Abulia: The Pathology of "Will" and Dopaminergic Dysfunction in Brain-Injured Patients

Journal Title: Sultan Qaboos University Medical Journal - Year 1999, Vol 1, Issue 1


The present paper describes a series of single-case evaluations of the effects of bromocriptine, a dopamine D2 post-synaptic receptor agonist in 13 patients with clinical features cf abulia. Method - An open trial in seven males and six females who had either traumatic brain injury or subarachnoid haemorrhage between two months and five years previously. After repeated baseline assessments, bromocriptine was administered in gradually increasing doses, Assessments were repeated at increasing doses, during maintenance, and after withdrawal. Same newly developed structured instruments for quantifying motivation were used; measures of anxiety and depression, and cognitive tests sensitive to motivation were also administered. Results- Following bromocriptine treatment improved on all scores measured other than mood. Improvement was maintained after bromocriptine withdrawal in nine of the patients. Conclusion- Abulia in patients with brain injury may result from dysfunction in the mesocorticolimbic dopaminergic cirucity, giving rise to associated deficiencies in reward responsiveness and cognitive function. New rating are propsed of motivation in brain injured patients.

Authors and Affiliations

Samir ALl-Adawi| College of Medicine, Sultan Qaboos University, P.O.Box 35, Al-Khod 123, Muscat, Sultanate of Oman. Institute of Psychiatry, Kings College, De Crespigny Park, Denmark Hill, London, UK. Regional Neurological Rehabilitation Unit, Homerton Hospital, Homerton Row, London, E9 6SR, U.K., J. H Powell| Department of Psychology, Goldsmiths College, University of London , Lewisham Way, New Cross, London, SE14 6 NW, U.K. Regional Neurological Rehabilitation Unit, Homerton Hospital, Homerton Row, London, E9 6SR, U.K. , S. Basavappa| Critical Care Research Laboratories, Harvard Medical School and Children s Hospital, Boston, MA02115, U.S.A, R. J. Greenwood| Regional Neurological Rehabilitation Unit, Homerton Hospital, Homerton Row, London, E9 6SR, U.K.


Related Articles

Patients’ and Nurses’ Perceptions of Post-Coronary Artery Bypass Graft Learning Needs in Two Omani Hospitals

ABSTRACT: Objectives: Little is known about nurses’ and patients’ perceptions of learning needs following coronary artery bypass graft (CABG) surgery in Oman. This study aimed to identify patients' and nurses' perception...

Work-Related Musculoskeletal Symptoms in Otorhinolaryngology-Head and Neck Surgery Residents

Objectives: Work-related musculoskeletal disorders in Saudi Arabia are not often reported in the literature. This study aimed to identify musculoskeletal symptoms among otorhinolaryngology residents in Saudi Arabia. Meth...

Prevalence of Sleep Deprivation and Relation with Depressive Symptoms among Medical Residents in King Fahd University Hospital, Saudi Arabia

Objectives: Sleep deprivation is common among medical residents of all specialties. Tis study aimed to determine the prevalence of sleep deprivation and depressive symptoms among medical residents in King Fahd Universi...

Frequency of Glomerular Dysfunction in Children with Beta Thalassaemia Major

Objectives: Tis study investigated the frequency of glomerular dysfunction in children with beta thalassaemia major (β-TM) by using different markers and correlating them with serum ferritin and iron chelation therap...

A Cerebellar High-Grade Neuroepithelial Tumour with BCOR Alteration in a five-year-old Child: A case report

New groups of high-grade neuroepithelial tumours (HGNET) have emerged from the reclassification of central nervous system (CNS) embryonal tumours that have recognised CNS HGNET with BCOR alteration (CNS HGNET-BCOR). We r...

Download PDF file
  • EP ID EP13592
  • DOI -
  • Views 399
  • Downloads 23

How To Cite

Samir ALl-Adawi, J. H Powell, S. Basavappa, R. J. Greenwood (1999). Abulia: The Pathology of "Will" and Dopaminergic Dysfunction in Brain-Injured Patients. Sultan Qaboos University Medical Journal, 1(1), 27-40. https://europub.co.uk/articles/-A-13592