Aboulia: neurobehavioural dysfunction of dopaminergic system

Recent advances in the understanding of the neural substrates of goal-direc ted behaviour have created new interest in unlocking the mystery behind tho se disorders that are characterized by poverty of thought and action. In th is review, various studies will be considered which proffer converging evid ence that the dopaminergic brain circuitry running from ventral tegmental a reas in the midbrain, via nucleus accumbens in the forebrain, to the fronta l cortex, tends to produce aboulia when its restitutive function fails. Suc h aboulic deficits occur in various neurological and psychiatric disorders in which they have profound implications for the patients' management, reha bilitation and social interactions. We begin by examining the consequences of dopamine agonism and antagonism i n pre-clinical studies and draw on the inferences that can be made from stu dies in humans. We then go on to discuss aboulic features in neuropsychiatr ic conditions, focusing on clinical manifestation, animal models, abnormal dopamine activity and pharmacological interventions. (C) 2000 Harcourt Publ ishers Ltd.