Premanifest Huntington's disease: Examination of oculomotor abnormalities in clinical practice

Neurological Motor Disorder

Driving with a neurodegenerative disorder: an overview of the current literature

Neurological Motor Disorder

Juvenile-onset Huntington disease pathophysiology and neurodevelopment: a review

Huntington disease is an autosomal dominant inherited brain disorder that typically becomes manifest in adulthood. Juvenile-onset Huntington disease refers to approximately 5% of patients with symptom onset before the age of 21 years. The causal factor is a pathologically expanded CAG repeat in the Huntington gene. Age at onset is inversely correlated with CAG repeat length. Juvenile-onset patients have distinct symptoms and signs with more severe pathology of involved brain structures in comparison with disease onset in adulthood. The aim of this review is to compare clinical and pathological features in juvenile- and adult-onset Huntington disease and to explore which processes potentially contribute to the observed differences. A specific focus is placed on molecular mechanisms of mutant huntingtin in early neurodevelopment and the interaction of a neurodegenerative disease and postnatal brain maturation. The importance of a better understanding of pathophysiological differences between juvenile- and adult-onset Huntington disease lies in development and implementation of new therapeutic strategies. (c) 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder SocietyFunctional Genomics of Muscle, Nerve and Brain Disorder

Life at school in Australia and Japan: the impact of stress and support on bullying and adaptation to school

In this international, comparative study, path analysis was used to examine eight different aspects of Japanese and Australian students' experiences of school life in relation to their effect on adaptation to school. Adaptation was constructed to include information on enjoyment of school, feelings of belonging to school, and relationships with other students. Two separate path models were tested to compare questionnaire data from over 3000 Australian and 6000 Japanese students across Years 5-10. The questionnaire was developed collaboratively by the authors to examine issues of common concern in both countries. Issues that related to the impact on adaptation to school of stress and support: family teachers, peers and school work, as well as bullying were of particular interest. Lack of support and the influential effect of stress were found to exert direct negative effects on adaptation to school, especially for high school students in Japan and Australia. The path results also confirmed the stressful effects of bullying in both countries. The finding of a strong relationship between bullying others and being victimised is discussed in the paper. Finally, the differences and similarities between Japanese and Australian students' perceptions of school life are extrapolated

The visual cortex and visual cognition in Huntington's disease: An overview of current literature

Neuro Imaging Researc

Altered Intracortical T-1-Weighted/T-2-Weighted Ratio Signal in Huntington's Disease

Neurological Motor Disorder

The prevalence of pain in Huntington’s Disease in a large worldwide cohort

Introduction: Pain could be an unknown non-motor symptom in Huntington's Disease (HD). The aim is therefore, to study the prevalence of pain interference, painful conditions and analgesic use across the different stages of HD and compare these levels to non-HD gene mutation carriers.Methods: A cross-sectional analysis of the Enroll-HD study was conducted in premanifest, manifest HD gene mutation carriers (n = 3989 and n = 7,485, respectively) and in non-HD gene mutation carriers (n = 3719). To investigate group differences, multivariable logistic regression analysis was performed with pairwise comparisons.Results: In the HD mutation carriers, the overall prevalence of pain interference was 34% (95% CI 31%-35%), of painful conditions 17% (95% CI 15%-19%) and analgesic use 13% (95% CI 11%-15%). Compared to non-mutation carriers, the prevalence of pain interference was significantly higher in the middle stage of HD (33% [95% CI 31%-35%] vs 42% [95% CI 39%-45%], P = 0,02), whereas the prevalence of painful conditions was significant lower in the late and middle stage of HD (17% [95% CI 16%-18%] vs 12% [95% CI 10%-14%], 15% [95% CI 13%-17%], P < 0,01]. No significant group difference was present in analgesic use.Conclusions: The prevalence of pain interference increases as HD progresses, however, the prevalence of painful conditions and analgesics do not increase accordingly. Further studies are necessary to investigate the aetiology of pain in HD and the risk for undertreatment of pain.Development and application of statistical models for medical scientific researc

Validating automated segmentation tools in the assessment of caudate atrophy in Huntington's disease

Background: Neuroimaging shows considerable promise in generating sensitive and objective outcome measures for therapeutic trials across a range of neurodegenerative conditions. For volumetric measures the current gold standard is manual delineation, which is unfeasible for samples sizes required for large clinical trials.Methods: Using a cohort of early Huntington's disease (HD) patients (n = 46) and controls (n = 35), we compared the performance of four automated segmentation tools (FIRST, FreeSurfer, STEPS, MALP-EM) with manual delineation for generating cross-sectional caudate volume, a region known to be vulnerable in HD. We then examined the effect of each of these baseline regions on the ability to detect change over 15 months using the established longitudinal Caudate Boundary Shift Integral (cBSI) method, an automated longitudinal pipeline requiring a baseline caudate region as an input.Results: All tools, except Freesurfer, generated significantly smaller caudate volumes than the manually derived regions. Jaccard indices showed poorer levels of overlap between each automated segmentation and manual delineation in the HD patients compared with controls. Nevertheless, each method was able to demonstrate significant group differences in volume (p < 0.001). STEPS performed best qualitatively as well as quantitively in the baseline analysis. Caudate atrophy measures generated by the cBSI using automated baseline regions were largely consistent with those derived from a manually segmented baseline, with STEPS providing the most robust cBSI values across both control and HD groups.Conclusions: Atrophy measures from the cBSI were relatively robust to differences in baseline segmentation technique, suggesting that fully automated pipelines could be used to generate outcome measures for clinical trials.Neurological Motor Disorder