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Journal of Neurology

, Volume 261, Issue 12, pp 2319–2328 | Cite as

Apathy in untreated, de novo patients with Parkinson’s disease: validation study of Apathy Evaluation Scale

  • Gabriella Santangelo
  • Paolo Barone
  • Sofia Cuoco
  • Simona Raimo
  • Domenica Pezzella
  • Marina Picillo
  • Roberto Erro
  • Marcello Moccia
  • Maria Teresa Pellecchia
  • Marianna Amboni
  • Santangelo Franco
  • Dario Grossi
  • Luigi TrojanoEmail author
  • Carmine Vitale
Original Communication

Abstract

Apathy is a behavioural disturbance occurring alone or in concomitance with depression in Parkinson’s disease (PD). Here we present a validation study for the self-report version of the Apathy Evaluation Scale (AES-S), carried out in a sample of 60 non-demented, non-depressed untreated, drug-naïve, de novo PD patients; 20 patients of the sample (33.3 %) were classified as apathetic according to current clinical criteria. All enrolled patients completed the AES-S and a neurological and cognitive assessment. Mean AES-S score was 34.43. AES-S did not show floor or ceiling effect. Cronbach’s alpha was 0.872. Principal component analysis revealed three factors: the first (34.4 % of the variance) represented constitutive aspects of the construct of apathy; the second (8.5 % of the variance) represented a social dimension; the third factor (7.9 % of the variance) represented a dimension related to insight. With respect to clinical criteria for apathy considered as the gold standard, receiver operating characteristics curve analysis showed that a cut-off of 36/37 has the maximum discrimination power. High sensitivity and negative predictive values were obtained with cut-off scores of 33/34 or lower; high specificity and positive predictive values were obtained with cut-off scores of 38/39 or higher. AES-S score correlated with scores on frontal tasks, but not on Beck Depression Inventory, Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr scale. The AES-S is a reliable and valid questionnaire for detecting apathy in PD. For screening purposes a 33/34 cut-off score is indicated, but a 38/39 cut-off score is necessary when a high specificity is desired.

Keywords

Parkinson’s disease Nonmotor symptoms Apathy Apathy Evaluation Scale Validation study Frontal executive dysfunctions 

Notes

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standards

The present study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Supplementary material

415_2014_7498_MOESM1_ESM.docx (105 kb)
Supplementary material 1 (DOCX 105 kb)
415_2014_7498_MOESM2_ESM.docx (101 kb)
Supplementary material 2 (DOCX 100 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Gabriella Santangelo
    • 1
    • 2
  • Paolo Barone
    • 3
  • Sofia Cuoco
    • 1
    • 3
  • Simona Raimo
    • 1
  • Domenica Pezzella
    • 1
  • Marina Picillo
    • 3
  • Roberto Erro
    • 4
    • 5
  • Marcello Moccia
    • 6
  • Maria Teresa Pellecchia
    • 3
  • Marianna Amboni
    • 2
  • Santangelo Franco
    • 6
  • Dario Grossi
    • 1
  • Luigi Trojano
    • 1
    Email author
  • Carmine Vitale
    • 2
    • 7
  1. 1.Department of PsychologySecond University of NaplesCasertaItaly
  2. 2.IDC-Hermitage-CapodimonteNaplesItaly
  3. 3.Department of Medicine and Surgery, Neurodegenerative Diseases CenterUniversity of SalernoSalernoItaly
  4. 4.Dipartimento di Scienze Neurologiche e del MovimentoUniversità di VeronaVeronaItaly
  5. 5.Sobell Department of Motor Neuroscience and Movement DisordersUniversity College London (UCL) Institute of NeurologyLondonUK
  6. 6.Department of Neuroscience Reproductive and Odontostomatologic SciencesUniversity of Naples Federico IINaplesItaly
  7. 7.University ParthenopeNaplesItaly

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