Cognitive Impairment in Huntington Disease: Diagnosis and Treatment

  • Jane S. PaulsenEmail author


Cognition has been well characterized in the various stages of Huntington disease (HD) as well as in the prodrome before the motor diagnosis is given. Although the clinical diagnosis of HD relies on the manifestation of motor abnormalities, the associated impairments have been growing in prominence for several reasons. First, research to understand the most debilitating aspects of HD has suggested that cognitive and behavioral changes place the greatest burden on families, are most highly associated with functional decline, and can be predictive of institutionalization. Second, cognitive impairments are evident at least 15 years prior to the time at which motor diagnosis is given. Finally, cognitive decline is associated with biological markers such as brain atrophy, circulating levels of brain-derived neurotrophic factors, and insulin-like growth factor 1. Efforts are now underway to develop valid and reliable measures of cognition in the prodrome as well as in all stages of HD so that clinical trials can be conducted using cognitive outcomes.


Mild cognitive impairment Dementia Cognitive impairment Diagnosis Huntington disease Prodrome of HD 



J.S. Paulsen and the PREDICT–HD study are supported by the National Institutes for Health, National Institute of Neurological Disorders and Stroke (R01 NS040068-11), CHDI Foundation, Inc., and the National Institute of Neurological Disorders & Stroke, (R01 NS054893) Cognitive and Functional Brain Changes in Preclinical HD.


Conflicts of interest: J.S. Paulsen: has received a consulting fee or honoraria from Schlesinger Associates; and has received support for travel to meetings for a study from the National Institutes of Health, the CHDI Foundation, the Huntington’s Disease Society of America, and the Huntington’s Study Group.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Departments of Psychiatry, Neurology, Neurosciences, and Psychology The University of Iowa Roy J. and Lucille A. Carver College of MedicineIowa CityUSA

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