The neuroanatomical and neurochemical basis of apathy and impulsivity in frontotemporal lobar degeneration

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Apathy and impulsivity are common and often coexistent consequences of frontotemporal lobar degeneration (FTLD). They increase patient morbidity and carer distress, but remain under-estimated and poorly treated. Recent trans-diagnostic approaches that span the spectrum of clinical presentations of FTLD and parkinsonism, indicate that apathy and impulsivity can be fractionated into multiple neuroanatomical and pharmacological systems. These include ventral/dorsal frontostriatal circuits for reward-sensitivity, response-inhibition, and decision-making; moderated by noradrenaline, dopamine, and serotonin. Improved assessment tools, formal models of cognition and behavior, combined with brain imaging and psychopharmacology, are creating new therapeutic targets and establishing principles for stratification in future clinical trials.

Original languageEnglish
JournalCurrent Opinion in Behavioral Sciences
Volume22
Pages (from-to)14-20
Number of pages7
ISSN2352-1546
DOIs
Publication statusPublished - 2018

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