Apathy in Schizophrenia

L'apathie Dans La Schizophrénie: Étude Neuropsychologique Et Anatomique

Apathy, defined as a quantitative reduction of voluntary, goal-directed behaviours (GDB), is a core component of negative symptoms. It has been suggested that the physiopathology of apathy is not a single entity but may be multiple, depending on which specific process or macrofunction is disrupted during completion of GDB. In line with this notion, Levy and Dubois proposed dividing apathic syndromes into three subtypes of disrupted processing: 'a-motivation', 'cognitive inertia', and 'uncoupling'. In schizophrenia, apathy has been associated with executive dysfunction, functional impairment and poor outcome. However, the neurobiological underpinnings of apathy in schizophrenia are poorly understood.

Primary objective: confirm that chronic schizophrenic patients are apathic compared to healthy volunteers

Secondary objectives:

• investigate if apathy is related to a particular aspect of the disease (i.e. negative, positive symptomatology and/or deficit form)
• investigate if apathy correlates with executive dysfunction
• investigate if apathy is associated with a specific mechanism using an experimental task specially designed to investigate the different mechanism (i.e. 'a-motivation', 'cognitive inertia', and 'uncoupling')
• investigate if there is a volumetric abnormality affecting the executive system in apathic schizophrenic patients
• link these eventual volumetric abnormalities to prefrontal cortex-basal ganglia circuits according to a specific subtype of apathy in the apathic schizophrenic group

Study Overview

• Status: Completed
• Conditions: Schizophrenia; Apathy

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• France
  • Paris, France, 75013
    • INSERM MEDU 945, Centre de Recherche-Institut du Cerveau et de la Moelle (CR-ICM), Hôpital de la Pitié Salpétrière

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 55 years (Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

schizophrenic patients:

• outpatients of the Corentin Celton psychiatric service
• inpatients of the Corentin Celton Day Hospital Unit

healthy volunteers: community

Description

Inclusion Criteria (healthy volunteers):

• Male or Female aged 20 to 55 years old included
• Under French public assurance system

Exclusion Criteria (healthy volunteers):

• Personal history of neurological disorders
• Personal history of head injury
• Alcohol or substance abuse
• Under psychotropic drug
• Contraindication for MRI

Inclusion Criteria (schizophrenic patients):

• Male or Female aged 20 to 55 years old included
• Under French public assurance system
• diagnosis of schizophrenia according to the DSM-IV R criteria
• Duration of illness > 5 years
• clinical stability during the past 2 months (defined as no treatment modification or hospitalisation 2 months prior evaluation)

Exclusion Criteria (schizophrenic patients):

• Schizo-affective disorder
• Personal history of neurological disorders
• Personal history of head injury
• Alcohol or substance abuse
• Contraindication for MRI

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
healthy volunteers
chronic schizophrenic patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
apathy as measured by Starkstein's Apathy Evaluation Scale	baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
neuropsychological performance	Global mental efficience: Mill Hill B and Raven's progressive matrices 38; Executive functioning:Modified Card Sorting Test, Trail Making A and B, Stroop Test, Verbal Fluences, Frontal Assessment Battery (FAB, Dubois et al., 2000); Social and Emotional Cognition: SEA (Social and Emotional Evaluation (SEA, Funkiewiez et al., 2012); Working memory (Grober and Buschke - 16 items, digit span); Instrumental functions: Rey Osterrieth Complex figure)	baseline
clinical assessment (for patients only)	scores on evaluation scales (PANSS, SAPS, SANS, CDS, SDS)	baseline
volumetric brain abnormalities	voxel based morphometry	baseline

Collaborators and Investigators

• Sponsor: Institut National de la Santé Et de la Recherche Médicale, France
• Investigators: Principal Investigator: Richard Levy, MD, INSERM MEDU 945, Centre de Recherche-Institut du Cerveau et de la Moelle (CR-ICM), Hôpital de la Pitié Salpétrière, 75013 Paris

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2012
• Primary Completion (Actual): June 5, 2013
• Study Completion (Actual): June 5, 2013

Study Registration Dates

• First Submitted: September 7, 2012
• First Submitted That Met QC Criteria: September 17, 2012
• First Posted (Estimated): September 21, 2012

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 21, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders; Schizophrenia
• Other Study ID Numbers: C11-39; 2011-A01610-41 (Registry Identifier: IDRCB)