Abstract
Huntington's disease (HD) is monogenic neurodegenerative disorder caused by CAG expansions within the Huntingtin gene (Htt); it has a prevalence of 1 in 10,000 worldwide and is invariably fatal. Typically, healthy individuals have fewer than 35 CAG repeats, while the CAG expansions range from 36 to ~200 in HD patients. The hallmark of HD is neurodegeneration, especially in the striatal nuclei, basal ganglia and cerebral cortex, leading to neurological symptoms that involve motor, cognitive, and psychiatric events. However, HD is a complex disorder that may also affect peripheral organs, so it is possible that HD patients could be affected by comorbidities. Hence, we investigated the prevalence of comorbid conditions in HD patients (pre-symptomatic and symptomatic groups) and compared the frequency of those conditions to a control group. Our groups represent 65% of HD gene carriers registered in Poland. We identified 8 clusters of comorbid conditions in both HD groups, namely: musculoskeletal, allergies, cardiovascular, neurological, gastrointestinal, thyroid, psychiatric, and ophthalmologic. We found that HD patients have a significantly higher percentage of co-existing conditions in comparison to the control group. Among the 8 clusters of diseases, musculoskeletal, psychiatric, and cardiovascular events were significantly more frequent in both pre- and symptomatic HD patients, while neurological and gastrointestinal clusters showed significantly higher occurrence in the HD symptomatic group. A greater recognition of comorbidity in HD might help to better understand health outcomes and improve clinical management.
Highlights
Huntington’s disease (HD) is the most common hereditary neurodegenerative disorder and is caused by CAG trinucleotide repeat expansions within the Huntingtin gene (Htt) [1], whose products are constitutively expressed in many tissues and organs [2,3,4,5]
HD progression occurs with age and it is anticipated that symptomatic HD patients will be on average older than the pre-symptomatic patients
HD is described by a spectrum of various psychiatric features, as well behavioral abnormalities, including: depression, anxiety, irritability, apathy, obsessive-compulsive disorder (OCD) and psychosis [25]
Summary
Huntington’s disease (HD) is the most common hereditary neurodegenerative disorder and is caused by CAG trinucleotide repeat expansions within the Huntingtin gene (Htt) [1], whose products are constitutively expressed in many tissues and organs [2,3,4,5]. There is currently no treatment that targets the molecular cause of the disease, several approaches are in development that target the pathological mutant Huntingtin gene (HTT) [7]; these include novel gene therapy tools such as synthetic zinc finger proteins [8]. The neurodegeneration leads to a wide-range of clinical features including personality changes, motor impairment, subcortical dementia and weight loss. These symptoms progress over the course of the disease, typically resulting in death after 15–21 years [7]
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