Substance abuse may hasten motor onset of Huntington disease: Evaluating the Enroll-HD database.
OBJECTIVE
To investigate the relationship between substances of abuse and age at motor onset (AMO) in patients with Huntington disease (HD) in a large and diverse patient population.


METHODS
This was a retrospective, observational study of the Enroll-HD database. Participants were determined to belong to 1 of 3 substance abuse groups: (1) tobacco abusers, (2) alcohol abusers, and (3) drug abusers. A group of participants who had never abused substances served as a control group. The average AMO of patients in the substance abuse groups was compared to the control group. The number of CAG repeats was used as a covariate in all analyses.


RESULTS
The average difference in AMOs of participants in the tobacco (n = 566), alcohol (n = 374), and drug abuse groups (n = 217) compared to the control group (n = 692) were 2.3 (F1, 1,258= 33.8,p< 0.0001), 1.0 (F1, 1,066= 4.2,p= 0.04), and 3.3 (F1, 909= 29.7,p< 0.0001) years earlier, respectively. In all substance abuse groups, the AMO was lowered to a greater degree in female participants than it was in male participants.


CONCLUSIONS
Substances of abuse have a strong effect on the AMO in patients with HD. These effects seem to be amplified in women with HD compared to men. These results may provide a safe intervention capable of adding disease-free years to patients with HD.
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City. Jordan-schultz@uiowa.edu.
Jordan L
JL
Schultz
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City.
John A
JA
Kamholz
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City.
David J
DJ
Moser
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City.
Shawna M E
SM
Feely
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City.
Jane S
JS
Paulsen
From the Departments of Pharmaceutical Care (J.L.S.), Neurology (J.L.S., J.A.K., S.M.E.F., J.S.P., P.C.N.), Psychiatry (J.A.K., D.J.M., J.S.P., P.C.N.), and Pediatrics (P.C.N.), The University of Iowa Hospitals and Clinics, Iowa City.
Peg C
PC
Nopoulos
D017668:Age of Onset; D016208:Databases, Factual; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications* / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012189:Retrospective Studies; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000235:genetics / Q000503:physiopathology*; D018911:Trinucleotide Repeats