Abulia is a neurological disorder that causes a lack of will or initiative, and falls in the middle of the spectrum of Decreased Motivation Disorders. It can be caused by brain damage, dopamine-related dysfunction, or brain injury, and is characterized by decreased voluntary movement, reduced emotional responsiveness, and decreased social interaction. It is more common in patients with Alzheimer’s disease and is typically treated with medications, usually antidepressants.
Abulia, also called Blocq disease, is a neurological condition in which the patient lacks will or initiative. It falls in the middle of the spectrum of disorders known as Decreased Motivation Disorders (MDDs), of which the least serious is apathy and the most serious is akinetic mutism, in which the patient tends not to speak or not to speak at all. Aboulia can be caused by lesions on the frontal lobe or basal ganglia of the brain, dopamine-related dysfunction, or brain injury. The frontal lobe controls higher thinking, while the basal ganglia control movement, so damage to either area can result in decreased motivation.
Aboulia is characterized by little or decreased voluntary movement, difficulty initiating or sustaining movement, reduced emotional responsiveness, increased response time to questions and prompts, increased passivity, and decreased social interaction and interest in regular activities . Some patients also have a reduced appetite and may not be able to fully chew and swallow food. The condition sometimes appears on its own, and sometimes as a symptom of some other neurological condition, such as Alzheimer’s disease, schizophrenia, or depression. Huntington’s disease, Parkinson’s disease and other degenerative disorders of the central nervous system can cause legions to form which can lead to the development of abulia.
Abulia is more common in patients with Alzheimer’s disease. Fifty to 50 percent of Alzheimer’s patients show a lack of motivation. The more severe and more advanced the case with Alzheimer’s disease, the more likely it is to present with a lack of motivation.
Aboulia can be difficult to diagnose due to its status as a point on the MDD spectrum. Clinical observation and discussion with the patient’s relatives and health professionals are the first steps in diagnosing the disorder. Computed tomography (CT) or magnetic resonance imaging (MRI) can help identify brain lesions that may be causing the abulia.
Aboulia is typically treated with medications, usually antidepressants. Before prescribing such medications, doctors attempt to treat any underlying causes of the disorder, such as controlling headaches or seizures, or optimizing vision, hearing, and speech. These methods alone may be sufficient to help improve the patient’s condition.
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