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SCIENTIFIC LITERATURE · MED

The neuroanatomical and neurochemical basis of apathy and impulsivity in frontotemporal lobar degeneration.

Curr Opin Behav Sci · 2018-08-01

DOI: 10.1016/j.cobeha.2017.12.015PMID: 31032387

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Research overview

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Apathy and impulsivity are common and often coexistent consequences of frontotemporal lobar degeneration (FTLD). They increase patient morbidity and carer distress, but remain under-estimated and poorly treated. Recent trans-diagnostic approaches that span the spectrum of clinical presentations of FTLD and parkinsonism, indicate that apathy and impulsivity can be fractionated into multiple neuroanatomical and pharmacological systems. These include ventral/dorsal fronto-striatal circuits for reward-sensitivity, response-inhibition, and decision-making; moderated by noradrenaline, dopamine, and serotonin. Improved assessment tools, formal models of cognition and behavior, combined with brain imaging and psycho-pharmacology, are creating new therapeutic targets and establishing principles for stratification in future clinical trials.

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