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The Role of Hypothalamic Pathology for Non-Motor Features of Huntington's Disease

Cheong, Rachel Y. LU ; Gabery, Sanaz LU and Petersén, Åsa LU (2019) In Journal of Huntington's disease 8(4). p.375-391
Abstract

Huntington's disease (HD) is a fatal genetic neurodegenerative disorder. It has mainly been considered a movement disorder with cognitive symptoms and these features have been associated with pathology of the striatum and cerebral cortex. Importantly, individuals with the mutant huntingtin gene suffer from a spectrum of non-motor features often decades before the motor disorder manifests. These symptoms and signs include a range of psychiatric symptoms, sleep problems and metabolic changes with weight loss particularly in later stages. A higher body mass index at diagnosis is associated with slower disease progression. The common psychiatric symptom of apathy progresses with the disease. The fact that non-motor features are present... (More)

Huntington's disease (HD) is a fatal genetic neurodegenerative disorder. It has mainly been considered a movement disorder with cognitive symptoms and these features have been associated with pathology of the striatum and cerebral cortex. Importantly, individuals with the mutant huntingtin gene suffer from a spectrum of non-motor features often decades before the motor disorder manifests. These symptoms and signs include a range of psychiatric symptoms, sleep problems and metabolic changes with weight loss particularly in later stages. A higher body mass index at diagnosis is associated with slower disease progression. The common psychiatric symptom of apathy progresses with the disease. The fact that non-motor features are present early in the disease and that they show an association to disease progression suggest that unravelling the underlying neurobiological mechanisms may uncover novel targets for early disease intervention and better symptomatic treatment. The hypothalamus and the limbic system are important brain regions that regulate emotion, social cognition, sleep and metabolism. A number of studies using neuroimaging, postmortem human tissue and genetic manipulation in animal models of the disease has collectively shown that the hypothalamus and the limbic system are affected in HD. These findings include the loss of neuropeptide-expressing neurons such as orexin (hypocretin), oxytocin, vasopressin, somatostatin and VIP, and increased levels of SIRT1 in distinct nuclei of the hypothalamus. This review provides a summary of the results obtained so far and highlights the potential importance of these changes for the understanding of non-motor features in HD.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Huntington's disease, hypocretin, hypothalamus, orexin, oxytocin, vasopressin
in
Journal of Huntington's disease
volume
8
issue
4
pages
17 pages
publisher
IOS Press
external identifiers
  • pmid:31594240
  • scopus:85074245630
ISSN
1879-6397
DOI
10.3233/JHD-190372
language
English
LU publication?
yes
id
328f5d2c-72ff-4235-89c5-ef5f40eea22f
date added to LUP
2019-11-19 16:32:18
date last changed
2024-03-04 08:08:25
@article{328f5d2c-72ff-4235-89c5-ef5f40eea22f,
  abstract     = {{<p>Huntington's disease (HD) is a fatal genetic neurodegenerative disorder. It has mainly been considered a movement disorder with cognitive symptoms and these features have been associated with pathology of the striatum and cerebral cortex. Importantly, individuals with the mutant huntingtin gene suffer from a spectrum of non-motor features often decades before the motor disorder manifests. These symptoms and signs include a range of psychiatric symptoms, sleep problems and metabolic changes with weight loss particularly in later stages. A higher body mass index at diagnosis is associated with slower disease progression. The common psychiatric symptom of apathy progresses with the disease. The fact that non-motor features are present early in the disease and that they show an association to disease progression suggest that unravelling the underlying neurobiological mechanisms may uncover novel targets for early disease intervention and better symptomatic treatment. The hypothalamus and the limbic system are important brain regions that regulate emotion, social cognition, sleep and metabolism. A number of studies using neuroimaging, postmortem human tissue and genetic manipulation in animal models of the disease has collectively shown that the hypothalamus and the limbic system are affected in HD. These findings include the loss of neuropeptide-expressing neurons such as orexin (hypocretin), oxytocin, vasopressin, somatostatin and VIP, and increased levels of SIRT1 in distinct nuclei of the hypothalamus. This review provides a summary of the results obtained so far and highlights the potential importance of these changes for the understanding of non-motor features in HD.</p>}},
  author       = {{Cheong, Rachel Y. and Gabery, Sanaz and Petersén, Åsa}},
  issn         = {{1879-6397}},
  keywords     = {{Huntington's disease; hypocretin; hypothalamus; orexin; oxytocin; vasopressin}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  pages        = {{375--391}},
  publisher    = {{IOS Press}},
  series       = {{Journal of Huntington's disease}},
  title        = {{The Role of Hypothalamic Pathology for Non-Motor Features of Huntington's Disease}},
  url          = {{http://dx.doi.org/10.3233/JHD-190372}},
  doi          = {{10.3233/JHD-190372}},
  volume       = {{8}},
  year         = {{2019}},
}