Background Parkinsonism is a common and invalidating feature of Huntington’s disease (HD) that results difficult to manage since levodopa and/or dopaminergic agonists may exacerbate chorea and psychiatric symptoms.
Methods Two patients exhibiting a rigid-akinetic form of HD, -with apathetic symptoms and slight depression in patient A and major depression in patient B were treated with Rasagiline (a monoaminoxidasa-B inhibitor used in Parkinson’s disease) 1mg/day. Motor function, cognition and affect were explored through the Unified Huntington Disease Rating Scale (UHDRS), neuropsychological assessment, the Hospital Anxiety and Depression Scale and the Starkstein’s Apathy Scale.
Results One month after initiation of Rasagiline, motor function improved on rigidity/bradykinesia (measured with finger taps, pronate supinate-hands, bradykiensia-body and rigidity items). Patient A improved nine points (Initial UHDRS = 33, final 24) and patient B ten (Initial UHDRS = 24, final 14). No worsening on chorea neither in other items was seen. Significant amelioration of apathy and depression was also evidenced in both cases. In Patient A, apathy score decreased from 18 to 12 points and from 12 to 7 for depression. In patient B, apathy decreased from 22 to 13, while depression from 14 to 6. The Global impression of change was rated by the patients up to 70% of improvement in both cases. Neurologist rated up to 50% for patient A and 70% for patient B. Both remained stable after 3-month follow-up.
Conclusions In our reported cases of HD, rasagiline appeared effective to treat parkinsonism. Future studies are needed to clarify the potential usefulness of Rasagiline for the management of HD.