Apathy Antedating and Evolving With Dementia: A Case Report and Insights Into Apathy as a Network Dysfunction.
Apathy Antedating and Evolving With Dementia: A Case Report and Insights Into Apathy as a Network Dysfunction.
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DOI：
10.7759/cureus.13802
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发表时间：
2021-03-10
期刊：
影响因子：
--
通讯作者：
Kesserwani H
中科院分区：
文献类型：
--
作者：
Kesserwani H
冷漠是一种动机障碍，其特征是对显着的内源性或外源性影响或刺激缺乏动力或漠不关心。在古典文献中，它被称为精神能量或活力缺乏，归因于涉及下丘脑后部、丘脑、扣带皮层和海马结构的交感神经通路功能障碍。最近的先进成像研究扩大了网络功能障碍的范围，包括多巴胺能中脑边缘系统和测量中脑边缘系统价或能量的显着网络。经典的帕佩斯回路也在冷漠的发病机制中发挥着作用。为了理解神经退行性疾病、创伤和中风等多种疾病中出现的冷漠机制，我们需要将冷漠视为一种网络障碍。在这份报告中，我们提出了一个早于阿尔茨海默病并随其发展的冷漠案例，并深入研究了冷漠的网络理论并探索了潜在的药物疗法。
Apathy is a motivational disorder characterized by a lack of drive or indifference to salient endogenous or exogenous influences or stimuli. In the classical literature, it was referred to as a lack of mental energy or vitality and attributed to dysfunction of the ergotropic sympathetic pathway involving the posterior hypothalamus, thalamus, cingulate cortex, and hippocampal formation. Recent advanced imaging studies have expanded the ambit of network dysfunction to include the dopaminergic mesolimbic system and the salience network that gauges the valence or energy of the mesolimbic system. The classic Papez circuit also has a role in the pathogenesis of apathy. In order to understand the mechanisms of apathy seen with a wide range of diseases including neurodegenerative disorders, trauma, and strokes, one needs to think of apathy as a network disorder. In this report, we present a case of apathy antedating and evolving with Alzheimer’s disease and delve into the network theory of apathy and explore potential pharmacological therapies.
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