An overview of the huntingtons disease

But the disease may emerge earlier or later in life. An earlier emergence of the disease often results in a somewhat different set of symptoms and faster disease progression. Which symptoms appear first varies greatly among affected people.

An overview of the huntingtons disease

Swallowing problems, danger of choking Inability to care for oneself Abnormalities of movement. Disturbances of both involuntary and voluntary movements occur in individuals with HD. Chorea, an involuntary movement disorder consisting of non-repetitive, non-periodic jerking of limbs, face, or trunk, is the major sign of the disease.

The choreic movements are continuously present during waking hours, cannot be suppressed voluntarily, and are worsened by stress. With advancing disease duration, other involuntary movements such as bradykinesia, rigidity, and dystonia occur.

Impairment in voluntary motor function is an early sign.

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Affected individuals and their families describe clumsiness in common daily activities. Motor speed, fine motor control, and gait are affected. Oculomotor disturbances occur early and worsen progressively.

Dysarthria occurs early and is common. Dysphagia occurs in the late stages.

Huntington's Disease Cause and Risk Factor

A global and progressive decline in cognitive capabilities occurs in all individuals with HD. Cognitive changes include forgetfulness, slowness of thought processes, impaired visuospatial abilities, and impaired ability to manipulate acquired knowledge.

Several studies have identified subtle but definite cognitive deficits prior to the onset of motor symptoms [ Bourne et alMontoya et alPaulsen et alTabrizi et alRupp et al ].

The initial changes often involve loss of mental flexibility and impairment of executive functions such as mental planning and organization of sequential activities. Memory deficits with greater impairment for retrieval of information occur early, but verbal cues, priming, and sufficient time may lead to partial or correct recall.

Early in the disease the memory deficits in HD are usually much less severe than in Alzheimer disease. The overall cognitive and behavioral An overview of the huntingtons disease in individuals with HD is more similar to frontotemporal dementia than to Alzheimer disease.

Attention and concentration are involved early [ Peinemann et al ], resulting in easy distractibility. Language functions are relatively preserved, but a diminished level of syntactic complexity, cortical speech abnormalities, paraphasic errors, and word-finding difficulties are common in late stages.

Neuropsychologic testing reveals impaired visuospatial abilities, particularly in late stages of the disease. Individuals with HD develop significant personality changes, affective psychosis, or schizophrenic psychosis [ Rosenblatt ].

Prior to onset of HD, they tend to score high on measures of depression, hostility, obsessive-compulsiveness, anxiety, and psychoticism [ Duff et al ]. Unlike the progressive cognitive and motor disturbances, the psychiatric changes tend not to progress with disease severity [ Epping et al ].

Behavioral disturbances such as intermittent explosiveness, apathy, aggression, alcohol abuse, sexual dysfunction and deviations, and increased appetite are frequent.

Delusions, often paranoid, are common. Hallucinations are less common. Depression and suicide risk.

An overview of the huntingtons disease

The incidence of depression in preclinical and symptomatic individuals is more than twice the general population [ Paulsen et al bMarshall et al ]. The etiology of depression in HD is unclear; it may be a pathologic rather than a psychological consequence of having the disease [ Slaughter et alPouladi et al ].

Suicide and suicide ideation are common in persons with HD, but the incidence rate changes with disease course and predictive testing results [ Larsson et alRobins Wahlinvan Duijn et al ]. The critical periods for suicide risk were found to be just prior to receiving a diagnosis and later, when affected individuals experience a loss of independence [ Baliko et alPaulsen et al aEddy et al ].

It is also common for persons with HD to demonstrate increased appetite and energy expenditure [ Pratley et alTrejo et alGaba et al ]. Insomnia and daytime somnolence may also be present, although this is more commonly due to psychiatric changes, depression, or chorea [ Videnovic et al ].

The primary neuropathologic feature of HD is degeneration of neurons in the caudate and putamen as well as the cerebral cortex [ Waldvogel et al ]. The preferential degeneration of enkephalin-containing, medium spiny neurons of the indirect pathway of movement control in the basal ganglia provides the neurobiologic basis for chorea [ Galvan et al ].

The additional loss of substance P-containing medium spiny neurons of the direct pathway results in akinesia and dystonia [ Galvan et al ]. Region-specific patterns of neuronal loss in the basal ganglia and cortex may underlie the most evident symptoms in affected individuals and could contribute to the phenotypic variability among individuals [ Thu et alHadzi et alKim et alWaldvogel et alMehrabi et al ].

Intraneuronal inclusions containing huntingtin, the protein expressed from HTT, are also a prominent neuropathologic feature of the disease.

Imaging studies provide additional support for the clinical diagnosis of HD and are valuable tools for studying progression of the disease [ Biglan et alPaulsenTabrizi et alTabrizi et alTabrizi et al ]. In addition to significant striatal atrophy in symptomatic individuals, regional and whole-brain gray and white matter changes have been detected [ Majid et alTabrizi et alTabrizi et alTabrizi et al ].

Furthermore, MRI studies have revealed progressive gray and white matter atrophy many years prior to predicted disease onset [ Tabrizi et alTabrizi et alTabrizi et al ].

Numerous studies in recent years have used neuroimaging to elucidate the clinical progression of HD, with the specific interest of using these objective measures in clinical trials for testing efficacy of experimental therapeutics [ Tabrizi et alTabrizi et al ].

The motor, cognitive, and psychiatric disturbances observed in adult HD are also observed in juvenile HD, but the clinical presentation of these disturbances is different.

An individual with a CAG repeat in the range is not believed to be at risk of developing HD but, because of instability in the CAG tract, may be at risk of having a child with an allele in the pathogenic CAG range [ Semaka et alKay et al ].Huntington's disease is a condition that stops parts of the brain working properly over time.

It's passed on (inherited) from a person's parents. It gets gradually worse over time and is usually fatal after a period of up to 20 years.

Full-time nursing care is needed in the later stages of the. Research and Clinical Interests. Movement disorders, motor cortex excitability, Parkinson's disease, stuttering.

Methods: Transcranial magnetic stimulation, somatosensory evoked potentials, structural and functional magnetic resonance imaging. Huntington's Disease Cause and Risk Factor.

Having a parent with Huntington's is the risk factor. An offspring of an affected parent has a 50 percent chance of inheriting the disease.

Rheumatoid Arthritis (RA) is a chronic, autoimmune, inflammatory arthritis. In rheumatoid arthritis, the body’s immune system attacks the synovium, a layer of tissue that lines the joints, causing painful swelling and inflammation that can eventually result in bone erosion and joint most often affects the joints of the hands and feet, although the inflammation can also affect.

Vertebrate models (e.g., rodents, swine, nonhuman primates) have long played a central role in biomedical research because they share much in common with humans with respect to genetics, development, physiology, behavior and disease. A diagnosis of Huntington's disease may come as quite a shock.

There's a lot to take in. But tapping into a support system, such as a social worker, therapist, or support group, can make the.

An overview of the huntingtons disease
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