Diagnosis of Hypoactivity with Apathy in Stroke

A range of instruments are currently used to measure apathy in stroke [172]. The most frequently used scales are the Apathy Evaluation Scale [14], the Starkstein Apathy Scale [173], and the Neuropsychiatric Inventory [10]. The Neuropsychiatric Inventory was been selected for the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network’s vascular cognitive impairment harmonization standards [174]. However, the prevalence of apathy reported using the Neuropsychiatric Inventory was found to be lower than in studies using other informant-based scales (23 % vs. 39. 4 %, respectively) [33]. Administration of the Behavioral Dysexecutive Syndrome Inventory has shown that hypoactivity with apathy is the most frequent behavioral change [3, 175]. Furthermore, behavioral disorders were more frequent in cerebral infarct and hemorrhage than in ruptured aneurysm and cerebral venous thrombosis [3, 175].

Management of Apathy in Stroke

Several case reports and a few trials on small patient populations have been reported (for review, [33]) with contradictory results. There is no evidence to support the use of a specific pharmacological treatment.

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