Evidence map›Paper›PMID 30737341›Full record

ArticleNeurology2019

Apathy is associated with large-scale white matter network disruption in small vessel disease.

Jonathan Tay, Anil M Tuladhar, Matthew J Hollocks, Rebecca L Brookes, Daniel J Tozer, Thomas R Barrick, Masud Husain, Frank-Erik de Leeuw, Hugh S Markus

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 4 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Pooled it
  2. Neuroimaging correlates of post-stroke fatigue: A systematic review and meta-analysis.International journal of stroke : official journal of the International Stroke Society · 2023
    Pooled it
  3. Pooled it
  4. Empirical support for the vascular apathy hypothesis: A structured review.International journal of geriatric psychiatry · 2020
    Pooled it
  5. Trial
  6. Article
  7. On the relationships between apathy, depression and anhedonia.Journal of neurology, neurosurgery, and psychiatry · 2026
    Article
  8. Article
  9. Article
  10. Clinical Associations and Possible Risk Factors for Affective Neuropsychiatric Symptoms in Older Adults With and Without Cognitive Impairment.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026
    Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Article
  17. Prevalence, treatment, and neural correlates of apathy in different forms of dementia: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jonathan TayFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK. jt629@medschl.cam.ac.uk.
Anil M TuladharFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Matthew J HollocksFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Rebecca L BrookesFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Daniel J TozerFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Thomas R BarrickFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Masud HusainFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Frank-Erik de LeeuwFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
Hugh S MarkusFrom the Department of Clinical Neurosciences (J.T., M.J.H., R.L.B., D.J.T., H.S.M.), University of Cambridge, UK; Department of Neurology (A.M.T., F.-E.d.L.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Neuroscience Research Centre (T.R.B.), Molecular and Clinical Sciences Research Institute, St. George's University of London; and Nuffield Department of Clinical Neurosciences (M.H.), University of Oxford, UK.
University of Cambridge · GBSt George's, University of London · GB

Funding

Wellcome Trust 206330/Z/17/Z
6 · The paper itself

Abstract

objectiveTo investigate whether white matter network disruption underlies the pathogenesis of apathy, but not depression, in cerebral small vessel disease (SVD).

methodsThree hundred thirty-one patients with SVD from the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) study completed measures of apathy and depression and underwent structural MRI. Streamlines reflecting underlying white matter fibers were reconstructed with diffusion tensor tractography. First, path analysis was used to determine whether network measures mediated associations between apathy and radiologic markers of SVD. Next, we examined differences in whole-brain network measures between participants with only apathy, only depression, and comorbid apathy and depression and a control group free of neuropsychiatric symptoms. Finally, we examined regional network differences associated with apathy.

resultsPath analysis demonstrated that network disruption mediated the relationship between apathy and SVD markers. Patients with apathy, compared to all other groups, were impaired on whole-brain measures of network density and efficiency. Regional network analyses in both the apathy subgroup and the entire sample revealed that apathy was associated with impaired connectivity in premotor and cingulate regions.

conclusionsOur results suggest that apathy, but not depression, is associated with white matter tract disconnection in SVD. The subnetworks delineated suggest that apathy may be driven by damage to white matter networks underlying action initiation and effort-based decision making.

Indexed as

ApathyAgedCerebral Small Vessel DiseasesDepressionDiffusion Tensor ImagingFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeural PathwaysWhite Matter

Identifiers

PMID30737341
PMCPMC6511108
OpenAlexW2911292325

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.