Clinical Expression and Progression of Huntington’s Disease

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurodegenerative Diseases".

Deadline for manuscript submissions: closed (5 October 2021) | Viewed by 11591

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Medway School of Pharmacy, University of Kent, Anson Building, Canterbury ME4 4TB, UK
Interests: alzheimer’s disease; traumatic brain injury; neuropathology; COVID-19
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Special Issue Information

Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor, psychiatric, and cognitive deficits. Several studies have identified a large set of possible genetic modifiers, distinct from the HD locus itself, that could modify the clinical expression and progression of the disease. Current research seeks to uncover the exact molecular mechanisms driving the pathogenic cascade and clinical features of this complex disorder.

This Special Issue aims to gather cutting edge research on and expand our understanding of the mechanisms behind HD, which in turn open up novel therapeutic approaches for treating this currently incurable condition. Therefore, I invite authors to submit review articles, original research articles, or commentaries related to recent advances on the pathogenic process and clinical expression of HD.

Dr. Romina Vuono
Guest Editor

Manuscript Submission Information

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Keywords

  • Huntington’s disease
  • genetic modifiers
  • onset
  • progression
  • neurodegeneration
  • therapy

Published Papers (3 papers)

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Research

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12 pages, 1007 KiB  
Article
Brain Region and Cell Compartment Dependent Regulation of Electron Transport System Components in Huntington’s Disease Model Mice
by Johannes Burtscher, Giuseppe Pepe, Federico Marracino, Luca Capocci, Susy Giova, Grégoire P. Millet, Alba Di Pardo and Vittorio Maglione
Brain Sci. 2021, 11(10), 1267; https://doi.org/10.3390/brainsci11101267 - 24 Sep 2021
Viewed by 3334
Abstract
Huntington’s disease (HD) is a rare hereditary neurodegenerative disorder characterized by multiple metabolic dysfunctions including defects in mitochondrial homeostasis and functions. Although we have recently reported age-related changes in the respiratory capacities in different brain areas in HD mice, the precise mechanisms of [...] Read more.
Huntington’s disease (HD) is a rare hereditary neurodegenerative disorder characterized by multiple metabolic dysfunctions including defects in mitochondrial homeostasis and functions. Although we have recently reported age-related changes in the respiratory capacities in different brain areas in HD mice, the precise mechanisms of how mitochondria become compromised in HD are still poorly understood. In this study, we investigated mRNA and protein levels of selected subunits of electron transport system (ETS) complexes and ATP-synthase in the cortex and striatum of symptomatic R6/2 mice. Our findings reveal a brain-region-specific differential expression of both nuclear and mitochondrial-encoded ETS components, indicating defects of transcription, translation and/or mitochondrial import of mitochondrial ETS components in R6/2 mouse brains. Full article
(This article belongs to the Special Issue Clinical Expression and Progression of Huntington’s Disease)
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14 pages, 1183 KiB  
Article
Differential Diagnosis of Chorea—HIV Infection Delays Diagnosis of Huntington’s Disease by Years
by Jannis Achenbach, Simon Faissner and Carsten Saft
Brain Sci. 2021, 11(6), 710; https://doi.org/10.3390/brainsci11060710 - 27 May 2021
Cited by 5 | Viewed by 2967
Abstract
Background: There is a broad range of potential differential diagnoses for chorea. Besides rare, inherited neurodegenerative diseases such as Huntington’s disease (HD) chorea can accompany basal ganglia disorders due to vasculitis or infections, e.g., with the human immunodeficiency virus (HIV). The clinical picture [...] Read more.
Background: There is a broad range of potential differential diagnoses for chorea. Besides rare, inherited neurodegenerative diseases such as Huntington’s disease (HD) chorea can accompany basal ganglia disorders due to vasculitis or infections, e.g., with the human immunodeficiency virus (HIV). The clinical picture is complicated by the rare occurrence of HIV infection and HD. Methods: First, we present a case suffering simultaneously from HIV and HD (HIV/HD) focusing on clinical manifestation and disease onset. We investigated cross-sectional data regarding molecular genetic, motoric, cognitive, functional, and psychiatric disease manifestation of HIV/HD in comparison to motor-manifest HD patients without HIV infection (nonHIV/HD) in the largest cohort of HD patients worldwide using the registry study ENROLL-HD. Data were analyzed using ANCOVA analyses controlling for covariates of age and CAG repeat length between groups in IBM SPSS Statistics V.25. Results: The HD diagnosis in our case report was delayed by approximately nine years due to the false assumption that the HIV infection might have been the cause of chorea. Out of n = 21,116 participants in ENROLL-HD, we identified n = 10,125 motor-manifest HD patients. n = 23 male participants were classified as suffering from HIV infection as a comorbidity, compared to n = 4898 male non-HIV/HD patients. Except for age, with HIV/HD being significantly younger (p < 0.050), we observed no group differences regarding sociodemographic, genetic, educational, motoric, functional, and cognitive parameters. Male HIV/HD patients reported about a 5.3-year-earlier onset of HD symptoms noticed by themselves compared to non-HIV/HD (p < 0.050). Moreover, patients in the HIV/HD group had a longer diagnostic delay of 1.8 years between onset of symptoms and HD diagnosis and a longer time regarding assessment of first symptoms by the rater and judgement of the patient (all p < 0.050). Unexpectedly, HIV/HD patients showed less irritability in the Hospital Anxiety and Depression Scale (all p < 0.05). Conclusions: The HD diagnosis in HIV-infected male patients is secured with a diagnostic delay between first symptoms noticed by the patient and final diagnosis. Treating physicians therefore should be sensitized to think of potential alternative diagnoses in HIV-infected patients also afflicted by movement disorders, especially if there is evidence of subcortical atrophy and a history of hyperkinesia, even without a clear HD-family history. Those patients should be transferred for early genetic testing to avoid further unnecessary diagnostics and improve sociomedical care. Full article
(This article belongs to the Special Issue Clinical Expression and Progression of Huntington’s Disease)
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Review

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15 pages, 492 KiB  
Review
Problems with Social Cognition and Decision-Making in Huntington’s Disease: Why Is it Important?
by Sarah L. Mason, Miriam Schaepers and Roger A. Barker
Brain Sci. 2021, 11(7), 838; https://doi.org/10.3390/brainsci11070838 - 24 Jun 2021
Cited by 10 | Viewed by 4492
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Clinical Expression and Progression of Huntington’s Disease)
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