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Neuroimaging Correlates of Apathy and Depression in Alzheimer’s Disease

Received May 7, 2008; revised July 31, 2008; accepted August 1, 2008. Drs. Starkstein, Brockman, and Power are affiliated with the School of Psychiatry and Clinical Neurosciences at University of Western Australia Fremantle Hospital, Western Australia; Dr Mizrahi is affiliated with PET Center for Addiction and Mental Health, Clarke Division, Toronto, Canada; Drs. Capizzano and Acion are affiliated with the Department of Psychiatry at the University of Iowa, Iowa City, Iowa. Address correspondence to Prof. Sergio E. Starkstein, Education building T-7, Fremantle Hospital, Fremantle, 6959 WA, Australia; ses{at}cyllene.uwa.edu.au (e-mail).

A consecutive series of 79 patients with probable Alzheimer’s disease were assessed with a structured psychiatric evaluation, and diagnoses of apathy and depression were made using standardized criteria. Three-dimensional MRI scans were obtained from all patients, and images were segmented into gray matter, white matter, and CSF. White matter hyperintensities were edited on segmented images, and lobar assignments (frontal, temporal, parietal, and occipital) were made based on Talairach coordinates. Patients with apathy showed a significantly larger volume of frontal white matter hyperintensities than patients without apathy. Patients with depression had a significantly larger volume of right parietal white matter hyperintensities than patients without depression. However, neither apathy nor depression was significantly associated with lobar gray or white matter atrophy. Frontal and right parietal white matter hyperintensities are the strongest brain structural correlates of apathy and depression in Alzheimer’s disease.

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