The current working definition of apathy is a decrease in goal-directed behaviours characterized by reduced interest and emotions that cannot be attributed to diminished levels of consciousness, cognitive impairment or emotional distress (Starkstein and Leentjens, 2008). It thereby constitutes a prominent and disabling symptom by itself or as a component of ‘negative signs’ in strategically-placed focal lesions of the basal ganglia, neurodegenerative diseases such as Parkinson’s disease, certain forms of fronto-temporal dementia, Alzheimer’s and Huntington’s disease and in both schizophrenia and major depression (Bhatia and Marsden, 1994; Levy and Dubois, 2006; Starkstein and Leentjens, 2008). It is widely acknowledged nowadays that apathy is a frequent non-motor symptom in Parkinson’s disease, and affects up to 40% of de novo patients, resulting in a considerable burden for both patients and caregivers (Pagonabarraga et al., 2015). To the best of our knowledge, no study has examined either how apathy emerged as an independent symptom in Parkinson’s disease in the late 19th century, or the conceptual changes which mark its evolution from its early beginnings to its current importance. Such historical assessment might also reveal a parallel delineation of terms relating to both apathy and frontal subcortical circuit disorders.

中文翻译：

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帕金森病冷漠概念描述中的历史十字路口

当前对冷漠的有效定义是目标导向行为的减少，其特征是兴趣和情感的降低，这不能归因于意识水平，认知障碍或情绪困扰的降低（Starkstein和Leentjens，2008）。因此，它本身或在战略性放置的基底节局灶性病变，帕金森氏病等神经退行性疾病，某些形式的额颞叶痴呆，阿尔茨海默氏症和亨廷顿氏病以及在精神分裂症和重度抑郁症中都有发生（Bhatia和Marsden，1994； Levy和Dubois，2006； Starkstein和Leentjens，2008）。如今，人们普遍认为冷漠是帕金森氏病的一种常见的非运动性症状，影响了40％的帕金森氏病。从头开始的新患者，给患者和护理人员都带来了沉重的负担（Pagonabarraga等人，2015）。据我们所知，没有研究检查冷漠是如何在19世纪后期成为帕金森氏病的独立症状，还是标志着其从早期开始发展到现在的重要性的概念性变化。这样的历史评估也可能揭示出与冷漠和额叶皮下回路异常有关的术语的平行描述。