The neural correlates of apathy in the context of aging and brain disorders: a meta-analysis of neuroimaging studies

Hongjie Yan; Huijun Wu; Zenglin Cai; Shouyun Du; Lejun Li; Bingchao Xu; Chunqi Chang; Nizhuan Wang

doi:10.3389/fnagi.2023.1181558

The neural correlates of apathy in the context of aging and brain disorders: a meta-analysis of neuroimaging studies

Front Aging Neurosci. 2023 Jun 16:15:1181558. doi: 10.3389/fnagi.2023.1181558. eCollection 2023.

Authors

Hongjie Yan^#¹, Huijun Wu^#^{2

3}, Zenglin Cai^#^{4

5}, Shouyun Du⁶, Lejun Li⁷, Bingchao Xu¹, Chunqi Chang^{2

8}, Nizhuan Wang⁹

Affiliations

¹ Department of Neurology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
² School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.
³ Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
⁴ Department of Neurology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China.
⁵ Department of Neurology, Gusu School, Suzhou Science and Technology Town Hospital, Nanjing Medical University, Suzhou, China.
⁶ Department of Neurology, Guanyun People's Hospital, Guanyun, China.
⁷ Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China.
⁸ Pengcheng Laboratory, Shenzhen, China.
⁹ School of Biomedical Engineering, ShanghaiTech University, Shanghai, China.

^# Contributed equally.

Abstract

Introduction: Apathy is a prevalent mood disturbance that occurs in a wide range of populations, including those with normal cognitive aging, mental disorders, neurodegenerative disorders and traumatic brain injuries. Recently, neuroimaging technologies have been employed to elucidate the neural substrates underlying brain disorders accompanying apathy. However, the consistent neural correlates of apathy across normal aging and brain disorders are still unclear.

Methods: This paper first provides a brief review of the neural mechanism of apathy in healthy elderly individuals, those with mental disorders, neurodegenerative disorders, and traumatic brain injuries. Further, following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, the structural and functional neuroimaging meta-analysis using activation likelihood estimation method is performed on the apathy group with brain disorders and the healthy elderly, aiming at exploring the neural correlates of apathy.

Results: The structural neuroimaging meta-analysis showed that gray matter atrophy is associated with apathy in the bilateral precentral gyrus (BA 13/6), bilateral insula (BA 47), bilateral medial frontal gyrus (BA 11), bilateral inferior frontal gyrus, left caudate (putamen) and right anterior cingulate, while the functional neuroimaging meta-analysis suggested that the functional connectivity in putamen and lateral globus pallidus is correlated with apathy.

Discussion: Through the neuroimaging meta-analysis, this study has identified the potential neural locations of apathy in terms of brain structure and function, which may offer valuable pathophysiological insights for developing more effective therapeutic interventions for affected patients.

Keywords: apathy; mental disorder; meta-analysis; neurodegenerative disorder; normal cognitive aging; traumatic brain injury.

Publication types

Review

Grants and funding

This work was supported by National Natural Science Foundation of China (No. 82001160), “HaiYan Plan” Scientific Research Funding Project of Lianyungang City (No. 2017-QD-009), The First People’s Hospital of Lianyungang–Advanced Technology Support Project (No. XJ1811), Project of Huaguoshan Mountain Talent Plan - Doctors for Innovation and Entrepreneurship, Special Project for Diagnosis and Treatment of Key Clinical Diseases in Suzhou (No. LCZX202029), Suzhou City Medical Device and New Medicine Clinical Trial Institutional Capacity Improvement Project (No. SLT202001), Suzhou Science and Technology Development Plan (No. SS2019048), Scientific research project of Gusu School, Nanjing Medical University (No. GSKY20210240), and Research Projects on Aging Health of Lianyungang City (No. L202201).