Neuropsychiatric aspects of Huntington's disease.
OBJECTIVE
Neuropsychiatric symptoms are common in Huntington's disease and have been considered its presenting manifestation. Research characterising these symptoms in Huntington's disease is variable, however, encumbered by limitations within and across studies. Gaining a better understanding of neuropsychiatric symptoms is essential, as these symptoms have implications for disease management, prognosis, and quality of life for patients and caregivers.


METHODS
Fifty two patients with Huntington's disease were administered standardised measures of cognition, psychiatric symptoms, and motor abnormalities. Patient caregivers were administered the neuropsychiatric inventory.


RESULTS
Ninety eight per cent of the patients exhibited neuropsychiatric symptoms, the most prevalent being dysphoria, agitation, irritability, apathy, and anxiety. Symptoms ranged from mild to severe and were unrelated to dementia and chorea.


CONCLUSIONS
Neuropsychiatric symptoms are prevalent in Huntington's disease and are relatively independent of cognitive and motor aspects of the disease. Hypothesised links between neuropsychiatric symptoms of Huntington's disease and frontal-striatal circuitry were explored. Findings indicate that dimensional measures of neuropsychiatric symptoms are essential to capture the full range of pathology in Huntington's disease and are vital to include in a comprehensive assessment of the disease.
Paulsen
J S
JS
Department of Psychiatry, The University of Iowa, 2880 JPP, 200 Hawkins Drive, Iowa City, IA 52242, USA. jane-paulsen@uiowa.edu
Ready
R E
RE
Hamilton
J M
JM
Mega
M S
MS
Cummings
J L
JL
D000328:Adult; D000368:Aged; D003071:Cognition; D004522:Educational Status; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D006816:Huntington Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009048:Motor Skills; D009422:Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D009483:Neuropsychological Tests; D015995:Prevalence; D011595:Psychomotor Agitation; D012720:Severity of Illness Index; D014793:Visual Cortex / Q000503:physiopathology