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Research paper
Apathy and impaired emotional facial recognition networks overlap in Parkinson's disease: a PET study with conjunction analyses
  1. Gabriel Robert1,2,
  2. Florence Le Jeune1,3,
  3. Thibault Dondaine1,2,4,
  4. Sophie Drapier1,4,
  5. Julie Péron5,
  6. Clément Lozachmeur1,2,
  7. Paul Sauleau1,4,
  8. Jean-François Houvenaghel1,4,
  9. David Travers1,2,
  10. Bruno Millet1,2,
  11. Marc Vérin1,4,
  12. Dominique Drapier1,2
  1. 1Behavior and Basal Ganglia host team 4712, University of Rennes 1, Rennes, France
  2. 2Department of Psychiatry, Rennes University Hospital, Guillaume Régnier Hospital Centre, Rennes, France
  3. 3Department of Nuclear Medicine, Rennes University Hospital, Eugene Marquis Hospital Centre, Rennes, France
  4. 4Department of Neurology, Rennes University Hospital, Rennes, France
  5. 5Neuroscience of Emotion and Affective Dynamics lab, Swiss Center for Affective Sciences, Geneva, Switzerland
  1. Correspondence to Dr Gabriel Robert, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Centre Hospitalier Guillaume Régnier, 108 Avenue du Général Leclerc, Rennes 35000, France; gabriel.hadrien.robert{at}


Apathy is a disabling non-motor symptom that is frequently observed in Parkinson's disease (PD). Its description and physiopathology suggest that it is partially mediated by emotional impairment, but this research issue has never been addressed at a clinical and metabolic level. We therefore conducted a metabolic study using 18fluorodeoxyglucose positron emission tomography (18FDG PET) in 36 PD patients without depression and dementia. Apathy was assessed on the Apathy Evaluation Scale (AES), and emotional facial recognition (EFR) performances (ie, percentage of correct responses) were calculated for each patient. Confounding factors such as age, antiparkinsonian and antidepressant medication, global cognitive functions and depressive symptoms were controlled for. We found a significant negative correlation between AES scores and performances on the EFR task. The apathy network was characterised by increased metabolism within the left posterior cingulate (PC) cortex (Brodmann area (BA) 31). The impaired EFR network was characterised by decreased metabolism within the bilateral PC gyrus (BA 31), right superior frontal gyrus (BAs 10, 9 and 6) and left superior frontal gyrus (BA 10 and 11). By applying conjunction analyses to both networks, we identified the right premotor cortex (BA 6), right orbitofrontal cortex (BA 10), left middle frontal gyrus (BA 8) and left posterior cingulate gyrus (BA 31) as the structures supporting the association between apathy and impaired EFR. These results confirm that apathy in PD is partially mediated by impaired EFR, opening up new prospects for alleviating apathy in PD, such as emotional rehabilitation.

  • Neuropsychiatry
  • Parkinson's Disease
  • Pet, Functional Imaging

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