Brain structure in juvenile-onset Huntington disease.

Brain structure in juvenile-onset Huntington disease.

Publication date: Apr 10, 2019

To assess brain morphometry in a sample of patients with juvenile-onset Huntington disease (JOHD) and several mouse models of Huntington disease (HD) that likely represent the human JOHD phenotype.

Despite sharing the mutation in the Huntingtin gene, adult-onset HD characteristically presents as a hyperkinetic motor disorder, while JOHD typically presents as a hypokinetic motor disease. The University of Iowa Kids-JHD program enrolls individuals 5 to 25 years of age who have already received the clinical diagnosis. A total of 19 children with juvenile HD (JHD) (mean CAG = 72) were studied. Patients with JHD were compared to healthy controls (n = 234) using a cross-sectional study design. Volumetric data from structural MRI was compared between groups. In addition, we used the same procedure to evaluate brain morphology of R6/2, zQ175, HdhQ250 HD mice models.

Participants with JHD had substantially reduced intracranial volumes. After controlling for the small intracranial volume size, the volumes of subcortical regions (caudate, putamen, globus pallidus, and thalamus) and of cortical white matter were significantly decreased in patients with JHD. However, the cerebellum was proportionately enlarged in the JHD sample. The cerebral cortex was largely unaffected. Likewise, HD mice had a lower volume of striatum and a higher volume of cerebellum, mirroring the human MRI results.

The primary pathology of JOHD extends beyond changes in the striatal volume. Brain morphology in both mice and human patients with JHD shows proportional cerebellar enlargement. This pattern of brain changes may explain the unique picture of hypokinetic motor symptoms in JHD, which is not seen in the hyperkinetic chorea-like phenotype of adult-onset HD.

Tereshchenko, A., , Magnotta, Epping, E., Mathews, K., Espe-Pfeifer, P., Martin, E., Dawson, J., Duan, W., and Nopoulos, P. Brain structure in juvenile-onset Huntington disease. 06442. 2019 Neurology.

Concepts Keywords
Brain MRI
Caudate Putamen Hypokinesia
Cerebellar Huntingtin
Cerebellum Brain size
Cerebral Cortex Brain
Chorea Cerebellum
Cortical Huntington’s disease
Cross Trinucleotide repeat disorders
Gene RTT
Globus Pallidus Autosomal dominant disorders
Huntingtin Medicine
Huntington Branches of biology
Iowa Anatomy
Morphology
MRI
Mutation
Neurology
Pathology
Phenotype
Striatal
Striatum
Thalamus
White Matter

Semantics

Type Source Name
disease DOID chorea
disease MESH chorea
gene UNIPROT CYREN
disease MESH diagnosis
pathway BSID Disease
disease DOID JOHD
disease MESH juvenile-onset Huntington disease

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