Emotion regulation difficulties are selectively associated with executive and behavioural apathy in Huntington's disease.
6 affiliations
- 1Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. [email protected].
- 2Department of Psychology, University of Copenhagen, Copenhagen, Denmark. [email protected].
- 3Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- 4Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
- 5Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
- 6Department of Clinical Genetics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Abstract
Objective
Apathy occurs frequently in psychiatric and neurological disorders and is associated with functional impairment, reduced quality of life, and caregiver burden. Its underlying mechanisms are incompletely understood, but recent studies indicate that apathy is multidimensional and has heterogeneous manifestations across disorders. Self-regulatory processes, such as emotion regulation, may contribute to these manifestations, but this relationship has received little attention. Huntington's disease (HD) provides a clinical model for examining whether emotion regulation difficulties are associated with global and multidimensional apathy.Methods
Eighty-nine HD gene expansion carriers (HDGECs) completed the Difficulties in Emotion Regulation Scale, Lille Apathy Rating Scale, and Dimensional Apathy Scale. Cognitive screening included the Montreal Cognitive Assessment and depressive symptoms were assessed with the Hamilton Depression Rating Scale. Hierarchical regressions examined associations between emotion regulation difficulties and apathy, adjusting for depressive symptoms.Results
Greater emotion regulation difficulties were associated with global, Executive, and Behaviour/Initiation apathy, but not Emotional apathy. After accounting for depressive symptoms, Executive and Behaviour/Initiation apathy explained an additional 24.2% of variance in emotion regulation difficulties, whereas global apathy explained an additional 5.8%. Exploratory subgroup analyses found an independent association between Executive apathy and emotion regulation difficulties in premanifest but not manifest HDGECs.Conclusions
Emotion regulation difficulties were associated with global apathy and showed the strongest associations with Executive and Behaviour/Initiation apathy, independent of depressive symptoms. These findings suggest that self-regulatory processes may be relevant to the heterogeneous manifestations of apathy and highlight the importance of examining specific apathy dimensions when investigating its underlying mechanisms and informing potential treatment approaches.
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BibTeX
@article{poulsen2026emotion,
title = {{Emotion regulation difficulties are selectively associated with executive and behavioural apathy in Huntington's disease.}},
author = {Emilie Poulsen and Birna Ásbjörnsdóttir and Lena E Hjermind and Jørgen E Nielsen and Asmus Vogel},
journal = {Journal of neurology},
year = {2026},
month = oct,
doi = {10.1007/s00415-026-14214-0},
url = {https://europepmc.org/article/MED/42909626},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Emotion regulation difficulties are selectively associated with executive and behavioural apathy in Huntington's disease.
AU - Emilie Poulsen
AU - Birna Ásbjörnsdóttir
AU - Lena E Hjermind
AU - Jørgen E Nielsen
AU - Asmus Vogel
PY - 2026
DA - 2026/10/23
JO - Journal of neurology
DO - 10.1007/s00415-026-14214-0
UR - https://europepmc.org/article/MED/42909626
AB - Objective Apathy occurs frequently in psychiatric and neurological disorders and is associated with functional impairment, reduced quality of life, and caregiver burden. Its underlying mechanisms are incompletely understood, but recent studies indicate that apathy is multidimensional and has heterogeneous manifestations across disorders. Self-regulatory processes, such as emotion regulation, may contribute to these manifestations, but this relationship has received little attention. Huntington's disease (HD) provides a clinical model for examining whether emotion regulation difficulties are associated with global and multidimensional apathy.Methods Eighty-nine HD gene expansion carriers (HDGECs) completed the Difficulties in Emotion Regulation Scale, Lille Apathy Rating Scale, and Dimensional Apathy Scale. Cognitive screening included the Montreal Cognitive Assessment and depressive symptoms were assessed with the Hamilton Depression Rating Scale. Hierarchical regressions examined associations between emotion regulation difficulties and apathy, adjusting for depressive symptoms.Results Greater emotion regulation difficulties were associated with global, Executive, and Behaviour/Initiation apathy, but not Emotional apathy. After accounting for depressive symptoms, Executive and Behaviour/Initiation apathy explained an additional 24.2% of variance in emotion regulation difficulties, whereas global apathy explained an additional 5.8%. Exploratory subgroup analyses found an independent association between Executive apathy and emotion regulation difficulties in premanifest but not manifest HDGECs.Conclusions Emotion regulation difficulties were associated with global apathy and showed the strongest associations with Executive and Behaviour/Initiation apathy, independent of depressive symptoms. These findings suggest that self-regulatory processes may be relevant to the heterogeneous manifestations of apathy and highlight the importance of examining specific apathy dimensions when investigating its underlying mechanisms and informing potential treatment approaches.
SN - 0340-5354
SN - 1432-1459
ER -