Apathy, not depressive symptoms, as a predictor of semantic and phonemic fluency task performance in stroke and transient ischemic attack.

Autor: Fishman KN; a Department of Psychology, Faculty of Social Sciences , University of Ottawa , Ottawa , ON , Canada., Ashbaugh AR; a Department of Psychology, Faculty of Social Sciences , University of Ottawa , Ottawa , ON , Canada., Lanctôt KL; b Department of Medicine (Psychiatry) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Cayley ML; c Department of Medicine (Neurology) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Herrmann N; d Department of Medicine (Psychiatry) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Murray BJ; c Department of Medicine (Neurology) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Sicard M; c Department of Medicine (Neurology) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Lien K; c Department of Medicine (Neurology) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada., Sahlas DJ; e Department of Medicine (Neurology), Hamilton Health Sciences , Hamilton General Hospital, McMaster University , Hamilton , ON , Canada., Swartz RH; c Department of Medicine (Neurology) , Sunnybrook Health Sciences Centre , Toronto , ON , Canada.
Jazyk: angličtina
Zdroj: Journal of clinical and experimental neuropsychology [J Clin Exp Neuropsychol] 2018 Jun; Vol. 40 (5), pp. 449-461. Date of Electronic Publication: 2017 Sep 15.
DOI: 10.1080/13803395.2017.1371282
Abstrakt: Objectives: This study examined the relationship between apathy and cognition in patients with cerebrovascular disease. Apathy may result from damage to frontal subcortical circuits causing dysexecutive syndromes, but apathy is also related to depression. We assessed the ability of apathy to predict phonemic fluency and semantic fluency performance after controlling for depressive symptoms in 282 individuals with stroke and/or transient ischemic attack.
Method: Participants (N = 282) completed the Phonemic Fluency Test, Semantic Fluency Test, Center for Epidemiologic Studies Depression Scale, and Apathy Evaluation Scale. A cross-sectional correlational design was utilized.
Results: Using hierarchical linear regressions, apathy scores significantly predicted semantic fluency performance (β = -.159, p = .020), but not phonemic fluency performance (β = -.112, p = .129) after scaling scores by age and years of education and controlling for depressive symptoms. Depressive symptoms entered into the first step of both hierarchical linear regressions did not predict semantic fluency (β = -.035, p = .554) or phonemic fluency (β = -.081, p = .173). Apathy and depressive symptoms were moderately correlated, r(280) = .58, p < .001.
Conclusions: The results of this study are consistent with research supporting a differentiation between phonemic and semantic fluency tasks, whereby phonemic fluency tasks primarily involve frontal regions, and semantic fluency tasks involve recruitment of more extended networks. The results also highlight a distinction between apathy and depressive symptoms and suggest that apathy may be a more reliable predictor of cognitive deficits than measures of mood in individuals with cerebrovascular disease. Apathy may also be more related to cognition due to overlapping motivational and cognitive frontal subcortical circuitry. Future research should explore whether treatments for apathy could be a novel target for improving cognitive outcomes after stroke.
Databáze: MEDLINE
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