Damage to the basal ganglia, capsular genu, and/or anterior cingulate circuit, and/or acute caudate vascular lesions
Lack of will or initiative to make decisions (primary symptom), difficulty in initiating and sustaining purposeful movements, lack of spontaneous movement, reduced spontaneous speech, increased response time to queries, passivity, reduced emotional responsiveness, reduced social interactions, reduced interest in usual pastimes
Stimulants, dopamine agonists, or other agents such as cholinesterase inhibitors to increase motivation
Abulia, or aboulia for nonphysiological occurances, is generally referred to as the absence of the ability and/or will to make decisions independently. This is not to be confused with simple indecisiveness, as abulia is physiological. Aboulia, however, can be synonomous with extreme indecisiveness.
The decision making process involves several area of the cerebral cortex, and damage to these areas can reduce their function, but the extent of the damage typically is extreme in most cases.