Apathy in Schizophrenia

Study Overview
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Brief Summary
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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

Official Title
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L'Apathie Dans la schizophrénie: étude Neuropsychologique et Anatomique

Conditions
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Schizophrenia, Apathy

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| chronic schizophrenic patients<br> | |
| healthy volunteers<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | 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 |