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Necessary impairments? The downside of functional compensation in frontostriatal circuits in people with presymptomatic Huntingt­on’s­ di­sease
  1. Sean James Fallon1,2
  1. 1 National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol BS8 2BN, UK
  2. 2 Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to Dr Sean James Fallon, National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol BS8 2BN, UK; sj.fallon{at}

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Rerouting of frontostriatal circuits prior to the onset of Huntinton’s disease is associated with impaired attentional control

How necessary, and inevitable, is the pairing between a specific neural circuit and a certain behaviour? Are there consequences for not using the brain regions normatively recruited for a given behaviour?

These are some of the most fundamental questions that have important consequences for how we diagnose and treat neuropsychiatric disorders as they affect our understanding of the mapping between pathology and presentation that underscores clinical practice. The new paper by Langley et al 1 provides important answers to these questions through examining the neurocognitive deficits present in a unique cohort of presymptomatic (far from onset) individuals who will eventually develop Huntington’s disease (HD). Specifically, they examine whether the same frontostriatal circuits that support attentional control in healthy adults also support this faculty in pre-HD individuals.

The existence of parallel, but interacting, circuits that can be functionally described as cognitive, emotional or motoric within frontostriatal circuits accounts for both the selective and synoptic deficits across these domains in neuropsychiatric conditions like HD.2 Our understanding of frontostriatal circuits has been greatly enriched by the intradimensional/extradimensional (ID/ED) set-shifting task. Developed to disentangle attentional control processes, …

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  • Funding SJF is funded by National Institute for Health Research Biomedical Research Bristol.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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