Neural correlates of pure apathy in multiple sclerosis: An exploratory neuroimaging study

Pure apathy is relatively common in people with Multiple Sclerosis (PwMS), but its neural mechanisms remain unexplored. Therefore, we investigated the neural correlates of pure apathy in PwMS, differentiating it from depression. Sixty-two PwMS underwent neuropsychological assessments and Magnetic Resonance Imaging scans. Pure apathy is primarily associated with lesions in the cortical-limbic-subcortical system implicated in goal-directed behaviour and motivation. Apathy and depression arise from distinct yet partially overlapping neural mechanisms, with basal ganglia and limbic structures playing a key role.