摘要
Apathy is a common feature of neurodegenerative disorders but is difficult to study in a clinical trial setting due to practical and conceptual barriers. Principal challenges include a paucity of data regarding apathy in these disorders, an absence of established diagnostic criteria, the presence of confounding factors (eg, coexisting depression), use of concomitant medications, and an absence of a gold-standard apathy assessment scale. Based on a literature search and ongoing collaboration among the authors, we present recommendations for the design of future clinical trials of apathy, suggesting Alzheimer disease and Parkinson disease as models with relevance across a wider array of neuropsychiatric disorders. Recommendations address clarification of the targeted study population (apathy diagnosis and severity at baseline), confounding factors (mood/cognition, behavior, and treatment), outcome measures, study duration, use of comparators and considerations around environment, and the role of the caregiver and patient assent. This review contributes to the search for an optimal approach to study treatment of apathy in neuropsychiatric disorders.
摘要译文
冷漠是神经变性疾病的共同特征，但难以在临床试验设置，研究由于实际和概念的障碍主要挑战包括在这些疾病有关冷漠数据很少，不存在建立的诊断标准，混杂因素的存在（例如，共存抑郁症），合并用药，以及没有一个金标准的冷漠评估scaleBased了作者之间的文献检索和正在进行的合作，我们提出建议的冷漠未来的临床试验的设计，提示阿尔茨海默病和帕金森病与整个神经精神障碍的更广泛的相关车型建议解决澄清针对性的研究人群（在基线冷漠的诊断和严重程度）的，混杂因素（情绪/认知，行为和处理），成果的措施，研究持续时间，使用周围环境比较器和注意事项，护理人员和患者同意的作用这次审查有助于寻找研究治疗冷漠的神经精神疾病的最佳方法
Jeffrey Cummings, MD, DSc1⇑ Joseph H. Friedman, MD2 George Garibaldi, MD3 Martin Jones, PhD4 Wayne Macfadden, MD3 Laura Marsh, MD5,6,7 Philippe H. Robert, MD, PhD8 [1]. Apathy in Neurodegenerative Diseases[J]. Journal of Geriatric Psychiatry and Neurology, 2015,28(3): 159-173