Skip to main content
Log in

The epidemiology of Huntington's disease

  • Review Article
  • Published:
Human Genetics Aims and scope Submit manuscript

Summary

The available information on the world distribution of Huntington's disease (HD) from population surveys and death rate analysis is summarised and discussed in the light of genetic studies. It is concluded that most European populations, both Northern and Southern, show a relatively high prevalence (4–8 per 100,000), and that the disorder may also be frequent in India and parts of central Asia. HD is notably rare in Finland and in Japan, but data for Eastern Asia and Africa are inadequate. The disorder may have been underestimated in the American black population. Populations derived from recent European imigration show frequencies and origins of HD comparable to those expected from their own origins and expansion; there is no evidence to suggest that the HD gene has spread disproportionally and its selective effect may be close to neutral. Multiple separate introductions of the gene have been the rule in large populations. Several major foci of HD exist as the result of rapid population expansion. It is likely that a number of separate mutations for HD will be shown to be responsible for the disease, but that the high frequency of HD in European populations will prove to be the result of one or a very small number of mutations, probably of great antiquity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Arena R, Nuti M, Ludice A (1979) Rilievi epidemiologici della corea di Huntington nella Toscanna nord-occidentale. Atti 5 Riun Limpe 123–133

  • Arostegui G (1890) De la corea cronica progressiva. Cronica Medica Chirurgica Habana 16:74

    Google Scholar 

  • Bayulkem F, Turek I (1961) Huntington's chorea in Turkey. Psychiatr Q 35:358–360

    Google Scholar 

  • Bell J (1934) Huntington's chorea. In: Fisher RA (ed) Treasury of human inheritance, vol 4: Brothers CRD (1949) The history and incidence of Huntington's chorea in Tasmania. Proceedings of the Royal Australian College of Physicians. Cambridge, Cambridge University Press, pp 48–50

    Google Scholar 

  • Bickford JAR, Ellison RM (1953) High incidence of Huntington's chorea in the Duchy of Cornwall. J Ment Sci 99:291–294

    Google Scholar 

  • Bolt JMW (1970) Huntington's chorea in the west of Scotland. Br J Psychiatry 116:259–270

    Google Scholar 

  • Bruyn GW (1968) Huntington's chorea: historical, clinical and laboratory synopsis. In: Vinken PJ, Bruyn GW (eds) Handbook of neurology. North-Holland, vol 49. Amsterdam, pp 298–378

    Google Scholar 

  • Cameron D, Venters GA (1967) Some problems in Huntington's chorea. Scott Med J 12:152–156

    Google Scholar 

  • Caro AJ (1977) Huntington's chorea; a clinical problem in East Anglia. PhD thesis, University of East Anglia

  • Cassar P (1967) Huntington's chorea with special reference to its incidence in Malta. St Luke's Hosp Gazette, June 3–13

  • Cendrowski W (1964) Some remarks on the geography of Huntington's chorea. Neurology (Minneapolis) 14:839–843

    Google Scholar 

  • Chhutani PN (1957) Huntington's chorea in India. J Indian Med Assoc 29:156–157

    Google Scholar 

  • Clarke A (1990) Genetic imprinting in clinical genetics. In: Monk M. Surani A (eds) Genomic imprinting (Supplement to Development). Cambridge, pp 131–139

  • Conneally PM (1984) Huntington's disease: genetics and epidemiology. Am J Hum Genet 36:506–526

    Google Scholar 

  • Conneally PM, Haines J, Tanzi R, et al (1989) No evidence of linkage heterogeneity between Huntington disease (HD) and G8 (D4S10). Genomics 5:304–308

    Google Scholar 

  • Couto M (1891) Da corea de Huntington. Brasil-Medica 5:341–344

    Google Scholar 

  • Davenport CB, Muncey EB (1916) Huntington's chorea in relation to heredity and eugenics. Eugenics Record Office Bull 17:195–222

    Google Scholar 

  • Falstein EI, Stone H (1939) Huntington's chorea as a psychiatric and social problem in Illinois. Illinois Med J 75:164–165

    Google Scholar 

  • Folstein SE, Chase GA, Wahl WE, McDonnell AM, Folstein MF (1987) Huntington's disease in Maryland: clinical aspects of racial variation. Am J Hum Genet 41:168–179

    Google Scholar 

  • Frontali M, Malaspina P, Rossi C, et al (1990) Epidemiological and linkage studies on Huntington's disease in Italy. Hum Genet 85:167–170

    Google Scholar 

  • Gale F, Bennett JH (1969) Huntington's chorea in a South Australian community of aboriginal descent. Med J Aust 2:482–484

    Google Scholar 

  • Glendinning N (1975) A study in Huntington's chorea. MD thesis, University of London

  • Groppi C, Barontini F, Braco L, Sita D, Inzitari D, Amadulli L, Fratiglioni L (1986) Huntington's chorea: a prevalence study in the Florence area. Acta Psychiatr Scand 74:266–268

    Google Scholar 

  • Gudmundsson KR (1969) Prevalence and occurrence of some rare neurological diseases in Iceland. Acta Neurol Scand 45:114–118

    Google Scholar 

  • Gusella JF, Wexler NS, Conneally PN (1983) A polymorphic DNA marker genetically linked to Huntington's disease. Nature 306:234–238

    CAS  PubMed  Google Scholar 

  • Haddock RDW (1973) Neurological disorders in Ghana. In: Spillane JD (ed) Tropical neurology. Oxford University Press, Oxford, pp 143–190

    Google Scholar 

  • Harley HG, Brook JD, Rundle SA, Crow S, Reardon W, Buckler AJ, Harper PS, Housman DE (1992) Expansion of an unstable DNA region and phenotypic variation in myotonic dystrophy. Lancet 339:1125–1127

    Google Scholar 

  • Harper PS (1976) Genetic variation in Wales. J R Coll Physicians Lond 10:321–332

    Google Scholar 

  • Harper PS (1991) Genetic aspects of Huntington's disease. In: Harper PS (ed) Huntington's disease. Saunders, London, pp 281–315

    Google Scholar 

  • Harper PS, Walker DA, Tyler A, Newcombe RG, Davies K (1979) Huntington's chorea. The basis for long-term prevention. Lancet II:346–349

    Google Scholar 

  • Harper PS, Harley HG, Reardon W, Shaw DJ (1992) Anticipation in myotonic dystrophy: new light on an old problem. Am J Hum Genet (in press)

  • Harries JR (1973) Neurological disorders in Kenya. In: Spillane JD (ed) Tropical neurology. Oxford University Press, Oxford, pp 207–212

    Google Scholar 

  • Hayden MR (1979) Huntington's chorea in South Africa. PhD thesis, University of Cape Town

  • Hayden MR (1981) Huntington's chorea. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Hayden MR, Hayden MR, Hopkins HC, Macrae M, Beighton PH (1980a) The origin of Huntington's chorea in the Afrikaner population of South Africa. S Afr Med J 58:197–203

    Google Scholar 

  • Hayden MR, MacGregor JM, Beighton PH (1980b) The prevalence of Huntington's chorea in South Africa. S Afr Med J 58:193–196

    Google Scholar 

  • Heathfield KWG (1967) Huntington's chorea: investigation into the prevalence of disease in the area covered by the North East Metropolitan Board. Brain 90:203–232

    Google Scholar 

  • Heathfield KWG, MacKenzie ICK (1971) Huntington's chorea in Bedfordshire. Guy's Hosp Rep 120:295–230

    Google Scholar 

  • Hetherington HB, Wechsler Z (1942) Huntington's chorea in a naive Melanesian family of the British Solomon Islands. Med J Aust 1:599–600

    Google Scholar 

  • Hogg JE, Massey EW, Schoenberg BS (1979) Mortality from Huntington's disease in the United States. Adv Neurol 23:27–33

    Google Scholar 

  • Huntington G (1872) On chorea. Med Surg Rep 26:320–321

    Google Scholar 

  • Husquinet H (1970) La choree de Huntington dans les 4 provinces Belges. In: Warot P (ed) CR 67E Congr Psychiat Neurol Langue Franc. Masson, Paris, pp 1079–1118

    Google Scholar 

  • Hutton PW (1956) Neurological disease in Uganda. East Afr Med J 133:209–223

    Google Scholar 

  • Ikonen E, Palo J, Ott J (1990) Huntington's disease in Finland: linkage disequilibrium of chromosomes 4RFLP haplotype and exclusion of a tight linkage between the disease and D4S43 locus. Am J Hum Genet 46:5–11

    Google Scholar 

  • Joubert J, Botha MC (1988) Huntington's disease in South African blacks: a report of 8 cases. S Afr Med J 73:489–494

    Google Scholar 

  • Kanazawa I (1983) Prevalence rate of Huntington's disease in Ibaraki prefecture. Annual report of research committee of CNS degenerative diseases, Ministry of Health and Welfare of Japan, pp 151–156

  • Kishimoto K, Nakamura M, Sotrokawa Y (1957) Population genetics study — Huntington's chorea in Japan. Annual report. Res Inst Environ Med 9:195–211

    Google Scholar 

  • Kozlova SI, Dadali EL, Prytkov AN, Bolshakova LP, Sibiryakova LG, et al (1986) Population, demographic and clinical-genetic studies of the Huntington disease in an Azerbaijan local region. Genetica 22:2534–2539

    Google Scholar 

  • Kurland LT (1958) Descriptive epidemiology of selected neurologic and myopathic disorders with particular reference to a survey in Rochester, Minnesota. J Chronic Disord 8:378–418

    Google Scholar 

  • Kurtzke JF (1979) Huntington's disease: mortality and morbidity data from outside the United States. Adv Neurol 23:13–25

    Google Scholar 

  • Lanska DJ, Levine L, Lanska MJ, Schoenberg BS (1988) Huntington's disease mortality in the United States. Neurology 38:769–772

    Google Scholar 

  • Leger JM, Ronauil R, Vallat JN (1974) Huntington's chorea in Limousin: statistical and clinical study. Rev Med Limoges 5:147–153

    Google Scholar 

  • Lyon RL (1962) Huntington's chorea in the Moray firth area. Br Med J I:1301–1306

    Google Scholar 

  • MacMillan JC, Harper PS (1991) Single gene neurological disorders in South Walkes; an apidemiological study. Ann Neurol 30:411–414

    Google Scholar 

  • Mainini P, Lucci B, Guidetti D, Casoli C (1982) Prevalenzi della mallattis di Huntington nelle Provincie di Reggio Emilia e Parma

  • Marx RN (1973) Huntington's chorea in Minnesota. Adv Neurol 1:237–243

    Google Scholar 

  • Mastromauro CA, Meissen GJ, Cupples LA, Berkman B, Myers RH (1989) Estimation of fertility and fitness in Huntington's disease in New England. Am J Med Genet 33:248–254

    Google Scholar 

  • Mattsson B (1974) Huntington's chorea in Sweden. I. Prevalence and genetic data. Acta Psychiatr Scand [Suppl] 255:211–255

    Google Scholar 

  • Merrit AD, Conneally PM, Rahman NF, Drew AL (1969) Juvenile Huntington's chorea. In: Barbeau A, Brunette JR (eds) Progress in neurogenetics. Excerpta Medica, Amsterdam, pp 645–650

    Google Scholar 

  • Narabayashi H (1973) Huntington's chorea in Japan: review of the literature. Adv Neurol 1:253–259

    Google Scholar 

  • Office of Health Economics (1980) Huntington's chorea. Publication 67, pp 1–35

  • Oliver JE (1970) Huntington's chorea in Northamptonshire. Br Med J II:650

    Google Scholar 

  • Osuntoken BO (1973) Neurological disorders in Nigeria. In: Spillane JD (ed) Tropical neurology. Oxford University Press, Oxford, pp 161–190

    Google Scholar 

  • Palo J, Somer H, Ikonen EM, Karila L, Perltonen L (1987) Low prevalence of Huntington's disease in Finland. Lancet II:805–806

    Google Scholar 

  • Panse F (1942) Die Erbchorea: eine klinische-genetische Studie. Thieme, Leipzig

    Google Scholar 

  • Parker N (1958) Observation on Huntington's chorea based on a Queensland survey. Med J Aust 45:351–357

    Google Scholar 

  • Pearson JS, Petersen MC, Lazarte JA, Blodgett HE, Kley IB (1955) An educational approach to the social problem of Huntington's chorea. Proc Mayo Clin 30:349–357

    Google Scholar 

  • Penney JB, Young AB, Shoulson I (1990) Huntington's disease in Venezuela: 7 years of follow-up on symptomatic and asymptomatic individuals. Mov Disord 5:93–99

    Google Scholar 

  • Petit H (1970) La maladie de Huntington. In: Warot P (ed) CR 67E Congr Psychiat Neurol Langue Franc. Masson, Paris, pp 901–1058

    Google Scholar 

  • Pleydell MJ (1954) Huntington's chorea in Northamptonshire. Br Med J II:1121–1128

    Google Scholar 

  • Pleydell MJ (1955) Huntington's chorea in Northamptonshire. Br Med J II:889

    Google Scholar 

  • Pridmore SA (1990a) Age of onset of Huntington's disease in Tasmania. Med J Aust 153:133–134

    Google Scholar 

  • Pridmore SA (1990b) The prevalence of Huntington's disease in Tasmania. Med J Aust 153:133–134

    Google Scholar 

  • Pritchard C, Cox DR, Myers RM (1991) The end in sight for Huntington's disease? Am J Hum Genet 49:1–6

    Google Scholar 

  • Przuntek H, Steigerwald A (1987) Epidemiologische Untersuchung zur Huntington'schen Erkrankung im Einzugsgebiet der Würzburger Neurologischen Universitätsklinik unter besonderer Berücksichtigung des unterfränkischen Raumes. Nervenarzt 58:424–427

    Google Scholar 

  • Punnett RC (1908) Mendelian inheritance in man. Proc R Soc Med l:135–168

    Google Scholar 

  • Quarrell OWJ, Tyler A, Jones MP, Nordin M, Harper PS (1988) Population studies of Huntington's disease in Wales. Clin Genet 33:189–195

    Google Scholar 

  • Reed TE, Neel JV (1959) Huntington's chorea in Michigan. II. Selection and mutation. Am J Hum Genet 11:107–136

    Google Scholar 

  • Reed TW, Chandler JH, Hughes EM, Davidson RT (1958) Huntington's chorea in Michigan. I. Demography and genetics. Am J Hum Genet 10:201–225

    Google Scholar 

  • Reid JJ (1960) Huntington's chorea in Northamptonshire. Br Med J II:650

    Google Scholar 

  • Ridley RM, Frith CD, Farrer LA, Conneally PM (1991) Patterns of inheritance of the symptoms of Huntington's disease suggestive of an effect of genomic imprinting. J Med Genet 28:224–231

    Google Scholar 

  • Roccatagliata G, Albano C (1976) Sotria naturale della corea di Huntington. Riv Neurol 46:297–332

    Google Scholar 

  • Saugstad L, Odegard O (1986) Huntington's chorea in Norway. Psychol Med 16:39–48

    Google Scholar 

  • Schoenberg BS (1979) Epidemiologic approach to Huntington's disease. Adv Neurol 23:1–11

    Google Scholar 

  • Scrimgeour EM (1980) Huntington's disease in two New Britain families. J Med Genet 17:197–202

    Google Scholar 

  • Scrimgeour EM (1982) Huntington's chorea in Papua. Papua New Guinea Med J 25:12–15

    Google Scholar 

  • Scrimgeour EM (1983) Possible introduction of Huntington's chorea into Pacific Islands by New England Whalemen. Am J Med Genet 15:607–613

    Google Scholar 

  • Sepcic J, Antonelli L, Sepcic-Grahovas D, Materljan E (1989) Epidemiology of Huntington's disease in Rijeka district Yugoslavia. Neuroepidemiology 8:105–108

    Google Scholar 

  • Shaw DJ, Youngman S (1991) Molecular genetic approaches to Huntington's disease. In: Harper PS (ed) Huntington's disease. Saunders, London, pp 317–336

    Google Scholar 

  • Shiwach RS, Lindenbaum RH (1990) Prevalence of Huntington's disease among UK immigrants from the Indian subcontinent. Br J Psychiatry 157:598–599

    Google Scholar 

  • Shokeir MHK (1975) Investigations on Huntington's disease in the Canadian praries. I. Prevalence. Clin Genet 7:345–348

    Google Scholar 

  • Simpson A, Johnston AW (1989) The prevalence and patterns of care of Huntington's chorea in Grampian. Br J Psychiatry 155:799–804

    Google Scholar 

  • Singh A, Singh S, Jolly SS (1959) Huntington's chorea: a report of 4 new pedigrees from Punjab. Neurology (Bombay) 7:7–8

    Google Scholar 

  • Sjögren T (1936) Vererbungsmedizinische Untersuchungen über Huntingtons Chorea in einer schwedischen Bauernpopulation. Vererbkonstit-Lehre 19:131–165

    Google Scholar 

  • Snell RG, Lazarou LP, Youngman S, et al (1989) Linkage disequilibrium in Huntington's disease: an improved localisation for the gene. J Med Genet 26:673–675

    Google Scholar 

  • Stevens DL (1976) Huntington's chorea: a demographic, genetic and clinical study. MD thesis, University of London

  • Stine OC, Smith KD (1990) The estimation of selection coefficients in Afrikaners: Huntington's disease, porphyria variegata, and lipoid proteinosis. Am J Hum Genet 11:107–136

    Google Scholar 

  • Theilman J, Kanani S, Shiang R, et al (1989) Non-random association between alleles detected at D4S95 and D4S98 and the Huntington's disease gene. J Med Genet 26:676–681

    Google Scholar 

  • Walker DA, Harper PS, Wells CEC, Tyler A, Davies K, Newcombe RG (1981) Huntington's chorea in South Wales: a genetic and epidemiological study. Clin Genet 19:213–221

    Google Scholar 

  • Walker DA, Harper PS, Newcombe RG, Davies K (1983) Huntington's chorea in South Wales: mutation, fertility and genetic fitness. J Med Genet 20:12–17

    Google Scholar 

  • Wallace DC, Parker N (1973) Huntington's chorea in Queensland: the most recent story. Adv Neurol 1:223–236

    Google Scholar 

  • Wendt CG, Drohm D (1972) Die Huntingtonsche Chorea. Eine populations-genetische Studie. Thieme, Stuttgart

    Google Scholar 

  • Went LN, Vegter-van der Vlis M, Bruyn GW, Volkers WS (1983) Huntington's chorea in the Netherlands: the problem of genetic heterogeneity. Ann Hum Genet 47:205–214

    Google Scholar 

  • Wexler NS, Young AB, Tanzi RE (1987) Homozygotes for Huntington's disease. Nature 326:194–197

    Google Scholar 

  • Wright HM, Still CN, Ramson RK (1981) Huntington's disease in black kindreds in South Carolina. Arch Neurol 38:412–414

    Google Scholar 

  • Zölliker A (1949) Die Chorea Huntington in der Schweiz. Arch Neurol Psychiatr 64:448–459

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harper, P.S. The epidemiology of Huntington's disease. Hum Genet 89, 365–376 (1992). https://doi.org/10.1007/BF00194305

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00194305

Keywords

Navigation