Apathy Causes

Apathy
Published by HOPES
(Huntington's Outreach Project for Education, at Stanford University)

Characterized by indifference or lethargy, apathy is one of the most common behavioral symptoms of Huntington's Disease. An apathetic individual may seem to have a diminished concern for things he or she used to care about. The individual may seem uninterested in his or her surroundings and lose enthusiasm as well as spontaneity. A lack of motivation and loss of the ability to initiate conversation or activities also tends to occur in individuals suffering from apathy.

Coping with apathy can be very difficult for caregivers as well as for the affected family member. Families may feel that he or she is no longer the same person they knew because of the loss of interest in activities that were previously enjoyed. Apathy can also be a frustrating symptom of HD because a caregiver may feel that the person with HD is capable of performing an activity but wont.

Although the inability to initiate conversation or activity can occur independently, it tends to accompany apathy. The ability to initiate is a very complex brain function.

Apathy appears to be caused by changes in the brain due to HD. The middle and bottom sections of the frontal lobes are connected to the limbic system, a part of the brain that is associated with emotions.

HD leads to damage of a structure called the caudate nucleus, which may serve as a relay station for some of the messages being sent from the limbic system to the frontal lobes. As HD progresses, some of the connections from the caudate to the frontal lobes and limbic system are destroyed, potentially causing the frontal lobes to be disconnected from the emotions of the brain. As a result, the ability to self-initiate an activity is compromised, but the ability to perform the activity is retained.

Although aspects of apathy resemble depression, there are important distinctions. (see depression) Many patients suffering from apathy deny being sad. Once the initiative is provided, the person is usually capable and willing to be involved in a particular activity. To read an article about techniques for motivating individuals with HD, click here.