Apathy Is Not Depression in Huntington's Disease

Naarding, P.; Janzing, J. G.E.; Eling, P.; Werf, Steffie van der; Kremer, B.

doi:10.1176/appi.neuropsych.21.3.266

Cited by 37 publications

(50 citation statements)

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“…Only a few questions were inconsistent with others in the eight factors, particularly questions regarding anxiety, which were present in 3 different factors. Although there is evidence that apathy is a distinct syndrome in HD that correlates with disease progression (Levy et al 1998; Naarding et al 2009; van Duijn et al 2010), we included UHDRS questions regarding apathy in the factor analysis and found that they loaded onto the same factor as depressed mood. Factor models of the BDI-II have been proposed, often dividing the scale into somatic or cognitive (negative thoughts about oneself) domains as primary factors, with affective symptoms loading onto one or the other (Ward 2006; Chilcot et al 2011).…”

Section: Discussionmentioning

confidence: 99%

Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study

Epping

Mills

Beglinger

et al. 2013

Journal of Psychiatric Research

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Depression causes significant morbidity and mortality, and this also occurs in Huntington Disease (HD), an inherited neurodegenerative illness with motor, cognitive, and psychiatric symptoms. The presentation of depression in this population remains poorly understood, particularly in the prodromal period before development of significant motor symptoms. In this study, we assessed depressive symptoms in a sample of 803 individuals with the HD mutation in the prodromal stage and 223 mutation-negative participants at the time of entry in the Neurobiological Predictors of HD (PREDICT-HD) study. Clinical and biological HD variables potentially related to severity of depression were analyzed. A factor analysis was conducted to characterize the symptom domains of depression in a subset (n=168) with clinically significant depressive symptoms. Depressive symptoms were found to be more prevalent in HD mutation carriers but did not increase with proximity to HD diagnosis and were not associated with length of the HD mutation. Increased depressive symptoms were significantly associated with female gender, self-report of past history of depression, and a slight decrease in functioning, but not with time since genetic testing. The factor analysis identified symptom domains similar to prior studies in other populations. These results show that individuals with the HD mutation are at increased risk to develop depressive symptoms at any time during the HD prodrome. The clinical presentation appears to be similar to other populations. Severity and progression are not related to the HD mutation.

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Section: Discussionmentioning

confidence: 99%

Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study

Epping

Mills

Beglinger

et al. 2013

Journal of Psychiatric Research

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“…Research demonstrates that distinct syndromes of depression and apathy exist in HD and should be examined and treated independently [22]. Apathy is common in HD, developing as early as in the prodromal period [23], and it is more prevalent than depression in HD [24,25]. Unlike depression, apathy has been shown to increase with disease progression and to correlate with motor symptoms and cognitive dysfunction [25].…”

Section: What Is the Relationship Of Biological And Social Factors Withmentioning

confidence: 99%

“…Unlike depression, apathy has been shown to increase with disease progression and to correlate with motor symptoms and cognitive dysfunction [25]. Antidepressants are often prescribed to treat apathy, but the effectiveness of this treatment or any other is entirely unknown [24]. …”

Section: What Is the Relationship Of Biological And Social Factors Withmentioning

confidence: 99%

Depression in the Early Stages of Huntington Disease

Epping

Paulsen

2011

Neurodegen. Dis. Manage.

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Summary Huntington disease (HD) has traditionally been considered a movement disorder, but cognitive and psychiatric symptoms also prominently factor into its clinical presentation. Depression is one of the most common psychiatric disturbances in HD, with its prevalence highest in manifest disease during stage 2, but it is also present during the illness prodrome (the period before manifestation of motor symptoms). Identification and treatment of depression in individuals with the HD mutation is an essential part of clinical management in this population, especially owing to the high risk of suicide. This article summarizes what is currently known about the presentation and treatment of depression in the early stages of HD and provides advice to clinicians treating this population.

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“…Still, not all psychiatric symptoms in HD patients clearly progress with age either [50]. For example, while apathy appears to progressively worsen, depression does not [22,50–52]. Performance in the progressive ratio test at satiety has been suggested to be primarily affected by the rats’ hedonic value of the food reward, while motivation to perform the test during food restriction is thought to be more governed by the induced energy imbalance (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Using this protocol, we found that BACHD rats were less motivated than their WT littermates to perform the test. This was an interesting phenotype on its own, as it might be related to apathy symptoms that are frequently found in HD patients [21,22]. However, as the BACHD rats are obese without showing an increased body weight it would also mean that they likely carried more adipose tissue compared to WT rats during this restriction protocol.…”

Section: Introductionmentioning

confidence: 99%

Further investigation of phenotypes and confounding factors of progressive ratio performance and feeding behavior in the BACHD rat model of Huntington disease

Clemensson

Fabry

et al. 2017

PLoS ONE

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Huntington disease is an inherited neurodegenerative disorder characterized by motor, cognitive, psychiatric and metabolic symptoms. We recently published a study describing that the BACHD rat model of HD shows an obesity phenotype, which might affect their motivation to perform food-based behavioral tests. Further, we argued that using a food restriction protocol based on matching BACHD and wild type rats’ food consumption rates might resolve these motivational differences. In the current study, we followed up on these ideas in a longitudinal study of the rats’ performance in a progressive ratio test. We also investigated the phenotype of reduced food consumption rate, which is typically seen in food-restricted BACHD rats, in greater detail. In line with our previous study, the BACHD rats were less motivated to perform the progressive ratio test compared to their wild type littermates, although the phenotype was no longer present when the rats’ food consumption rates had been matched. However, video analysis of food consumption tests suggested that the reduced consumption rate found in the BACHD rats was not entirely based on differences in hunger, but likely involved motoric impairments. Thus, restriction protocols based on food consumption rates are not appropriate when working with BACHD rats. As an alternative, we suggest that studies where BACHD rats are used should investigate how the readouts of interest are affected by motivational differences, and use appropriate control tests to avoid misleading results. In addition, we show that BACHD rats display distinct behavioral changes in their progressive ratio performance, which might be indicative of striatal dysfunction.

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Apathy Is Not Depression in Huntington's Disease

Cited by 37 publications

References 0 publications

Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study

Characterization of depression in prodromal Huntington disease in the neurobiological predictors of HD (PREDICT-HD) study

Depression in the Early Stages of Huntington Disease

Further investigation of phenotypes and confounding factors of progressive ratio performance and feeding behavior in the BACHD rat model of Huntington disease

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