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Nicoll DR, Pirogovsky E, Collazo AE, Tierney SM, Corey-Bloom J, Gilbert PE. The effect of interference on temporal order memory in premanifest and manifest Huntington's disease. J Huntingtons Dis 2014; 2:297-304. [PMID: 25062677 DOI: 10.3233/jhd-130064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Frontal-striatal dysfunction has been linked to cognitive impairment in Huntington's disease (HD). The frontal lobes play a role in memory for the temporal order in which items occur in a sequence. However, little is known about temporal order memory in HD or how it may be affected by interference. OBJECTIVE The study assessed temporal order memory in patients with manifest HD (n = 20), premanifest gene carriers for HD (Pre-HD; n = 18), and controls (n = 25) using a computerized radial 8-arm maze. METHODS On the sample phase of each trial, participants viewed a random sequence of circles appearing one at a time at the end of each arm. On the choice phase, participants viewed two sample phase circles and chose the circle occurring earliest in the sequence. Manipulations of the temporal lag (defined as the number of circles occurring in the sample phase sequence between the two choice phase circles) were conducted to systematically vary interference. Temporally proximal lags were hypothesized to generate more interference relative to temporally distal lags. RESULTS The Pre-HD group was significantly impaired (p < 0.05) compared to controls on proximal temporal lags (high interference) but matched controls on distal lags (low interference). HD patients improved as a function of increased lag but demonstrated significant impairments (p < 0.05) across lags relative to controls. CONCLUSIONS Temporal order memory is differentially affected by interference during the premanifest and manifest stages of HD. The study identifies a fundamental, yet relatively unexamined, deficit associated with HD.
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Affiliation(s)
- Diane R Nicoll
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Eva Pirogovsky
- Veterans Affairs, San Diego Health Care System, San Diego, CA, USA Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Adrienne E Collazo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Savanna M Tierney
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Jody Corey-Bloom
- Department of Neurosciences, University of California - San Diego, La Jolla, CA, USA
| | - Paul E Gilbert
- Department of Psychology, San Diego State University, San Diego, CA, USA San Diego State University/University of California - San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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Evidence for divergent effects of neurodegeneration in Huntington's disease on attentional selection and neural plasticity: implications for excitotoxicity. Brain Struct Funct 2014; 220:1437-47. [PMID: 24590622 DOI: 10.1007/s00429-014-0735-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/12/2014] [Indexed: 12/25/2022]
Abstract
It is generally assumed that neurodegeneration leads to declines in cognitive functions. However, there is evidence that neurodegenerative processes related to excitotoxicity can lead to paradoxical improvements in circumscribed cognitive functions, while at the same time other processes are compromised. An open question is how such paradoxical improvements reported in literature and declines usually associated with neurodegeneration relate to each other. Do paradoxical improvements only reflect a transient phenomenon, or do they intensify in the course of neurodegeneration? We examine this question using behavioral and neurophysiological (EEG) data in a human model of excitotoxic neurodegeneration (i.e., Huntington's disease, HD). The results show that attentional selection processes decline during pre-manifest disease progression. Importantly, the efficacy of protocols used to induce neural plasticity in processes underlying attentional selection processes also increases in course of ongoing neurodegeneration in pre-manifest HD. This was reflected in behavioral data and electrophysiological correlates of processes related to the allocation of attention. To conclude, our results suggest that circumscribed enhancements of specific cognitive functions are as much a result of the developmental process of neurodegeneration as the well-known detrimental effects. The results account for the divergent effects of neurodegenerative processes closely related to excitotoxicity on cognitive functions.
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Hart EP, Dumas EM, van Zwet EW, van der Hiele K, Jurgens CK, Middelkoop HAM, van Dijk JG, Roos RAC. Longitudinal pilot-study of Sustained Attention to Response Task and P300 in manifest and pre-manifest Huntington's disease. J Neuropsychol 2013; 9:10-20. [PMID: 24151858 DOI: 10.1111/jnp.12031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 08/21/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Earlier research has found cross-sectional attentional control deficits in manifest Huntington's disease (HD) using neuropsychological testing combined with simultaneous P300 registration. In the current pilot-study, we investigate attentional control in pre-manifest and manifest HD over a 3-year follow-up period. METHOD Five manifest HD (MHD), 9 pre-manifest HD (PMHD), and 12 control subjects were included. Sustained Attention to Response task (SART) and P300 registration resulted in number of errors, reaction time (RT), and P300 amplitude and latency. RT change patterns surrounding No-go trials were also investigated. Within-subject differences were tested using paired-samples t-tests and between-group results with ANCOVA on delta scores (follow-up--baseline scores). RESULTS Manifest HD made more errors and were slower than controls and PMHD. Longitudinally, MHD showed an overall RT increase and a specific slowing on trials preceding a correct No-go trial (within-group effects). The latter was also seen in PMHD. P300 latency prolongation was found for controls on No-go and for MHD on Go trials. On specific trials surrounding both correct and incorrect No-go trials, MHD became significantly slower over time than controls and PMHD (between-group effects). CONCLUSIONS Over 3-years, MHD subjects became slower on the SART and showed a prolongation of P300 latency on specific SART trials. Specific slowing of performance over time was also seen in PMHD, suggestive of compensatory mechanisms in this group.
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Affiliation(s)
- Ellen P Hart
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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Transcranial magnetic stimulation as a tool for understanding neurophysiology in Huntington's disease: A review. Neurosci Biobehav Rev 2013; 37:1420-33. [DOI: 10.1016/j.neubiorev.2013.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/07/2013] [Accepted: 05/21/2013] [Indexed: 12/24/2022]
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Tang C, Feigin A. Monitoring Huntington's disease progression through preclinical and early stages. Neurodegener Dis Manag 2012; 2:421-435. [PMID: 23243467 PMCID: PMC3519443 DOI: 10.2217/nmt.12.34] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Huntington's disease (HD) is an autosomal dominant progressive neurodegenerative disorder that typically begins in middle adulthood. The neurodegenerative process that underlies HD, however, likely begins many years before clinical diagnosis. Since genetic testing can identify individuals that will develop HD during this preclinical period, clinical trials aiming to slow disease progression will likely focus on this phase of the illness in an effort to delay disease onset. How to best measure the efficacy of potential disease-modifying therapies in preclinical HD remains a complex challenge. This article will review the clinical and imaging measures that have been assessed as potential markers of disease progression in preclinical and early symptomatic HD.
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Affiliation(s)
- Chris Tang
- Center for Neurosciences, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - Andrew Feigin
- Center for Neurosciences, The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
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Deficits in selective attention in symptomatic Huntington disease: assessment using an attentional blink paradigm. Cogn Behav Neurol 2012; 25:1-6. [PMID: 22310306 DOI: 10.1097/wnn.0b013e318248c503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Impaired selective attention in Huntington disease (HD) may manifest as difficulty in identifying a single target embedded among a series of distractors in rapid serial visual presentation tasks. METHOD We used an attentional blink (AB) paradigm to examine whether attentional control is impaired in symptomatic HD. Fourteen HD patients and 13 age-matched healthy controls performed a rapid serial visual presentation task in which 2 targets (T1 and T2) and numerous distractors were presented in rapid succession. We assessed the accuracy of T1 identification and the AB (impaired T2 detection after the correct identification of T1). RESULTS Among the HD patients, identification of T1 was significantly impaired and AB was significantly larger but not longer. The HD patients also made significantly more random errors. CONCLUSIONS Frontostriatal or frontoparietal dysfunction is likely to compromise attentional control in HD, such that well-masked and rapidly presented target stimuli are difficult to detect and identify, especially as the difficulty level increases. Although we previously reported no AB deficits in presymptomatic HD, with manifest disease we found that the progressive frontoparietal cortical changes compromise attentional control mechanisms.
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Abstract
Huntington's disease (HD) is a genetic neurodegenerative disorder affecting the basal ganglia. These subcortical structures are particularly important for motor functions, response selection and implicit learning. In the current study, we have assessed prodromal and symptomatic HD participants with an implicit contextual learning task that is not based on motor learning, but on a purely visual implicit learning mechanism. We used an implicit contextual learning task in which subjects need to locate a target among several distractors. In half of the trials, the positions of the distractors and target stimuli were repeated. By memorizing this contextual information, attention can be guided faster to the target stimulus. Nine symptomatic HD participants, 16 prodromal HD participants and 22 control subjects were included. We found that the responses of the control subjects were faster for the repeated trials than for the new trials, indicating that their visual search was facilitated when repeated contextual information was present. In contrast, no difference in response times between the repeated and new trials was found for the symptomatic and prodromal HD participants. The results of the current study indicate that both prodromal and symptomatic HD participants are impaired on an implicit contextual learning task.
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Salomonczyk D, Panzera R, Pirogovosky E, Goldstein J, Corey-Bloom J, Simmons R, Gilbert PE. Impaired postural stability as a marker of premanifest Huntington's disease. Mov Disord 2011; 25:2428-33. [PMID: 20818666 DOI: 10.1002/mds.23309] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Subtle changes in fine motor control have been observed in individuals who carry the Huntington's disease (HD) mutation but have not yet manifested symptoms, referred to as premanifest HD (preHD). However, few studies have examined gross motor impairments in this population. This study sought to examine the role of sensory involvement in maintaining postural stability during the premanifest and manifest stages of HD using computerized dynamic posturography. Eleven HD participants, 22 preHD subdivided into "preHD Near" (<5 years from estimated clinical onset) and "preHD Far" (>5 years from estimated clinical onset), and 17 nongene carriers (NGC) completed a sensory organization test (SOT) to assess postural control when vestibular, visual, and somatosensory information was systematically degraded. The HD group demonstrated greater postural sway than the NGC and preHD Far groups on all conditions including baseline, and greater postural sway than the preHD Near group when sensory information was manipulated. The preHD Near group showed significantly greater postural sway than the preHD Far group when visual and somatosensory information was degraded and only vestibular information was available and reliable for maintaining postural stability. The results of this study highlight subtle postural deficits in the face of changing sensory conditions in preHD up to 5 years before estimated disease onset. The findings suggest that the SOT may be a highly sensitive indicator of early motor impairment and subsequent phenoconversion to manifest HD in preHD.
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Affiliation(s)
- Danielle Salomonczyk
- Department of Psychology, San Diego State University, San Diego, California 92120, USA
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Electrophysiological measures as potential biomarkers in Huntington's disease: Review and future directions. ACTA ACUST UNITED AC 2010; 64:177-94. [DOI: 10.1016/j.brainresrev.2010.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 03/24/2010] [Accepted: 03/29/2010] [Indexed: 01/18/2023]
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Abstract
Huntington disease (HD) is a devastating illness, although its autosomal dominant genetic transmission allows a unique opportunity to study apparently healthy individuals before manifest disease. Attempts to study early disease are not unique in neurology (e.g., Mild Cognitive Impairment, Vascular Cognitive Impairment), but studying otherwise-healthy appearing individuals who will go on with nearly 99% certainty to manifest the symptoms of brain disease does provide distinct but valuable information about the true natural history of the disease. The field has witnessed an explosion of research examining possible early indicators of HD during what is now referred to as the "prodrome" of HD. A NIH study in its ninth year (PREDICT-HD) has offered a glimpse into the transition from an apparently healthy state to an obviously diseased state, and can serve as a model for many other genetic diseases, both neurological and non-neurological.
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Affiliation(s)
- Jane S Paulsen
- University of Iowa, The Roy J. and Lucille A. Carver College of Medicine, Departments of Psychiatry, Neurology, Neurosciences, and Psychology, Iowa City, IA
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van Walsem MR, Sundet K, Retterstøl L, Sundseth Ø. A double blind evaluation of cognitive decline in a Norwegian cohort of asymptomatic carriers of Huntington's disease. J Clin Exp Neuropsychol 2009; 32:590-8. [PMID: 19916101 DOI: 10.1080/13803390903337878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Previous studies investigating subclinical signs of cognitive decline in presymptomatic carriers of Huntington's disease (HD) have shown conflicting results. The current study examines cognition in 105 at-risk individuals, using a broad neuropsychological test battery and adopting strict inclusion criteria for attaining a homogeneous sample. Results obtained by analyses of variance and effect size calculations indicate no clinical evidence of significant cognitive decline in asymptomatic HD carriers very far from onset of illness compared to noncarriers. Closeness to disease onset amongst gene carriers influenced cognition negatively whereas cytosine-adenine-guanine (CAG) repeat size did not. The findings call for longitudinal follow-up studies using a combination of clinical instruments and experimental paradigms to pinpoint when subtle cognitive deficits occur and within which of the cognitive domains.
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Affiliation(s)
- Marleen R van Walsem
- Oslo University Hospital, Rikshospitalet, Centre for Rare Disorders, Oslo, Norway
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Abstract
The current study examined temporal order memory in preclinical Huntington's disease (pre-HD). Participants were separated into less than 5 years (pre-HD near) and more than 5 years (pre-HD far) from estimated age of clinical diagnosis. Participants completed a temporal order memory task on a computerized radial eight-arm maze. On the study phase of each trial, participants viewed a random sequence of circles appearing one at a time at the end of each arm. On the choice phase, participants viewed two circles at the end of the study phase arms and chose the circle occurring earliest in the sequence. The task involved manipulations of the temporal lag, defined as the number of arms occurring in the sample phase sequence between the two choice phase arms. Research suggests that there is more interference for temporally proximal stimuli relative to temporally distal stimuli. There were no significant differences between the pre-HD far group and controls on the temporal order memory task. The pre-HD near group demonstrated significant impairments relative to the other groups on closer temporal lags, but were normal on the furthest temporal lag. Therefore, temporal order memory declines with increased temporal interference in pre-HD close to estimated diagnosis of HD.
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A failure to stop and attention fluctuations: an evoked oscillations study of the stop-signal paradigm. Clin Neurophysiol 2008; 119:556-567. [PMID: 18164656 DOI: 10.1016/j.clinph.2007.11.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 10/31/2007] [Accepted: 11/14/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE It is not always clear whether inhibition or attention deficit underlies a failure to stop a prepared motor response. One possible way to approach this question is to resort to measures of evoked oscillations since functional correlates of different frequency oscillations are relatively well understood. METHODS The present study examined event-related oscillations during a stop-signal task in non-clinical adults. In 25% of trials of an auditory discrimination tasks subjects had to refrain from a prepared motor response. RESULTS In successful stop trials, the Go N2 peaked later and the Stop N2 peaked earlier than in failed stop trials. Relative to successful, failed stop trials were associated with a larger N1-N2 and Go P3, and a smaller Stop P3 in the central and posterior cortical regions. The latter effect was exclusively determined by evoked delta oscillations, whereas all other frequency bands contributed to enhanced responses in failed comparative to successful stop trials. CONCLUSIONS The sum of presented evidence seems to show that success or failure to stop mostly depends on how the subject prepares for the Go and Stop stimuli in advance. If attention is more directed towards the Stop signal, the stopping succeeds, otherwise it fails. SIGNIFICANCE These data may contribute to understanding the cognitive basis of successful and unsuccessful stopping performance.
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Brandt J, Inscore AB, Ward J, Shpritz B, Rosenblatt A, Margolis RL, Ross CA. Neuropsychological deficits in Huntington's disease gene carriers and correlates of early "conversion". J Neuropsychiatry Clin Neurosci 2008; 20:466-72. [PMID: 19196932 PMCID: PMC2966303 DOI: 10.1176/jnp.2008.20.4.466] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors examined whether the baseline cognitive functioning of 21 clinically normal huntingtin mutation carriers who developed manifest Huntington's disease on follow-up differed from that of 49 mutation carriers who remain asymptomatic over the same period in a longitudinal study. One hundred thirty-four gene-negative offspring of Huntington's disease patients were studied as well. Overall, there were no differences in cognitive test performance among the three groups. However, "converters" who developed signs of Huntington's disease within 8.6 years demonstrated poorer performance on the Wisconsin Card Sorting Test at baseline. People with the Huntington's disease mutation who are carefully examined neurologically and found to be asymptomatic have, at most, very minimal problem-solving impairment, and only if they are within a few years of clinical onset.
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Affiliation(s)
- Jason Brandt
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Abstract
Woody Guthrie was an American songwriter, musician, writer, and political activist who died with Huntington disease (HD) in 1967 at age 55. His relatively brief creative life was incredibly productive with countless songs and a tremendous volume of letters to his name. His personal life was similarly driven with Woody having had 3 wives and at least 9 children and an insatiable appetite for traveling the United States. In this essay, I explore Guthrie's art in relation to the development of the overt behavioral changes and chorea that characterized his illness. Woody's most productive time artistically was in the 5 years immediately preceding the onset of overt symptoms of HD. I hypothesize that subclinical HD may have been an important driving force behind Woody Guthrie's creativity.
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Verny C, Allain P, Prudean A, Malinge MC, Gohier B, Scherer C, Bonneau D, Dubas F, Le Gall D. Cognitive changes in asymptomatic carriers of the Huntington disease mutation gene. Eur J Neurol 2007; 14:1344-50. [PMID: 17941857 DOI: 10.1111/j.1468-1331.2007.01975.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Huntington disease (HD) is a neurodegenerative disorder due to an excessive number of CAG repeats in the IT15 gene on chromosome 4. Studies of cognitive function in asymptomatic gene carriers have yielded contradictory results. This study compared cognitive performance in 44 subjects with the HD mutation (group of carriers) who had no clinical signs of HD and 39 at-risk individuals without HD mutation (group of non-carriers). Neuropsychological evaluation focused on global cognitive efficiency, psychomotor speed, attentional, executive and memory functions. Significant differences, with lower performances in the group of gene carriers, were detected for some measures of psychomotor speed, attention and executive functioning (all P < 0.01). More differences between groups were observed for memory measures, in particular on the California Verbal Memory Test. Complementing these observations, cognitive scores were correlated with age in the group of gene carriers, but not in the group of non-carriers. This suggests that the cognitive changes precede the appearance of the motor and psychiatric symptoms in HD and that tests proved to be sensitive to early HD deficiencies are better suited than global cognitive efficiency scales to observe them.
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Affiliation(s)
- C Verny
- Centre National de Référence pour les Maladies Neurogénétiques et Mitochondriales de l'Adulte, Centre Hospitalier Universitaire, Angers, France.
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