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Problems with Social Cognition and Decision-Making in Huntington’s Disease: Why Is it Important?

John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0PY, UK
NIHR Biomedical Research Centre, Addenbrookes Hospital, Cambridge CB2 0QQ, UK
Wellcome Trust Medical Research Council-Cambridge Stem Cell Institute, Cambridge CB2 0AW, UK
Author to whom correspondence should be addressed.
Academic Editor: Julien Rossignol
Brain Sci. 2021, 11(7), 838;
Received: 12 May 2021 / Revised: 11 June 2021 / Accepted: 18 June 2021 / Published: 24 June 2021
(This article belongs to the Special Issue Clinical Expression and Progression of Huntington’s Disease)
Huntington’s disease starts slowly and progresses over a 15–20 year period. Motor changes begin subtly, often going unnoticed by patients although they are typically visible to those close to them. At this point, it is the early non-motor problems of HD that arguably cause the most functional impairment. Approximately 65% of gene carriers will experience a reduction in their occupational level, and just under half will feel unable to manage their finances independently before a clinical diagnosis is made. Understanding what drives this impairment in activities of daily living is the key to helping people with HD to live more independently for longer, especially in early disease. Early cognitive decline is likely to play a contributory factor although few studies have looked directly at this relationship. Recently, it has been shown that along with the well documented dysexecutive syndrome seen in HD, changes in social cognition and decision-making are more common than previously thought. Furthermore, some of the early neuropathological and neurochemical changes seen in HD disrupt networks known to be involved in social functioning. In this review, we explore how HD changes the way individuals interact in a social world. Specifically, we summarise the literature on both classical and social decision-making (value-based decision-making in a social context) along with studies of theory of mind, empathy, alexithymia, and emotion recognition in HD. The literature specific to HD is discussed and supported by evidence from similar neurodegenerative disorders and healthy individuals to propose future directions and potential therapeutic avenues to be explored. View Full-Text
Keywords: social cognition; Huntington’s disease; decision-making social cognition; Huntington’s disease; decision-making
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MDPI and ACS Style

Mason, S.L.; Schaepers, M.; Barker, R.A. Problems with Social Cognition and Decision-Making in Huntington’s Disease: Why Is it Important? Brain Sci. 2021, 11, 838.

AMA Style

Mason SL, Schaepers M, Barker RA. Problems with Social Cognition and Decision-Making in Huntington’s Disease: Why Is it Important? Brain Sciences. 2021; 11(7):838.

Chicago/Turabian Style

Mason, Sarah L., Miriam Schaepers, and Roger A. Barker. 2021. "Problems with Social Cognition and Decision-Making in Huntington’s Disease: Why Is it Important?" Brain Sciences 11, no. 7: 838.

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