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Neurology, Neuropsychiatry, Psychosomatics

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Apathy, anhedonia and cognitive dysfunction: common symptoms of depression and neurological disorders

https://doi.org/10.14412/2074-2711-2022-5-96-102

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Abstract

Depression is one of the most common mental disorders in neurological practice. Among other symptoms of depression, a symptom complex represented by apathy, anhedonia, and cognitive impairment plays an important role. This review presents the clinical characteristics of the symptoms described above and discusses modern neurochemical and neuroimaging concepts of their pathogenesis. The problem of pathogenetically substantiated therapy of depression with a predominance of apathy, anhedonia and cognitive impairment is discussed. Fundamental and clinical arguments are presented in favor of the high efficacy of vortioxetine in depression with a predominance of apathy, anhedonia, and cognitive impairment. 

About the Authors

D. S. Petelin
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



S. P. Bairamova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



O. Yu. Sorokina
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



I. N. Niinoja
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



A. B. Lokshina
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



B. A. Volel
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

2, Bolshaya Pirogovska St., Build. 4, Moscow 119991



References

1. Golovacheva VA, Parfyonov VA. Depression in neurological practice: prevalence, diagnosis, treatment standards and new options for pharmacotherapy. Meditsinskiy sovet = Medical Council. 2015;(5):55-61. doi: 10.21518/2079-701X-2015-5-55-61 (In Russ.).

2. Romanov DV, Volel BA, Petelin DS. Approaches to therapy for depressions in neurology: prospects for the use of agomelatine. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):101-10. doi: 10.14412/2074-2711-2018-4-101-110 (In Russ.).

3. Romanov DV, Petelin DS, Volel BA. Depression in neurological practice. Meditsinskiy sovet = Medical Council. 2018;(1):38-45. doi: 10.21518/2079-701X2018-1-38-45 (In Russ.).

4. Rickards H. Depression in neurological disorders: Parkinson's disease, multiple sclerosis, and stroke. J Neurol Neurosurg Psychiatry. 2005 Mar;76 Suppl 1:i48-52. doi: 10.1136/jnnp.2004.060426

5. Vrieze E, Demyttenaere K, Bruffaerts R, et al. Dimensions in major depressive disorder and their relevance for treatment outcome. J Affect Disord. 2014 Feb;155:35-41. doi: 10.1016/j.jad.2013.10.020

6. Vares EA, Salum GA, Spanemberg L, et al. Depression Dimensions: Integrating Clinical Signs and Symptoms from the Perspectives of Clinicians and Patients. PLoS One. 2015 Aug 27;10(8):e0136037. doi: 10.1371/journal.pone.0136037

7. Sorokin SA. Endogennyye apaticheskiye depressii (voprosy psikhopatologii, kliniki i terapii): Dis. … kand. med. nauk [Endogenous apathetic depressions (issues of psychopathology, clinic and therapy): Dis. … cand. med. sci]. Moscow; 2015. 196 p. (In Russ.).

8. Lanctot KL, Agüera-Ortiz L, Brodaty H, et al. Apathy associated with neurocognitive disorders: Recent progress and future directions. Alzheimers Dement. 2017 Jan;13(1):84- 100. doi: 10.1016/j.jalz.2016.05.008

9. Husain M, Roiser JP. Neuroscience of apathy and anhedonia: a transdiagnostic approach. Nat Rev Neurosci. 2018 Aug;19(8):470-84. doi: 10.1038/s41583-018- 0029-9

10. Fahed M, Steffens DC. Apathy: Neurobiology, Assessment and Treatment. Clin Psychopharmacol Neurosci. 2021 May 31;19(2):181-9. doi: 10.9758/cpn.2021.19.2.181

11. Yuen GS, Bhutani S, Lucas BJ, et al. Apathy in late-life depression: common, persistent, and disabling. Am J Geriatr Psychiatry. 2015 May;23(5):488-94. doi: 10.1016/j.jagp.2014.06.005

12. Lenze EJ, Skidmore ER, Dew MA, et al. Does depression, apathy or cognitive impairment reduce the benefit of inpatient rehabilitation facilities for elderly hip fracture patients? Gen Hosp Psychiatry. 2007 Mar-Apr;29(2):141- 6. doi: 10.1016/j.genhosppsych.2007.01.001

13. Le Heron C, Holroyd CB, Salamone J, Husain M. Brain mechanisms underlying apathy. J Neurol Neurosurg Psychiatry. 2019 Mar;90(3):302-12. doi: 10.1136/jnnp-2018- 318265

14. Cooper JA, Arulpragasam AR, Treadway MT. Anhedonia in depression: biological mechanisms and computational models. Curr Opin Behav Sci. 2018 Aug;22:128-35. doi: 10.1016/j.cobeha.2018.01.024

15. Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev. 2011 Jan;35(3):537-55. doi: 10.1016/j.neubiorev.2010.06.006. Epub 2010 Jul 11.

16. Der-Avakian A, Markou A. The neurobiology of anhedonia and other reward-related deficits. Trends Neurosci. 2012 Jan;35(1):68-77. doi: 10.1016/j.tins.2011.11.005

17. Kasimova LN, Svyatogor MV. Angedonia in the structure of affective disorders: therapeutic opportunities. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(11):116-22. doi: 10.17116/jnevro2019119111116 (In Russ.).

18. Chong TT, Husain M. The role of dopamine in the pathophysiology and treatment of apathy. Prog Brain Res. 2016;229:389-426. doi: 10.1016/bs.pbr.2016.05.007. Epub 2016 Jul 29.

19. Hezemans FH, Wolpe N, O'Callaghan C, et al. Noradrenergic deficits contribute to apathy in Parkinson's disease through the precision of expected outcomes. PLoS Comput Biol. 2022 May 9;18(5):e1010079. doi: 10.1371/journal.pcbi.1010079

20. Pecina M, Karp JF, Mathew S, et al. Endogenous opioid system dysregulation in depression: implications for new therapeutic approaches. Mol Psychiatry. 2019 Apr;24(4):576-87. doi: 10.1038/s41380-018- 0117-2

21. McIntyre RS, Woldeyohannes HO, Soczynska JK, et al. Anhedonia and cognitive function in adults with MDD: results from the International Mood Disorders Collaborative Project. CNS Spectr. 2016 Oct;21(5):362-6. doi: 10.1017/S1092852915000747

22. Montoya-Murillo G, Ibarretxe-Bilbao N, Pena J, Ojeda N. The impact of apathy on cognitive performance in the elderly. Int J Geriatr Psychiatry. 2019 May;34(5):657-65. doi: 10.1002/gps.5062

23. Akhapkin RV, Maslova MA. Cognitive impairments in non-psychotic depressive disorders. Rossiyskiy psikhiatricheskiy zhurnal = Russian Journal of Psychiatry. 2015;(1):43-50 (In Russ.).

24. Knight MJ, Mills NT, Baune BT. Contemporary methods of improving cognitive dysfunction in clinical depression. Expert Rev Neurother. 2019 May;19(5):431-43. doi: 10.1080/14737175.2019.1610395. Epub 2019 Apr 25.

25. Knight MJ, Baune BT. Cognitive dysfunction in major depressive disorder. Curr Opin Psychiatry. 2018 Jan;31(1):26-31. doi: 10.1097/YCO.0000000000000378

26. Lam RW, Kennedy SH, Mclntyre RS, Khullar A. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry. 2014 Dec;59(12):649-54. doi: 10.1177/070674371405901206

27. Park C, Pan Z, Brietzke E, et al. Predicting antidepressant response using early changes in cognition: A systematic review. Behav Brain Res. 2018 Nov 1;353:154-60. doi: 10.1016/j.bbr.2018.07.011

28. Jones RD, Tranel D, Benton A, Paulsen J. Differentiating dementia from “pseudodementia” early in the clinical course: utility of neuropsychological tests. Neuropsychology. 1992;6(1):13-21. doi: 10.1037/0894-4105.6.1.13

29. Berrios GE. “Depressive pseudodementia” or “Melancholic dementia”: a 19th century view. J Neurol Neurosurg Psychiatry. 1985 May;48(5):393-400. doi: 10.1136/jnnp.48.5.393

30. Saez-Fonseca JA, Lee L, Walker Z. Longterm outcome of depressive pseudodementia in the elderly. J Affect Disord. 2007 Aug;101(1- 3):123-9. doi: 10.1016/j.jad.2006.11.004

31. Sekhon S, Marwaha R. Depressive Cognitive Disorders. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559256/

32. Kendrick T, Peveler R. Guidelines for the management of depression: NICE work? Br J Psychiatry. 2010 Nov;197(5):345-7. doi: 10.1192/bjp.bp.109.074575

33. Bauer M, Pfennig A, Severus E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J Biol Psychiatry. 2013 Jul;14(5):334-85. doi: 10.3109/15622975.2013.804195. Epub 2013 Jul 3.

34. Rossiyskoye obshchestvo psikhiatrov. Klinicheskiye rekomendatsii. Rekurrentnoye depressivnoye rasstroystvo, diagnostika i lecheniye [Russian Society of Psychiatrists. Clinical guidelines. Recurrent depressive disorder, diagnosis and treatment]. Moscow; 2014 (In Russ.).

35. Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. Br J Psychiatry. 2009 Sep;195(3):211-7. doi: 10.1192/bjp.bp.108.051110

36. Padala PR, Padala KP, Majagi AS, et al. Selective serotonin reuptake inhibitors-associated apathy syndrome: A cross sectional study. Medicine (Baltimore). 2020 Aug 14;99(33):e21497. doi: 10.1097/MD.0000000000021497

37. Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004 May;10(3):196-9. doi: 10.1097/00131746-200405000-00010

38. Petrova NN, Markin AV. Apathy syndrome in depressed patients previously treated with selective serotonin reuptake inhibitors. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2020;120(1):111-7. doi: 10.17116/jnevro2020120011111 (In Russ.).

39. Fava M, Graves LM, Benazzi F, et al. A cross-sectional study of the prevalence of cognitive and physical symptoms during long-term antidepressant treatment. J Clin Psychiatry. 2006 Nov;67(11):1754-9. doi: 10.4088/jcp.v67n1113

40. Petelin DS, Gamirova AN, Voskresenskaya ON, Volel BA. SSRI-associated apathy in Alzheimer's disease: a case series. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(4):51-3. doi: 10.14412/2074-2711-2022-4-51-53 (In Russ.).

41. McCabe C, Mishor Z, Cowen PJ, Harmer CJ. Diminished neural processing of aversive and rewarding stimuli during selective serotonin reuptake inhibitor treatment. Biol Psychiatry. 2010 Mar 1;67(5):439-45. doi: 10.1016/j.biopsych.2009.11.001

42. Hindmarch I. Cognitive toxicity of pharmacotherapeutic agents used in social anxiety disorder. Int J Clin Pract. 2009 Jul;63(7):1085-94. doi: 10.1111/j.1742-1241.2009.02085.x

43. Sowa-Kucma M, Panczyszyn-Trzewik P, Misztak P, et al. Vortioxetine: A review of the pharmacology and clinical profile of the novel antidepressant. Pharmacol Rep. 2017 Aug;69(4):595-601. doi: 10.1016/j.pharep.2017.01.030

44. Varrone A, Svenningsson P, Marklund P, et al. 5-HT1B receptor imaging and cognition: a positron emission tomography study in control subjects and Parkinson's disease patients. Synapse. 2015 Jul;69(7):365-74. doi: 10.1002/syn.21823

45. Arnsten AF, Lin CH, Van Dyck CH, Stanhope KJ. The effects of 5-HT3 receptor antagonists on cognitive performance in aged monkeys. Neurobiol Aging. 1997 JanFeb;18(1):21-8. doi: 10.1016/s0197-4580(96)00162-5

46. Meneses A. 5-HT7 receptor stimulation and blockade: a therapeutic paradox about memory formation and amnesia. Front BehavNeurosci. 2014 Jun 12;8:207. doi: 10.3389/fnbeh.2014.00207

47. Fagiolini A, Florea I, Loft H, Christensen MC. Effectiveness of Vortioxetine on Emotional Blunting in Patients with Major Depressive Disorder with inadequate response to SSRI/SNRI treatment. J Affect Disord. 2021 Mar 15;283:472-9. doi: 10.1016/j.jad.2020.11.106

48. McIntyre RS, Loft H, Christensen MC. Efficacy of Vortioxetine on Anhedonia: Results from a Pooled Analysis of Short-Term Studies in Patients with Major Depressive Disorder. Neuropsychiatr Dis Treat. 2021 Feb 22;17:575-85. doi: 10.2147/NDT.S296451

49. Baune BT, Brignone M, Larsen KG. A Network Meta-Analysis Comparing Effects of Various Antidepressant Classes on the Digit Symbol Substitution Test (DSST) as a Measure of Cognitive Dysfunction in Patients with Major Depressive Disorder. Int J Neuropsychopharmacol. 2018 Feb 1;21(2):97- 107. doi: 10.1093/ijnp/pyx070


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For citations:


Petelin D.S., Bairamova S.P., Sorokina O.Yu., Niinoja I.N., Lokshina A.B., Volel B.A. Apathy, anhedonia and cognitive dysfunction: common symptoms of depression and neurological disorders. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):96-102. https://doi.org/10.14412/2074-2711-2022-5-96-102

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)