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SPECT and PET Imaging of Apathy

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PET and SPECT in Psychiatry

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Abstract

Apathy is a frequent behavioural syndrome which is now characterised by precise criteria. It can be found in various neuropsychiatric diseases. In Alzheimer’s disease (AD), in particular, it is present at all stages, and, in patients with minor/mild cognitive disorders, it is a risk factor for dementia conversion.

An anterior cingulate-subcortical circuit which originates from the anterior cingulate cortex in Brodmann’s area (BA) 24 and 32 and projects to the ventral striatum, is the main anatomical support of motivated behaviour. Lesions of this cortico-subcortical circuit are responsible for apathetic syndromes.

SPECT perfusion studies first demonstrated in vivo the relationships between apathy and lesions of this circuit. FDG PET studies confirmed these findings in particular in AD. In degenerative diseases, apathy is generally related to anterior cingulate hypoperfusion or hypometabolism. This is a recognisable pattern for image interpretation.

In post-stroke patients, the situation is different, apathy being mostly due to lesions located at the subcortical levels of the circuit.

In Parkinson disease, in particular under subthalamic nucleus deep brain stimulation which is known to increase apathy, the metabolic pattern is somehow different with an increased metabolism in the right frontal areas and a decrease in the posterior cingulate.

In many neuropsychiatric disorders, brain molecular imaging is helpful to show or confirm the possible anatomical correlates of apathy and its association with other local regional dysfunctions. This has to be taken into account in the image reporting since it can have therapeutic implications.

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Authors and Affiliations

  1. Nuclear Medicine Department, Centre Antoine Lacassagne, Nice, UMR-E4320 CEA TIRO, Université Côte d’Azur, Nice, France

    Jacques Darcourt

  2. Nuclear Medicine Department, Centre Eugène Marquis, Rennes. EA 4712 Comportement et Noyaux Gris Centraux, Université de Rennes 1, Rennes, France

    Florence Le Jeune

  3. EA CoBTeK, Memory Centre—Université Côte d’Azur, Nice, France

    Valéria Manera & Philippe Robert

Authors
  1. Jacques Darcourt
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  2. Florence Le Jeune
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  3. Valéria Manera
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  4. Philippe Robert
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Corresponding author

Correspondence to Jacques Darcourt .

Editor information

Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering, Medical Engineering and Computer Science, Offenburg University, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F. J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, The Netherlands

    Iris E. Sommer

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Darcourt, J., Le Jeune, F., Manera, V., Robert, P. (2021). SPECT and PET Imaging of Apathy. In: Dierckx, R.A., Otte, A., de Vries, E.F.J., van Waarde, A., Sommer, I.E. (eds) PET and SPECT in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-57231-0_31

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  • DOI: https://doi.org/10.1007/978-3-030-57231-0_31

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