RESIDENT & FELLOW

Possible role of the basal ganglia in poor reward sensitivity and apathy after stroke One in 3 stroke survivors is affected by apathy, distur-bance of goal-directed behavior (GDB)1 that can result from the disruption of neural structures con-trolling GDB, of which the prefrontal cortex (PFC) and the basal ganglia (BG) are thought to be of par-ticular relevance (figure).1,2 Recent proposals suggest that reward insensitivity associated with BG dysfunc-tion may be a key component of apathy.3,4 In a recent Neurology ® article, Rochat et al.5 addressed this issue directly by assessing the contri-bution of reward insensitivity to self-reported apathy and how this may relate to damage within fronto