Massimo, Lauren M.

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2014 - 201912020 - 20252
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  • Publication
    The Cognitive and Neural Basis for Apathy in Frontotemporal Degeneration
    (2014-01-01) Massimo, Lauren M.; Massimo, Lauren M.; Massimo, Lauren M.
    The syndrome of apathy, defined as a reduction in goal-directed behavior (GDB), has profound consequences for morbidity and mortality in the patient and for family-caregiver burden. Apathy is one of the primary neuropsychiatric syndromes associated with the disruption of the frontal-striatal system, but the behavioral and biological mechanisms underlying apathy are not well understood. Apathy is especially prevalent in behavioral variant frontotemporal degeneration (bvFTD). In a sample of 20 apathetic adults with bvFTD and 17 normal controls (NC), impairments in three components of GDB--initiation, planning and motivation--were examined using a novel computerized reaction time test. Employing structural neuroimaging techniques, I then examined the neural basis of GDB in these apathetic bvFTD participants. I found evidence that apathy is associated with an impairment in any of the three GDB components. Initiation, planning, and motivation each map onto three distinct brain regions in the frontal lobe that work together in a large-scale neural network. Furthermore, I was able to identify participants with specific subtypes of apathy, depending on the impaired GDB mechanism. I developed and submitted a proposal for continued study of the phenomenon; the proposal was awarded. The long-term potential impact of this beginning program of research is profound for patients with neurodegenerative disease, their caregivers, and families. Current treatment of apathy has been hindered due to poor understanding of the mechanisms underlying this condition. This work will lead to a better understanding of these mechanisms and structures fundamental to the behavior, and, with this knowledge, tailored interventions can be designed and implemented by professional and lay caregivers. Thus, a more precise characterization of apathy will allow providers to implement the most appropriate therapy for a given patient.
  • Publication
    The Association of Spirituality & Memory in Older Black and White U.S. Adults
    (2025-06-10) Britt, Katherine C.; Dong, Fanghong; Hamilton, Jill B.; Massimo, Lauren M.; Hodgson, Nancy A.; Stites, Shana D.; Mechanic-Hamilton, Dawn
    This study investigates associations between religiousness and spirituality with memory and executive function among cognitively unimpaired older Black and White adults. We examined data from the Aging Brain Cohort (ABC) at The University of Pennsylvania Alzheimer’s Disease Research Center from 2021-2022. Participants who reported higher spirituality but not religiousness had better memory but not executive function, controlling for age, education, sex, and social interaction. Greater spirituality is associated with better memory among older Black and White Americans in this sample, informing a greater understanding of the underlying connection between spirituality and cognitive health.
  • Publication
    Higher Neighborhood Deprivation is Associated with Accelerated Disease Progression in Behavioral-Variant Frontotemporal Degeneration.
    (2025-10-01) Boyle, Rory; Dehghani, Nadia; Emrani, Sheina; Wadhwani, Anil R.; Matyi, Melanie; Cousins, Katheryn A.Q.; Rhodes, Emma; Nelson, Brian; Stites, Shana D.; Xie, Sharon X.; Dratch, Laynie; Van Deerlin, Vivianna M; Snyder, Allison; Irwin, David J.; McMillan, Corey T.; Massimo; Massimo, Lauren M.
    Neighborhood deprivation is associated with shorter survival, cognitive impairment and neurodegeneration in aging and Alzheimer’s disease. However, the association of neighborhood deprivation with disease progression in behavioral-variant frontotemporal degeneration (bvFTD) is unknown. METHODS: We examined associations between tertiles of neighborhood deprivation, using the Area Deprivation Index (ADI), and survival in 311 individuals clinically diagnosed with bvFTD from the Penn FTD Center. In a subset (n=161) with complete baseline data across measures of global cognition, executive function, and language, we examined the association of ADI with longitudinal change. RESULTS: Compared to adults living in the least deprived neighborhoods, those living in the most deprived neighborhoods showed shorter survival after symptom onset and faster decline in global cognition, executive and language functions, independent of genetic risk. DISCUSSION: Living in more deprived neighborhoods was associated with an accelerated disease course in bvFTD, highlighting an important socioeconomic disparity in disease prognosis.