Thanks to medical imaging (CT, MRI ...), neurobiological abnormalities have been observed and implicated in apathy. The neural circuits involved mainly involve two hormones: dopamine and acetylcholine.
This attack focuses on an area of the brain called the orbito-frontal cortex. The neural circuits reached in apathy are involved in motivational processes, in that they form an interface between emotions, decision-making and action.
As a result, the person with apathy experiences less emotional reactivity to environmental stimuli, as well as less sensitivity to the reward. Being unable to measure the emotional consequences of a possible action, the subject remains stuck in the absence of decision-making.The causes of apathy are diverse and related to pathologies responsible for dysfunction of the brain area involved in motivation.
Depending on each pathology, the expression of apathy may find nuances insofar as it depends on the modalities of reaching the neural circuits.
> Psychiatric illnesses
Apathy is a very common symptom of schizophrenia. Occurs in more than 50% of cases, it is part of the so-called negative symptoms, term used to designate the symptoms responsible for withdrawal from social life.
If schizophrenia is often equated with a quirk of behavior and the expression of delusional elements (such as hallucinations), the so-called "negative" symptoms, mainly represented by apathy, remain little known. However, they are frequent, and their intensity is directly related to a greater socio-familial handicap. They can be partially or totally reduced by the antipsychotic treatments prescribed in schizophrenia.In about 50% of cases, bipolar disorder, cyclothymia, and post-traumatic stress disorder may be responsible for apathy.
Dementias are age-related diseases caused by progressive degeneration of nerve cells.
- Alzheimer's disease: apathy is a common symptom of Alzheimer's disease, observable from the beginning of the disease and correlated with its progression. Apathy is present in about 3/4 of the cases.
- Parkinson's disease: Parkinson's disease is observed in more than 1/4 of the cases. If apathy appears associated with the intensity of executive cognitive disorders (difficulty of organization, planning of daily life, etc.), it would not be related to the severity of motor disorders.
- Frontotemporal Dementia : Apathy is one of the most common initial signs, and its severity depends on the importance of neuronal loss. Apathy is observed in 70% of all stages.
- Supra-nuclear progressive paralysis : it is a rare neuro-degenerative disease responsible for apathy in about 70% of cases.
> Other neurological diseases ...
Any disease likely to reach the brain (Huntington's disease, head trauma, stroke, various dementias, infections, etc.) may be responsible for apathy, in the case of an impairment of the brain area involved in the disease. motivation.
> Toxic or medicinal causes
Drug causes: Some drugs, such as neuroleptics (otherwise known as antipsychotics) or some antidepressants, may be responsible for apathy.
If this side effect becomes disabling for daily life, it is best, if possible, to change the treatment.
Toxic causes: addiction, as well as alcohol and cannabis abuse can be responsible for apathy.
In addition to the consequences of the consumption of toxic substances, apathy may be one of the manifestations of withdrawal from certain psycho-stimulants (cocaine, amphetamines, etc.).Want to react, share your experience or ask a question? See you on our FORUMS Psychology, Depression or Stress and anxieties !
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