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Apathy is associated with white matter network disruption and specific cognitive deficits in Parkinson's disease

Published online by Cambridge University Press:  11 June 2020

Ming-Ching Wen Open the ORCID record for Ming-Ching Wen [Opens in a new window] ,
Alexandre Thiery ,
Wen-Yih Isaac Tseng ,
Trina Kok ,
Zheyu Xu ,
Shu Ting Chua  and
Louis C.S. Tan
Ming-Ching Wen*
Affiliation:
Department of Research, National Neuroscience Institute, Singapore Duke-NUS Medical School, Singapore
Alexandre Thiery
Affiliation:
Department of Statistics and Applied Probability, National University of Singapore, Singapore
Wen-Yih Isaac Tseng
Affiliation:
Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
Trina Kok
Affiliation:
Clinical Imaging Research Centre, National University of Singapore, Singapore
Zheyu Xu
Affiliation:
Department of Neurology, National Neuroscience Institute, Singapore
Shu Ting Chua
Affiliation:
Department of Neurology, National Neuroscience Institute, Singapore
Louis C.S. Tan
Affiliation:
Department of Research, National Neuroscience Institute, Singapore Duke-NUS Medical School, Singapore Department of Neurology, National Neuroscience Institute, Singapore
*
Author for correspondence: Ming-Ching Wen, E-mail: [email protected]
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Abstract

Background

Apathy is common in Parkinson's disease (PD) but its underlying white matter (WM) architecture is not well understood. Moreover, how apathy affects cognitive functions in PD remains unclear. We investigated apathy-related WM network alterations and the impact of apathy on cognition in the context of PD.

Methods

Apathetic PD patients (aPD), non-apathetic PD patients (naPD), and matched healthy controls (HCs) underwent brain scans and clinical assessment. Graph-theoretical and network-based analyses were used for group comparisons of WM features derived from diffusion spectrum imaging (DSI). Path analysis was used to determine the direct and indirect effects of apathy and other correlates on different cognitive functions.

Results

The aPD group was impaired on neural integration measured by global efficiency (p = 0.009) and characteristic path length (p = 0.04), executive function (p < 0.001), episodic memory (p < 0.001) and visuospatial ability (p = 0.02), and had reduced connectivity between the bilateral parietal lobes and between the putamen and temporal regions (p < 0.05). In PD, executive function was directly impacted by apathy and motor severity and indirectly influenced by depression; episodic memory was directly and indirectly impacted by apathy and depression, respectively; conversely, visuospatial ability was not related to any of these factors. Neural integration, though being marginally correlated with apathy, was not associated with cognition.

Conclusions

Our results suggest compromised neural integration and reduced structural connectivity in aPD. Apathy, depression, and motor severity showed distinct impacts on different cognitive functions with apathy being the most influential determinant of cognition in PD.

Keywords

Apathycognitiondiffusion spectrum imaginggraph theorymotor severity
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 2 , January 2022 , pp. 264 - 273
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Senior author.

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