Zespół apatii w chorobach neurologicznych – stan wiedzy i aktualne kierunki badań
Apathy syndrome in neurological diseases - state of knowledge and current research directions

Summary/Abstract: Objective: Apathy is sometimes indicated as a symptom in various diseases, including: in psychiatry, but for several decades it has also been distinguished as an independent syndrome accompanying many neurological diseases. Although still omitted in current medical classifications, apathy syndrome is the subject of numerous theoretical and clinical analyses. Dissemination of knowledge about it among clinicians - including the possibility of recognizing and differentiating it, especially from depression - is of fundamental importance for the effectiveness of therapeutic interventions. The paper presents the definitions and diagnostic criteria of apathy syndrome proposed in the literature. It presents data on its frequency in various diseases, relationships with brain pathology and a number of clinical variables.Theses: Modern concepts emphasize the syndromic nature, multidimensionality of the apathy syndrome and its connections with broadly understood functions of the frontal lobes. The domains of functioning in which symptoms of apathy may be revealed include the cognitive and emotional spheres, social interactions and behavior (initiating and maintaining any purposeful activity). The syndrome's relative independence from depression is pointed out, its importance as a prognostic factor in the development of dementia, its relationship with the quality of life, the effectiveness of rehabilitation and the psychological burden on caregivers are emphasized. When searching for the cerebral basis of apathy, a number of partially overlapping processes and the significant role of the basal ganglia and selected areas of the prefrontal cortex are considered.Conclusion: Dysfunction of any link in complex prefrontal-subcortical circuits may be crucial for the occurrence of apathy symptoms, which explains the high frequency of the discussed syndrome in brain diseases, especially those involving damage to the basal ganglia and/or prefrontal cortex. The differences in the intensity of symptoms in individual domains and the repeatability of abnormality profiles observed depending on the analyzed disease entity and/or the location of brain pathology lead to the search for subtypes of the apathy syndrome.

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