학술논문
Apathy as a Treatment Target in Alzheimer's Disease: Implications for Clinical Trials.
Document Type
Academic Journal
Author
Mortby ME; School of Psychology, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia. Electronic address: m.mortby@unsw.edu.au.; Adler L; Clinical Insights, Inc., Maryland, MD.; Agüera-Ortiz L; Department of Psychiatry Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, & Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Madrid, Spain.; Bateman DR; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN; Regenstrief Institute, Inc., Indiana University Center for Aging Research, Indianapolis, IN.; Brodaty H; Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, Australia.; Cantillon M; Department of Psychiatry, Robert Wood Johnson Medical School, New Brunswick, NJ.; Geda YE; Alzheimer's Disease and Memory Disorder's Program, Department of Neurology, Barrow Neurological Institute, Phoenix, AZ.; Ismail Z; Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute, and O'Brien Institute of Public Health, University of Calgary, Calgary, Canada.; Lanctôt KL; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Departments of Psychiatry and Pharmacology/Toxicology, University of Toronto, Toronto, Canada.; Marshall GA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA.; Padala PR; Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, AR.; Politis A; Division of Geriatric Psychiatry, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.; Rosenberg PB; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.; Siarkos K; Division of Geriatric Psychiatry, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.; Sultzer DL; Institute for Memory Impairments and Neurological Disorders (UCI MIND), and Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine CA.; Theleritis C; Division of Geriatric Psychiatry, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
Source
Publisher: Elsevier Country of Publication: England NLM ID: 9309609 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-7214 (Electronic) Linking ISSN: 10647481 NLM ISO Abbreviation: Am J Geriatr Psychiatry Subsets: MEDLINE
Subject
Language
English
Abstract
Apathy is one of the most prevalent, stable and persistent neuropsychiatric symptom across the neurocognitive disorders spectrum. Recent advances in understanding of phenomenology, neurobiology and intervention trials highlight apathy as an important target for clinical intervention. We conducted a comprehensive review and critical evaluation of recent advances to determine the evidence-based suggestions for future trial designs. This review focused on 4 key areas: 1) pre-dementia states; 2) assessment; 3) mechanisms/biomarkers and 4) treatment/intervention efficacy. Considerable progress has been made in understanding apathy as a treatment target and appreciating pharmacological and non-pharmacological apathy treatment interventions. Areas requiring greater investigation include: diagnostic procedures, symptom measurement, understanding the biological mechanisms/biomarkers of apathy, and a well-formed approach to the development of treatment strategies. A better understanding of the subdomains and biological mechanisms of apathy will advance apathy as a treatment target for clinical trials.
Competing Interests: Conflict of Interest MEM, LA, LA-O, DRB, HB, YG, GAM, PRP, AP, KS report no conflicts with any product mentioned or concepts discussed in this article. ZI has received consultation funding from Otsuka/Lundbeck, outside the submitted work. MC has received consultation funding from Allergan, Kyowa, Reviva, Sunovion and Otsuka. HB has received consultation funding from Nutricia Australia and Biogen. KLL has received consultation fees from BioXcel, Cerevel, Eisai, Kondor, Otsuka and Praxis, outside of the submitted work. PBR has received research funding support outside of this project from Lilly, Vaccinex, National Institute on Aging, Alzheimer’s Association, Functional Neuromodulation (FNMI), Lilly, Alzheimer’s Disease Cooperative Study (ADCS), Alzheimer’s Disease Trials Research Institute (ATRI), Alzheimer’s Clinical Trials Consortium (ACTC), Richman Family Precision Medicine Center of Excellence on Alzheimer’s Disease. PBR has received income from consulting, advisory boards, and/or DSMB from GLG, Leerink, Cerevel, Cerevance, Bioxcel, Sunovion, Acadia, Food and Drug Administration, Medalink, Novo Nordisk, Noble Insights, and Synaptogen. DLS has received research support from NIH and Eisai, has participated as a paid member of a DSMB or adjudication committee with Acadia, Avanir, Janssen, and Otsuka, and has received consulting fees from Avanir and NovoNordisk (all unrelated to apathy treatment).
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Competing Interests: Conflict of Interest MEM, LA, LA-O, DRB, HB, YG, GAM, PRP, AP, KS report no conflicts with any product mentioned or concepts discussed in this article. ZI has received consultation funding from Otsuka/Lundbeck, outside the submitted work. MC has received consultation funding from Allergan, Kyowa, Reviva, Sunovion and Otsuka. HB has received consultation funding from Nutricia Australia and Biogen. KLL has received consultation fees from BioXcel, Cerevel, Eisai, Kondor, Otsuka and Praxis, outside of the submitted work. PBR has received research funding support outside of this project from Lilly, Vaccinex, National Institute on Aging, Alzheimer’s Association, Functional Neuromodulation (FNMI), Lilly, Alzheimer’s Disease Cooperative Study (ADCS), Alzheimer’s Disease Trials Research Institute (ATRI), Alzheimer’s Clinical Trials Consortium (ACTC), Richman Family Precision Medicine Center of Excellence on Alzheimer’s Disease. PBR has received income from consulting, advisory boards, and/or DSMB from GLG, Leerink, Cerevel, Cerevance, Bioxcel, Sunovion, Acadia, Food and Drug Administration, Medalink, Novo Nordisk, Noble Insights, and Synaptogen. DLS has received research support from NIH and Eisai, has participated as a paid member of a DSMB or adjudication committee with Acadia, Avanir, Janssen, and Otsuka, and has received consulting fees from Avanir and NovoNordisk (all unrelated to apathy treatment).
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)