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Oosterloo M, Touze A, Byrne LM, Achenbach J, Aksoy H, Coleman A, Lammert D, Nance M, Nopoulos P, Reilmann R, Saft C, Santini H, Squitieri F, Tabrizi S, Burgunder JM, Quarrell O. Clinical Review of Juvenile Huntington's Disease. J Huntingtons Dis 2024; 13:149-161. [PMID: 38669553 PMCID: PMC11307030 DOI: 10.3233/jhd-231523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/28/2024]
Abstract
Juvenile Huntington's disease (JHD) is rare. In the first decade of life speech difficulties, rigidity, and dystonia are common clinical motor symptoms, whereas onset in the second decade motor symptoms may sometimes resemble adult-onset Huntington's disease (AOHD). Cognitive decline is mostly detected by declining school performances. Behavioral symptoms in general do not differ from AOHD but may be confused with autism spectrum disorder or attention deficit hyperactivity disorder and lead to misdiagnosis and/or diagnostic delay. JHD specific features are epilepsy, ataxia, spasticity, pain, itching, and possibly liver steatosis. Disease progression of JHD is faster compared to AOHD and the disease duration is shorter, particularly in case of higher CAG repeat lengths. The diagnosis is based on clinical judgement in combination with a positive family history and/or DNA analysis after careful consideration. Repeat length in JHD is usually > 55 and caused by anticipation, usually via paternal transmission. There are no pharmacological and multidisciplinary guidelines for JHD treatment. Future perspectives for earlier diagnosis are better diagnostic markers such as qualitative MRI and neurofilament light in serum.
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Affiliation(s)
- Mayke Oosterloo
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alexiane Touze
- Department of Neurodegenerative Disease, UCL Huntington’s Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Lauren M. Byrne
- Department of Neurodegenerative Disease, UCL Huntington’s Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jannis Achenbach
- Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
| | - Hande Aksoy
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annabelle Coleman
- Department of Neurodegenerative Disease, UCL Huntington’s Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Dawn Lammert
- Department of Neurology, Division of Child Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Martha Nance
- Struthers Parkinson’s Center, Minneapolis, MN, USA
| | - Peggy Nopoulos
- Departments of Psychiatry, Pediatrics, & Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Ralf Reilmann
- George-Huntington-Institute & Department of Radiology, University of Muenster, Muenster, Germany
- Department for Neurodegeneration, Hertie Institute for Clinical, Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Carsten Saft
- Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
| | | | - Ferdinando Squitieri
- Centre for Rare Neurological Diseases (CMRN), Italian League for Research on Huntington (LIRH) Foundation, Rome, Italy
- Huntington and Rare Diseases Unit, IRCCS Casa Sollievo Della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | - Sarah Tabrizi
- Department of Neurodegenerative Disease, UCL Huntington’s Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jean-Marc Burgunder
- Neurozentrum Siloah and Department of Neurology, Swiss HD Center, University of Bern, Bern, Switzerland
| | - Oliver Quarrell
- Department of Clinical Genetics, Sheffield Children’s Hospital, Sheffield, UK
- Department of Neurosciences University of Sheffield, Sheffield, UK
| | - on behalf of the Pediatric Huntington Disease Working Group of the European Huntington Disease Network
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurodegenerative Disease, UCL Huntington’s Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurology, Huntington Centre NRW, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Division of Child Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Struthers Parkinson’s Center, Minneapolis, MN, USA
- Departments of Psychiatry, Pediatrics, & Neurology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- George-Huntington-Institute & Department of Radiology, University of Muenster, Muenster, Germany
- Department for Neurodegeneration, Hertie Institute for Clinical, Brain Research, University of Tuebingen, Tuebingen, Germany
- Huntington’s Disease Association, England and Wales
- Centre for Rare Neurological Diseases (CMRN), Italian League for Research on Huntington (LIRH) Foundation, Rome, Italy
- Huntington and Rare Diseases Unit, IRCCS Casa Sollievo Della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
- Neurozentrum Siloah and Department of Neurology, Swiss HD Center, University of Bern, Bern, Switzerland
- Department of Clinical Genetics, Sheffield Children’s Hospital, Sheffield, UK
- Department of Neurosciences University of Sheffield, Sheffield, UK
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Innes EA, Qiu J, Morales‐Briceño H, Farrar MA, Mohammad SS. Oculomotor Apraxia as an Early Presenting Sign of Juvenile-Onset Huntington's Disease. Mov Disord Clin Pract 2023; 10:S12-S14. [PMID: 37636223 PMCID: PMC10448626 DOI: 10.1002/mdc3.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/02/2023] [Accepted: 04/17/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Emily Amy Innes
- Neurology DepartmentSydney Children’ Hospital at RandwickSydneyNew South WalesAustralia
- Sydney Medical SchoolThe University of Notre DameSydneyNew South WalesAustralia
| | - Jessica Qiu
- Sydney Medical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Movement Disorders Unit, Neurology DepartmentWestmead HospitalSydneyNew South WalesAustralia
| | - Hugo Morales‐Briceño
- Movement Disorders Unit, Neurology DepartmentWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Paediatrics, School of Women's and Children's HealthUNSW Medicine, The University of New South WalesSydneyNew South WalesAustralia
| | - Michelle A. Farrar
- Neurology DepartmentSydney Children’ Hospital at RandwickSydneyNew South WalesAustralia
- Discipline of Paediatrics, School of Women's and Children's HealthUNSW Medicine, The University of New South WalesSydneyNew South WalesAustralia
| | - Shekeeb S. Mohammad
- Sydney Medical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- TY Nelson Department of Neurology and NeurosurgeryThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Comparison of Saccadic Eye Movements Among the High-tension Glaucoma, Primary Angle-closure Glaucoma, and Normal-tension Glaucoma. J Glaucoma 2021; 30:e76-e82. [PMID: 33394842 DOI: 10.1097/ijg.0000000000001757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022]
Abstract
PRCIS Saccadic eye movements were compared between high-tension glaucoma (HTG), normal-tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). Saccades were differently affected between the subtypes of primary glaucoma. AIM The aim of the study was to compare saccadic eye movements in eyes with HTG, PACG, and NTG. METHODS Saccadic eye movements were recorded using the eye tracker Eyelink-1000 in 52 participants: 15 HTG, 14 PACG, 8 NTG, and 15 normal controls. All participants underwent a complete ophthalmic and visual field examination. Prosaccades were measured using the gap paradigm. Prosaccades were measured at 3 target eccentricities (5-, 7-, and 10-degree eccentricity). All prosaccade targets were projected outside the area of visual field defect. Saccade latency, average and peak velocity, and amplitude difference of the saccades were compared between glaucoma subtypes. RESULTS The mean±SD age was lesser in controls compared with glaucoma (P=0.02). The mean age in all the glaucoma subtypes was comparable (P=0.92). The average mean deviation in PACG (-16.66±6.69 dB) was worse (P=0.01) than in HTG (-11.56±6.08 dB) and NTG (-9.55±3.96 dB). The latencies were delayed, average and peak velocities were reduced, and saccades were hypometric in glaucoma compared with controls (P<0.01). Between subtypes, the differences in latency (P<0.01), peak velocity (P=0.02), and amplitude (P=0.02) were significant. Saccadic eye movements were significantly different in NTG compared with other glaucoma subtypes (post hoc analysis; latency (HTG vs. NTG; P<0.01, HTG vs. PACG; P=0.01), peak velocity (HTG vs. NTG; P=0.02) and amplitude difference (HTG vs. NTG; P=0.02). CONCLUSIONS Saccadic eye movement parameters were differently affected among the glaucoma subtypes. Saccadic parameters were more affected in NTG.
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