INSERM, Unité 1114, Strasbourg 67000, France.
University of Strasbourg, Strasbourg 67084, France.
Cereb Cortex. 2023 Jun 8;33(12):7714-7726. doi: 10.1093/cercor/bhad074.
Initiative apathy is the most disabling form of apathy, prevalent both in neuropsychiatric pathologies and in the healthy population. This apathy has been specifically associated with functional abnormalities of the anterior cingulate cortex, a key structure underlying Effort-based Decision-Making (EDM). The main aim of the present study was to explore, for the first time, the cognitive and neural effort mechanisms of initiative apathy, by distinguishing the steps of effort anticipation and effort expenditure and the potential modulating effect of motivation. We conducted an EEG study in 23 subjects with specific subclinical initiative apathy and 24 healthy subjects with no apathy. The subjects had to complete two effort tasks. The analysis of behavioral choices, CNV, and mPFC theta power highlighted that initiative apathy is associated with effort avoidance and impairments of effort anticipation and effort expenditure that suggest EDM deficits. Better knowledge of these impairments should aid the development of new, more targeted therapeutic interventions necessary for reducing the debilitating consequences of initiative apathy.
主动性冷漠是最具致残性的冷漠形式，既普遍存在于神经精神病理学中，也存在于健康人群中。这种冷漠与前扣带皮层的功能异常特别相关，前扣带皮层是基于努力的决策制定（EDM）的关键结构。本研究的主要目的是首次通过区分努力预期和努力支出的步骤以及动机的潜在调节作用，探索主动性冷漠的认知和神经努力机制。我们对 23 名有特定亚临床主动性冷漠的受试者和 24 名无冷漠的健康受试者进行了 EEG 研究。受试者必须完成两项努力任务。行为选择、CNV 和 mPFCθ 功率的分析表明，主动性冷漠与努力回避以及努力预期和努力支出的障碍有关，这表明 EDM 存在缺陷。对这些损伤的更好了解应该有助于开发新的、更有针对性的治疗干预措施，以减少主动性冷漠的致残后果。
