{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T23:45:56Z","timestamp":1776901556495,"version":"3.51.2"},"reference-count":82,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001530","name":"Canterbury Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008247","name":"University of Otago","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008247","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Oxford Clarendon Fund"},{"name":"Green Templeton College"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The neuropsychiatric syndrome of apathy is now recognized to be a common and disabling condition in Huntington\u2019s disease. However, the mechanisms underlying it are poorly understood. One way to investigate apathy is to use a theoretical framework of normal motivated behaviour, to determine where breakdown has occurred in people with this behavioural disruption. A fundamental computation underlying motivated, goal-directed behaviour across species is weighing up the costs and rewards associated with actions. Here, we asked whether people with apathy are more sensitive to costs of actions (physical effort and time delay), less sensitive to rewarding outcomes, or both. Based on the unique anatomical substrates associated with Huntington\u2019s disease pathology, we hypothesized that a general hypersensitivity to costs would underpin Huntington\u2019s disease apathy.<\/jats:p>\n               <jats:p>Genetically confirmed carriers of the expanded Huntingtin gene (premanifest to mild motor manifest disease, n = 53) were compared to healthy controls (n = 38). Participants performed a physical effort-based decision-making task (Apple Gathering Task) and a delay discounting task (Money Choice Questionnaire). Choice data was analysed using linear regression and drift diffusion models that also accounted for the time taken to make decisions.<\/jats:p>\n               <jats:p>Apathetic people with Huntington\u2019s disease accepted fewer offers overall on the Apple Gathering Task, specifically driven by increased sensitivity to physical effort costs, and not explained by motor severity, mood, cognition or medication. Drift diffusion modelling provided further evidence of effort hypersensitivity, with apathy associated with a faster drift rate towards rejecting offers as a function of varying effort. Increased delay sensitivity was also associated with apathy, both when analysing raw choice and drift rate, where there was moderate evidence of Huntington\u2019s disease apathy drifting faster towards the immediately available (low-cost) option. Furthermore, the effort and delay sensitivity parameters from these tasks were positively correlated.<\/jats:p>\n               <jats:p>The results demonstrate a clear mechanism for apathy in Huntington\u2019s disease, cost hypersensitivity, which manifests in both the effort and time costs associated with actions towards rewarding goals. This suggests that Huntington\u2019s disease pathology may cause a domain-general disruption of cost processing, which is distinct from apathy occurrence in other brain disorders and may require different therapeutic approaches.<\/jats:p>","DOI":"10.1093\/brain\/awae296","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T10:30:00Z","timestamp":1726137000000},"page":"861-874","source":"Crossref","is-referenced-by-count":8,"title":["Decision cost hypersensitivity underlies Huntington\u2019s disease apathy"],"prefix":"10.1093","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-743X","authenticated-orcid":false,"given":"Lee-Anne","family":"Morris","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Otago , Christchurch 8011 ,","place":["New Zealand"]},{"name":"New Zealand Brain Research Institute , Christchurch 8011 ,","place":["New 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M","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Auckland City Hospital, Te Whatu Ora Health New Zealand , Auckland 1023 ,","place":["New Zealand"]},{"name":"Centre for Brain Research Neurogenetics Research Clinic, University of Auckland , Auckland 1023 ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R","family":"MacAskill","sequence":"additional","affiliation":[{"name":"New Zealand Brain Research Institute , Christchurch 8011 ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J","family":"Myall","sequence":"additional","affiliation":[{"name":"New Zealand Brain Research Institute , Christchurch 8011 ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Apps","sequence":"additional","affiliation":[{"name":"Centre for Human Brain Health, School of Psychology, University of Birmingham , Birmingham B15 2SQ ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Auckland City Hospital, Te Whatu Ora Health New Zealand , Auckland 1023 ,","place":["New Zealand"]},{"name":"Centre for Brain Research Neurogenetics Research Clinic, University of Auckland , Auckland 1023 ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim J","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago , Christchurch 8011 ,","place":["New Zealand"]},{"name":"New Zealand Brain Research Institute , Christchurch 8011 ,","place":["New Zealand"]},{"name":"Department of Neurology, Christchurch Hospital, Te Whatu Ora Health New Zealand , Christchurch 8011 ,","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-9255","authenticated-orcid":false,"given":"Masud","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Experimental Psychology, University of Oxford , Oxford OX2 6GG ,","place":["UK"]},{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford , Oxford OX3 9DU ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Campbell J","family":"Le Heron","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago , Christchurch 8011 ,","place":["New Zealand"]},{"name":"New Zealand Brain Research Institute , Christchurch 8011 ,","place":["New Zealand"]},{"name":"Department of Neurology, Christchurch Hospital, Te Whatu Ora Health New Zealand , Christchurch 8011 ,","place":["New 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