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Unawareness of motor phenoconversion in Huntington disease
Journal article   Open access   Peer reviewed

Unawareness of motor phenoconversion in Huntington disease

Elizabeth A. McCusker, David G. Gunn, Eric A. Epping, Clement T. Loy, Kylie Radford, Jane Griffith, James A. Mills, Jeffrey D. Long, Jane S. Paulsen and PREDICT-HD Investigators
Neurology, Vol.81(13), pp.1141-1147
09/24/2013
DOI: 10.1212/WNL.0b013e3182a55f05
PMCID: PMC3795599
PMID: 23966256
url
https://europepmc.org/articles/pmc3795599View
Published (Version of record) Open Access

Abstract

Objective: To determine whether Huntington disease (HD) mutation carriers have motor symptoms (complaints) when definite motor onset (motor phenoconversion) is diagnosed and document differences between the groups with and without unawareness of motor signs. Methods: We analyzed data from 550 HD mutation carriers participating in the multicenter PREDICT-HD Study followed through the HD prodrome. Data analysis included demographics, the Unified Huntington's Disease Rating Scale (UHDRS) and the Participant HD History of symptoms, self-report of progression, and cognitive, behavioral, and imaging measures. Unawareness was identified when no motor symptoms were self-reported but when definite motor HD was diagnosed. Results: Of 38 (6.91%) with onset of motor HD, almost half (18/38 = 47.36%) had no motor symptoms despite signs of disease on the UHDRS motor rating and consistent with unawareness. A group with motor symptoms and signs was similar on a range of measures to the unaware group. Those with unawareness of HD signs reported less depression. Patients with symptoms had more striatal atrophy on imaging measures. Conclusions: Only half of the patients with newly diagnosed motor HD had motor symptoms. Unaware patients were less likely to be depressed. Self-report of symptoms may be inaccurate in HD at the earliest stage.
Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Science & Technology

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