Journal of Huntington's disease最新文献

Huntington's Disease Integrated Staging System (HD-ISS) stages are likely inclusion criteria in future clinical trials. Stage 1 volumetric cut-offs were derived using the FreeSurfer longitudinal stream (LG). However, trials will require cross-sectional stream (CS) application with one MRI. Volumetric outputs are not robust to software type or version. T1-weighted images from 88 participants with MRIs from baseline and follow-up HD-YAS visits were segmented using both streams. CS calculated smaller caudate and putamen volumes adjusted for total intracranial volume, with greater reduction for larger volumes, shifting towards HD-ISS stage 1. CS-specific cut-offs need to be established before application to clinical trials.

BackgroundHuntington's Disease (HD) is an autosomal dominant neurodegenerative disorder. Clinical features encompass a broad spectrum of movement disorders, psychiatric and cognitive symptoms, often progressing to dementia and imposing a substantial burden on patients and their families. While cholinesterase inhibitors and memantine are often used for symptomatic treatment of Alzheimer's Disease and other dementias, there is currently no approved medication for treating cognitive symptoms in HD.ObjectiveWe aim to review, summarize, and appraise evidence from the literature for the use of cholinesterase inhibitors and memantine in the treatment of cognitive symptoms in patients with HD.MethodsA searched was conducted in PubMed and SCOPUS, from inception until February 2024, for Randomized Clinical Trials (RCTs), open-label, and case-control studies. Quality appraisal was performed using ROBINS-I and ROB2 for non-randomized studies and RCTs, respectively.ResultsFive eligible studies (three RCTs, one extension study, and one retrospective case-control), exploring the use of rivastigmine (n = 3), memantine (n = 1), and donepezil (n = 1) were found. Only two had a follow-up period longer than eight months. Previous cognitive functioning was not specified in three out of five studies. Cognitive measures varied widely, with Unified Huntington's Disease Rating Scale and Mini-Mental State Exam being used more frequently. None of the studies showed a significant improvement in cognitive function. Side effects occurred in up to 50% of patients and were usually considered mild.ConclusionsThere is insufficient evidence in the literature to support the use of cholinesterase inhibitors or memantine for cognitive symptoms in patients with HD.

BackgroundGiven the scarcity of comprehensive data on Huntington's disease in many Asian and African countries, it is more effective to focus on specific regions where there is a significant concentration of available data.ObjectiveThis study decided to evaluate the epidemiology and features of Huntington's disease in countries of the Middle East, North Africa, and South Asia (MENASA) regions.MethodsIn this meta-analysis, the limited maximum likelihood (REML) approach was applied to the estimated point prevalence mentioned in original studies of each MENASA country. Additionally, research on Huntington's disease characteristics in each nation was utilized to give a general picture of the disease's status in those nations.ResultsThe pooled point prevalence estimation of the prevalence studies was 8.64 per 100,000 (95% CI, -0.04-17.33; I² = 100%). Among 14 cohort and cross-sectional studies on individuals with Huntington's disease in the MENASA region, 5.61% of the patients had juvenile-onset Huntington's disease, and 2.3% had late-onset Huntington's disease. In addition, 68.58%, 17.82%, and 45.17% of the individuals were reported with motor symptoms at the onset, abnormal cognitive assessment scores, and degrees of psychological disturbance, respectively. The mean age at onset was 44.85 years, and the mean number of pathologic CAG repeats was 45.46.ConclusionsNotable differences in the frequency of symptoms of onset and pooled prevalence of HD in the MENASA region probably address a serious lack of sufficient information. The results would help clinicians and governments develop public health strategies, and further research could be conducted on these results.

Accumulating morphological and electrophysiological evidence demonstrates that abnormal brain development is a key element in the progression of Huntington's disease (HD). Mutant huntingtin affects corticogenesis, cell migration, and differentiation. Cortical changes are reminiscent of focal cortical dysplasia, a malformation of cortical development that leads to hyperexcitability and epilepsy. Striatal development also is affected by the mutation. In animal models, recent studies provide additional evidence that neuronal morphology and intrinsic and electrophysiological properties deviate from normal development. Some changes indicate delayed development of cortical pyramidal neurons, while a subtype of striatal projection neuron displays a transient accelerated maturation. However, the brain is able to compensate for early abnormalities and, during a variable latent period, brain function appears normal. Eventually, homeostatic mechanisms begin to fail, resulting in the emergence of HD symptoms. The realization that neurodevelopment in HD is abnormal offers new insights and opens new avenues for early treatment. In this review, we present a brief summary of imaging and morphological studies from human carriers of the HD mutation followed by a more in-depth examination of recent findings in genetic animal models.

Huntington's disease (HD) is a neurodegenerative disorder caused by a repeat expansion in the HTT gene. The disease is well known for severe and progressive loss of neurons in the caudate and putamen, although other areas are also involved. Much of the attention on understanding the mechanisms underlying HD has focused on the neurons. The brain also contains large numbers of glial cells, such as astrocytes, oligodendrocytes, and microglia, which also become dysfunctional in HD. Astrocytes are one of the most abundant cell types in the central nervous system and are critical for regulating the brain environment and supporting neurons in many ways. In this review, we discuss the changes in astrocytes during the evolution of HD in the human brain. We detail the key phenotypes of astrocytes in human HD, which encompass reactive astrogliosis, loss of homeostatic function, gain of a neuroprotective function, changes in lipid metabolism, huntingtin protein aggregation, and limited somatic repeat expansion. We briefly discuss the conservation of these phenotypes in mouse models and propose a model of how astrocyte states change in human HD. Finally, we present open questions for astrocyte researchers in the HD field. Together, this review represents a valuable resource for readers interested in astrocytic changes in human HD.