title: Mentalizing in preclinical Huntington's disease: an fMRI study using cartoon picture stories.
abstract: Huntington's disease (HD) is an autosomal dominant degenerative brain disorder that is characterized by motor, cognitive and affective symptoms. Previous research has shown that patients with HD, similar to patients with schizophrenia, are impaired in their ability to appreciate the mental states of others. Functional brain imaging studies have shown that patients with schizophrenia underactivate the neural network involved in mentalizing, and that deviant patterns of brain activation are also present in individuals at high risk of developing a psychotic disorder. Accordingly, the present study sought to examine the brain activation in premanifest mutation carriers for HD. Thirty premanifest mutation carriers (13 males) defined by a positive gene test and absence of unequivocal HD symptoms ("pre-HD") performed a cartoon mentalizing task during functional brain imaging. For comparison, a group of 26 healthy controls took part in the study. BOLD responses revealed that pre-HD subjects activated the mentalizing network comprising prefrontal, temporoparietal and parietal brain regions during task performance. A comparison between pre-HD patients and healthy controls revealed no significant activation differences. Premanifest mutation carriers of HD activated the neural network involved in mentalizing similar to healthy control subjects. This suggests that impaired mentalizing emerges with the clinical manifestation of the disease, but is not necessarily part of the pre-manifest stage.
authors.affiliation: Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Gudrunstr. 56, 44791 Bochum, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Saft
authors.forename: Silke
authors.initials: S
authors.lastname: Lissek
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
authors.forename: Volkmar
authors.initials: V
authors.lastname: Nicolas
authors.forename: Martin
authors.initials: M
authors.lastname: Tegenthoff
authors.forename: Georg
authors.initials: G
authors.lastname: Juckel
authors.forename: Martin
authors.initials: M
authors.lastname: Brüne
mesh_terms: D000328:Adult; D002359:Cartoons as Topic; D002540:Cerebral Cortex / Q000502:physiology*; D003072:Cognition Disorders / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000502:physiology; D010775:Photic Stimulation / Q000379:methods; D017397:Prefrontal Cortex / Q000502:physiology; D013702:Temporal Lobe / Q000502:physiology; D055815:Young Adult