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Apathy and executive function in Parkinson's disease

A 2020/2021 Summer Studentship research project

Student: Nasya Thompson
Supervisors: Dr Campbell Le Heron, Dr Michael Macaskill
Sponsor: Canterbury Medical Research Foundation

Introduction

Apathy, or reduced motivated behaviour, is a common and disabling non-motor feature of Parkinson’s disease (PD). Recent work suggests it may be caused by disruption of the normal neurobiological process of effort-based decision making – how the brain integrates reward and cost information to drive behaviour (or not) towards goals. However the importance of executive functions (working memory, cognitive flexibility, planning) – which are also often disrupted in PD – to the development of apathy remains poorly understood, with no sizeable studies conducted to date. We will examine the relationship between executive function and apathy. We hypothesise that dysfunction of executive processes will be associated with the presence of apathy, driven by the behavioural, rather than emotional reactivity or social, subdomain of apathy.

Aim

Treatments for apathy remain limited, despite it being consistently rated as one of the most debilitating symptoms of PD. This research will broaden understanding of the different causes of this syndrome, which ultimately will allow individualised interventions (pharmacological and non-pharmacological) to specifically target disrupted cognitive pathways and restore motivated behaviour.

Method

Our longitudinal PD cohort (>200 patients + healthy controls) have undergone extensive neuropsychological testing, including executive functions. We will administer a fine-grained recently developed questionnaire, which dissociates behavioural, emotional and social dimensions of apathy, to these patients. Standard statistical approaches (multivariate linear regression) will be applied to examine the relationship between executive functions and apathy (dependent variable), controlling for factors such as global cognition and level of dopamine use.

Student researcher’s component of the study

The student researcher will administer the questionnaire to participants, collate all data, perform the statistical analyses (under close supervision/tuition) and contribute to writing a research paper.

Student prerequisites

Enthusiastic student with an interest in normal brain function and neurological disorders! Statistical skills helpful but will be taught as part of the project.