Research progress on the mechanisms of apathy in patients with idiopathic normal pressure hydrocephalus
BAI Wenju
HUANG Xiaoyuan
Wang Jichao
Abstract：Patients with idiopathic normal pressure hydrocephalus(iNPH)often experience neuropsychological impairments,among which apathy--characterized by a persistent decline in motivation and goal-directed behavior--is the most prominent.Its incidence is significantly higher than that of other psychiatric symptoms.This article reviews the research prog-ress on the neurobiological mechanisms of iNPH-related apathy,revealing that its etiology primarily involves the following four pathological cascades:reduced cerebral perfusion leads to hypoperfusion in the prefrontal-basal ganglia-thalamic circuit,triggering neurovascular unit damage and dysfunction of the reward network;cortical atrophy,through disruption of white mat-ter microstructure and reduction in gray matter volume,weakens emotional drive and cognitive regulation;decreased levels of neurotransmitters such as dopamine and serotonin directly impair the regulation threshold of motivated behavior;and accumula-tion of harmful substances like Aβ/tau proteins mediates neuroinflammation and synaptic plasticity impairment.Current research still faces challenges such as insufficient analysis of mechanistic heterogeneity and a lack of biomarker profiles.Future studies need to integrate multimodal imaging and molecular dynamic monitoring technologies to establish precise intervention strategies based on neural circuit remodeling,thereby providing a theoretical basis for the early identification and individualized treatment of apathy in iNPH.
Keywords：idiopathic normal pressure hydrocephalusapathypathogenesis
Publication Date：2026-01-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 60-64 )