International Psychogeriatrics

Review Article

A review of neuroimaging findings of apathy in Alzheimer's disease

Christos Theleritisa1a2a3 c1, Antonios Politisa1a4, Kostas Siarkosa1 and Costantine G. Lyketsosa4

a1 First Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, 74 Vas. Sofias Ave., 11528 Athens, Greece

a2 University Mental Health Research Institute, 2 Soranou Efesiou Str., Papagou 156 01, Athens, Greece

a3 Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, King's College London, UK

a4 The Johns Hopkins University, Baltimore, MD, USA


Background: Apathy is one of the most frequent “behavioral and psychological signs and symptoms of dementia” (BPSD) encountered in Alzheimer's disease (AD). There is a growing interest in the early diagnosis of apathetic elderly patients in the community since apathy has been associated with reduced daily functioning, caregiver distress, and poor outcome. The generalization of neuroimaging techniques might be able to offer help in this domain.

Methods: Within this context we conducted an extensive electronic search from the databases included in the National Library of Medicine as well as PsychInfo and Google Scholar for neuroimaging findings of apathy in AD.

Results: Neuroimaging findings lend support to the notion that frontal-subcortical networks are involved in the occurrence of apathy in AD.

Conclusions: Longitudinal studies comparing patients and normal individuals might allow us to infer on the association between apathy and neurodegenerative diseases and what can brain imaging markers tell us about the characterization of this association, thus revealing disease patterns, helping to distinguish clinically distinct cognitive syndromes, and allowing predictions.

(Received May 08 2013)

(Reviewed July 20 2013)

(Revised September 13 2013)

(Accepted September 16 2013)

(Online publication October 18 2013)

Key words:

  • neuroimaging studies;
  • apathy;
  • Alzheimer's disease;
  • dementia;
  • mild cognitive impairment;
  • depression;
  • frontal-subcortical networks;
  • anterior cingulate cortex


c1 Correspondence should be addressed to: Christos Theleritis, MD, 1st Psychiatry Department, University of Athens Medical School, Eginition Hopsital, 72–74 Vas. Sofias Avenue, 11528 Athens, Greece. Phone: +30 210 7289324. Email:;