Apathy and impulsivity are common and often coexistent consequences of frontotemporal lobar degeneration (FTLD). They increase patient morbidity and carer distress, but remain under-estimated and poorly treated. Recent trans-diagnostic approaches that span the spectrum of clinical presentations of FTLD and parkinsonism, indicate that apathy and impulsivity can be fractionated into multiple neuroanatomical and pharmacological systems. These include ventral/dorsal frontostriatal circuits for reward-sensitivity, response-inhibition, and decision-making; moderated by noradrenaline, dopamine, and serotonin. Improved assessment tools, formal models of cognition and behavior, combined with brain imaging and psychopharmacology, are creating new therapeutic targets and establishing principles for stratification in future clinical trials.

冷漠和冲动是额颞叶变性 (FTLD) 的常见且经常共存的后果。它们增加了患者的发病率和护理人员的痛苦，但仍然被低估和治疗不佳。最近跨越 FTLD 和帕金森症临床表现的跨诊断方法表明，冷漠和冲动可以分为多个神经解剖学和药理学系统。这些包括用于奖励敏感性、反应抑制和决策制定的腹侧/背侧额纹状​​体回路；由去甲肾上腺素、多巴胺和血清素调节。改进的评估工具、认知和行为的正式模型，结合脑成像和精神药理学，正在创造新的治疗目标，并在未来的临床试验中建立分层原则。