的证据研究来更好地理解旨在个性化方法的特定策略的作用。

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