Manifestation of mental disorders in Huntington’s disease: a literature review

Kamilė Martinkutė1, Giedrė Mačiokaitė1, Edgaras Dlugauskas2

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Psychiatry, Vilnius, Lithuania

Abstract

Background. Huntington’s disease (HD) is a neurodegenerative disease that is characterized by motor, cognitive and psychiatric symptoms. Most studies focus on the motor and cognitive symptoms of HD and pay less attention to psychiatric symptoms, which have a significant impact on patients’ life.

Aim: to review the scientific literature and summarize information about manifestation of mental disorders in Huntington’s disease and their specifics.

Methods. The literature review was conducted using medical database PubMed. 32 scientific articles in English language were selected using keywords and their combinations.

Results. Psychiatric disorders are common in 33 – 76% of HD patients and tend to worsen with disease progression. Up to 80% of patients with HD, psychiatric symptoms appear before motor disorders. The most common mental disorders in HD are depression, apathy, obsessive compulsive disorder, sleep disturbances, irritability, psychosis, suicide, mania. The pathogenesis of these disorders and HD is similar – damage occurs in the basal nuclei of the brain, the prefrontal cortex, the hypothalamus, and the striatal system is affected by atrophy. Depending on which disorders occur, appropriate medicaments are selected for their treatment, psychotherapy also has a positive effect.

Conclusions. Mental disorders are one of the main components of HD and are of great importance not only for patients’ quality of life, but also for their relatives and caregivers. Since up to 80% of HD patients, psychiatric symptoms appear before motor disorders, this may help in early diagnosis of HD.

 

Keywords: Huntington’s disease, mental disorders, depression, obsessive compulsive disorder, apathy, suicide.