Journal
JOURNAL OF HEAD TRAUMA REHABILITATION
Volume 20, Issue 4, Pages 377-388Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00001199-200507000-00009
Keywords
abulia; akinetic mutism; anterior cingulum; apathy; cholinesterase inhibitor; disorders of diminished motivation; dopamine agonist; methylpbenidate; traumatic brain injury; ventral pallidum
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Disorders of diminished motivation occur frequently in individuals with traumatic brain injury. Motivation is an ever-present, essential determinant of behavior and adaptation. The major syndromes of diminished motivation are apathy, abulia, and akinetic mutism. Depending on their etiology, disorders of diminished motivation may be a primary clinical disturbance, a symptom of another disorder, or a coexisting second disorder. This article presents a biopsychosocial approach to the assessment and management of motivational impairments in patients with traumatic brain injury. The recognition and differential diagnosis of disorders of diminished motivation, as well as the mechanism and clinical pathogenesis, are discussed.
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