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.