Objective: To assess the prevalence of apathy in patients with patients with Parkinson’s disease and to correlate it with nigrosomal imaging in a subset of patients.

Background: Apathy is a common yet neglected non motor symptom, which can be found at any stage of Parkinson’s disease (PD). Apathy is associated with poor quality of life and increased care giver burden. Hence, recognition of apathy is important for treatment and care. Nigrosomal imaging is a biomarker for PD but its association with non motor symptoms especially apathy is not defined.

Method: This is a single center prospective observational study, done between October 2018 to October 2019. Parkinson’s disease patients baseline data, UPDRS scores were recorded in all. Presence of apathy was assessed using Lille apathy rating scale (LARS). Nigrosomal imaging, an imaging biomarker for PD was performed in a subset using SWI imaging with a 3T MRI.

Results: 100 patients were included in this study. Twenty eight percent (28%) had apathy [14% each had moderate (grade 2) and severe grade(grade3)]. 13% had only mild signs of apathy (grade 1).The mean LARS score was -20.60(SD=10.145). Intellectual curiosity was the most affected subscore in our study (Mean= -1.99, SD=1.33). Table 1 shows the domains involved No statistically  difference was found between PD-Apathy and PD-Non Apathy groups in regards to age (p=0.32), age of onset (p=0.51), duration of symptoms (p=0.91), UPDRS scores and core clinical features. On comparison of normal PD patients and those with any grades of apathy, higher age (p=0.045), reduced alertness 30 min after awakening (p=0.014), longer time to get up in the morning (p=0.041) was seen in apathy group. Nigrosomal imaging (done in 20 patients) was abnormal in 90% of patients. 40% patients had bilateral symmetrical nigrosome abnormality and 50% had abnormality on opposite side of onset of Parkinson disease symptoms.

Conclusion: Apathy was prevalent in 28% of patients with Parkinson’s disease. Intellectual curiosity subscore was the most effected one. No statistical difference was found between abnormality on Nigrosomal imaging with side of onset of disease and presence or absence of apathy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-of-apathy-in-indian-patients-with-parkinsons-disease-and-its-correlation-with-nigrosomal-imaging/