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We read with great interest the paper of Hanajimaet al 1 reporting that intracortical inhibition of the motor cortex is normal in patients with chorea of various origins. At variance with these results we previously found2 a reduced intracortical inhibition in a group of patients with genetically confirmed Huntington's disease. Hanajimaet al suggest that the discrepancies between the two studies might be due to differences in patient selection as they included patients with early stage Huntington's disease to “study the pathophysiology of chorea unaffected by other disorders movement.” They postulated that our cases, because of the reported correlation with a dyskinesia rating scale, had a more advanced stage of the disease possibly with coexisting dystonia or rigidity. These assertions deserve some comments.
The mean disease duration of our nine patients with Huntington's disease was 6.2 (4.1) years which is actually shorter than the duration of the six patients reported by Hanajima et al (8.3 (5.9) years). Most of our patients could be considered in an early stage of the disease, according to the Unified Huntington's disease rating scale, and none presented dystonia, rigidity, or any other additional movement disorder. In this regard, however, it should be pointed out that bradykinesia is often associated with chorea in patients …