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The main objective of the study by Scott et al.1 was to explore the possible coexistence of apathy and impulse control disorders in a convenience sample of 887 patients with Parkinson disease (PD). Definitions are important in this neurologic study, as these behavioral entities are more often discussed in psychiatric journals than those devoted to neurology. The impulse control disorders referenced in this study were generally compulsive rather than impulsive disorders in the purest sense. As such, the clinical issues of concern focused largely on repetitive and difficult-to-stop behaviors rather than “out of the blue” impulsive surges. The behaviors reported are typical of those included under this designation within neurologic studies, but in the strictest sense they are more aligned with obsessive-compulsive behaviors than true impulsivity. In the same way, apathy has been variably defined, both as a symptom and as a syndrome. In this study, it was defined by a score on a validated scale.2 The symptoms of apathy are diminished motivation, interest, or emotional experience.2 The apathetic syndrome requires the addition of a variety of abnormalities associated with decreased goal-directed behavior and the social consequences of these behavioral anomalies.2,3 The authors merge these strict distinctions for this study, but as the field expands further, they may need to be separated for clearer precision.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 906
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