Synonyms for aboulia or Related words with aboulia

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Examples of "aboulia"
Many different causes of aboulia have been suggested. While there is some debate about the validity of aboulia as a separate disease, experts mostly agree that aboulia is the result of frontal lesions and not with cerebellar or brainstem lesions. As a result of more and more evidence showing that the mesolimbic and the mesocortical dopamine system are key to motivation and responsiveness to reward, aboulia may be a dopamine-related dysfunction. Aboulia may also result from a variety of brain injuries which cause personality change, such as dementing illnesses, trauma, or intracerebral hemorrhage (stroke), especially stroke causing diffuse injury to the right hemisphere.
Aboulia or abulia (from , meaning "will", with the prefix -a), in neurology, refers to a lack of will or initiative and can be seen as a disorder of diminished motivation (DDM). Aboulia falls in the middle of the spectrum of diminished motivation, with apathy being less extreme and akinetic mutism being more extreme than aboulia. A patient with aboulia is unable to act or make decisions independently. It may range in severity from subtle to overwhelming. It is also known as Blocq's disease (which also refers to abasia and astasia-abasia). Aboulia was originally considered to be a disorder of the will.
A survey of 2 movement disorder experts, 2 neuropsychiatrists, and 2 rehabilitation experts was conducted and the results did not seem to shed any light on the matter of differentiating aboulia from other DDMs. The experts used the terms apathy and aboulia interchangeably and even debated on whether or not aboulia was a discrete entity, or just a hazy gray area on a spectrum of more defined disorders. Four of the experts said aboulia was a sign and a symptom, but the group was split on whether or not it was a syndrome. Another survey, which consisted of true and false questions about what aboulia is distinct from, whether it is a sign, symptom, or syndrome, where lesions are present in cases of aboulia, what diseases are commonly associated with aboulia, and what current treatments are used for aboulia, was sent to 15 neurologists and 10 psychiatrists. Most experts agreed that aboulia is clinically distinct from depression, akinetic mutism, and alexithymia. However, only 32% believed aboulia was different from apathy, while 44% said they were not different, and 24% were unsure. Yet again, there was disagreement about whether or not aboulia is a sign, symptom, or syndrome.
Aboulia has been known to clinicians since 1838. However, in the time since its inception, the definition of aboulia has been subjected to many different forms, some even contradictory with previous ones. Aboulia has been described as a loss of drive, expression, loss of behavior and speech output, slowing and prolonged speech latency, and reduction of spontaneous thought content and initiative. The clinical features most commonly associated with aboulia are:
Both neurologists and psychiatrists recognize aboulia to be a distinct clinical entity, but its status as a syndrome is unclear. Although aboulia has been known to clinicians since 1838, it has been subjected to different interpretations – from 'a pure lack of will', in the absence of motor paralysis to, more recently, being considered 'a reduction in action emotion and cognition'. As a result of the changing definition of aboulia, there is currently a debate on whether or not aboulia is a sign or a symptom of another disease, or its own disease that seems to appear in the presence of other more well-researched diseases, such as Alzheimer's disease.
A lack of motivation has been reported in 25–50% of patients with Alzheimer's disease. While depression is also common in patients with this disease, aboulia is not a mere symptom of depressions because more than half of the patients with Alzheimer's disease with aboulia do not suffer from depression. Several studies have shown that aboulia is most prevalent in cases of severe dementia which may result from reduced metabolic activity in the prefrontal regions of the brain. Patients with Alzheimer's disease and aboulia are significantly older than patients with Alzheimer's who do not lack motivation. Going along with that, the prevalence of aboulia increased from 14% in patients with a mild case Alzheimer's disease to 61% in patients with a severe case of Alzheimer's disease, which most likely developed over time as the patient got older.
A case of aboulia after a transient ischemic attack in the frontal lobes is depicted in the episode "House Training" of the drama series "House, M.D.".
It is well documented that the caudate nucleus is involved in degenerative diseases of the central nervous system such as Huntington disease. In a case study of 32 acute caudate stroke patients, 48% were found to be experiencing aboulia. Most of the cases where aboulia was present were when the patients had a left caudate infarct that extended into the putamen as seen through a CT or MRI scan.
Diagnosis for aboulia can be quite difficult because it falls between two other disorders of diminished motivation, and one could easily see an extreme case of aboulia as akinetic mutism or a lesser case of aboulia as apathy and therefore, not treat the patient appropriately. If it were to be confused with apathy, it might lead to attempts to involve the patient with physical rehabilitation or other interventions where a source of strong motivation would be necessary to succeed but would still be absent. The best way to diagnose aboulia is through clinical observation of the patient as well as questioning of close relatives and loved ones to give the doctor a frame of reference with which they can compare the patient's new behavior to see if there is in fact a case of diminished motivation. In recent years, imaging studies using a CT or MRI scan have been shown to be quite helpful in localizing brain lesions which have been shown to be one of the main causes of aboulia.
Aboulia or Abulia, in neurology, refers to a lack of will or initiative. The patient is unable to act or make decisions independently. It may range from subtle to overwhelming in severity.
Avolition is sometimes mistaken for other, similar symptoms also affecting motivation, such as aboulia, anhedonia and asociality, or strong general disinterest. For example, aboulia is also a restriction in motivation and initiation, but characterized by an inability to set goals or make decisions and considered a disorder of diminished motivation. In order to provide effective treatment, the underlying cause of avolition (if any) has to be identified and it is important to properly differentiate it from other symptoms, even though they might reflect similar aspects of mental illness.
Most current treatments for aboulia are pharmacological, including the use of antidepressants. However, antidepressant treatment is not always successful and this has opened the door to alternative methods of treatment. The first step to successful treatment of aboulia, or any other DDM, is a preliminary evaluation of the patient's general medical condition and fixing the problems that can be fixed easily. This may mean controlling seizures or headaches, arranging physical or cognitive rehabilitation for cognitive and sensorimotor loss, or ensuring optimal hearing, vision, and speech. These elementary steps also increase motivation because improved physical status may enhance functional capacity, drive, and energy and thereby increase the patient's expectation that initiative and effort will be successful.
The study of motivation has been mostly about how stimuli come to acquire significance for animals. Only recently has the study of motivational processes been extended to integrate biological drives and emotional states in the explanation of purposeful behavior in human beings. Considering the number of disorders attributed to a lack of will and motivation, it is essential that aboulia and apathy be defined more precisely to avoid confusion.
Aboulia has also been associated with amphetamine withdrawal. It may complicate rehabilitation when a stroke patient is uninterested in performing tasks like walking despite being capable of doing so. It should be differentiated from apraxia, when a brain injured patient has impairment in comprehending the movements necessary to perform a motor task despite not having any paralysis that prevents performing the task; that condition can also result in lack of initiation of activity.
A young female scam artist named Lupe (Monique Gabriela Curnen) collapses while participating (possibly acting as a shill) in a Three-Card Monte scam on the street. She suffers from a lack of blood to the brain which temporarily paralyzed her ability to make decisions or exercise free will ("aboulia," says Foreman, as "part of a […] transient ischemic attack"). Based on her background, Foreman immediately suspects Lupe's condition stems from drug abuse, while Chase looks for other possibilities, such as toxins in her apartment. Lupe senses Foreman's disdain for the decisions she's made in her life, and Foreman grapples with his own humble past when his parents come to visit him.
Allochiria represents a psychical affection and the occurrence of any form of allochiria should be regarded as a positive indication of the presence of hysteria. Recognition of the allochiria may throw light upon a number of symptoms that would otherwise be misinterpreted as paresis, aboulia, and defective sensibility. This enables a correct analysis to be made of the precise defects present and serve as a guide toward the original focus of the whole affection and proving an important step in the exact psychological diagnosis that is an essential preliminary to the scientific treatment of hysteria.
Among his written works was a German translation of Louis-Florentin Calmeil's landmark work on the history of psychiatry, "De la Folie" (About the delusions). Leubuscher named his translation "Der Wahnsinn in den vier letzten Jahrhunderten" (On madness in the last four centuries). In 1852, he published the late Benno Reinhardt's pathological-anatomical studies. He also published an article on aboulia ('Über Abulie', Zeitschr. für Psychiat. 4, 562-578, 1847), listing a number of disorders of the will, such as "weak-willedness". Other literary works by Leubuscher include:
The symptoms of Pick's disease include difficulty in language and thinking, efforts to dissociate from family, behavioral changes, unwarranted anxiety, irrational fears, CBD (Compulsive buying disorder, or oniomania), impaired regulation of social conduct (e.g., breaches of etiquette, vulgar language, tactlessness, disinhibition, misperception), passivity, low motivation (aboulia), inertia, over-activity, pacing and wandering. The changes in personality allow doctors to distinguish between Pick's disease and Alzheimer's disease. Pick's disease is one of the causes of the clinical syndrome of frontotemporal lobar degeneration which has three subtypes. Pick's disease pathology is associated more with the frontotemporal dementia and progressive nonfluent aphasia subtypes than the semantic dementia subtype.
A case study involving two patients who suffered from acute confusional state and aboulia was conducted to see if these symptoms were the result of an infarct in the capsular genu. Using clinical neuropsychological and MRI evaluations at baseline and one year later showed that the cognitive impairment was still there one year after the stroke. Cognitive and behavioral alterations due to a genu infarct are most likely because the thalamo-cortical projection fibers that originate from the ventral-anterior and medial-dorsal nuclei traverse the internal capsule genu. These tracts are part of a complex system of cortical and subcortical frontal circuits through which the flow of information from the entire cortex takes place before reaching the basal ganglia. Cognitive deterioration could have occurred through the genu infarcts affecting the inferior and anterior thalamic peduncles. The interesting thing about this case study was that the patients did not show any functional deficit at the follow-up one year after the stroke and were not depressed but did show diminished motivation. This result supports the idea that aboulia may exist independently of depression as its own syndrome.
The anterior cingulate circuit consists of the anterior cingulate cortex, also referred to as Brodmann area 24, and its projections to the ventral striatum which includes the ventromedial caudate. The loop continues to connect to the ventral pallidum, which connects to the vental anterior nucleus of the thalamus. This circuit is essential for the initiation of behavior, motivation and goal orientation, which are the very things missing from a patient with a disorder of diminished motivation. Unilateral injury or injury along any point in the circuit leads to aboulia regardless of the side of the injury, but if there is bilateral damage, the patient will exhibit a more extreme case of diminished motivation, akinetic mutism.