Background Huntington’s disease (HD) is characterized by motor, psychiatric impairment and a slow but gradual and inexorable cognitive decline. It has been demonstrated that signs of this cognitive deterioration are already present in very early stages of the disease, often preceding the appearance of motor symptoms. Apraxia is a neuropsychological disorder related to movement deficits, both in terms of planning and motor programming. An apraxic patient is unable to perform certain precise gestures, movements with meaning and/or voluntary movements without meaning. Apraxic disorders have been frequently found in patients with dementia and other neurodegenerative diseases, such as HD. A peculiar form of apraxia is called Constructive Apraxia (CA), in which the patient shows increasing difficulties in reproducing two- and three-dimensional configurations, both on copy and from memory.

Aims In this retrospective study, the aim was to identify the prevalence and severity of CA in HD patients.

Methods The assessment of CA was carried out through the administration of simple figure copying tests, by comparing the frequency and types of errors in drawing tests with those committed by a control population.

Results The results obtained showed that CA is a subclinical symptom of HD, correlated with cognitive impairment but not with motor and psychiatric impairment and does not appear to be associated with characteristic errors.

Conclusions CA is more frequent in HD patients than in a control population, also in the early pre-motor stage of disease. The assessment of this form of apraxia could be useful for clinicians to investigate cognitive impairment in HD patients.