Neuropsychiatric aspects of Huntington's disease
- aDepartment of Psychiatry, The University of Iowa, 2880 JPP, 200 Hawkins Drive, Iowa City, IA 52242, USA, bDepartment of Neurology, cDepartment of Psychology, dDepartment of Psychiatry, UCSD School of Medicine, San Diego, CA, USA, eDepartment of Psychology, SDSU, San Diego, CA, USA, fDepartment of Neurology, UCLA School of Medicine, Los Angeles, CA, USA, gDepartment of Psychiatry, hDepartment of Biobehavioral Sciences
- Dr J S Paulsenjane-paulsen{at}uiowa.edu
- Received 12 June 2000
- Revised 30 January 2001
- Accepted 12 March 2001
Abstract
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.
METHOD 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.
