Irritability and Aggression. Irritability (Irr) is a common clinical problem in patients with neuropsychiatric disorders.
12 13 Indeed, reviews of psychiatric symptoms in Huntington's disease have suggested that depression, apathy, aggression, and disinhibition are common and suicide rates are over four times those of the general population.
Neuropsychiatric symptoms are often present well before the motor symptoms manifest, sometimes decades prior, and include depression, irritability/aggression, executive dysfunction (eg, apathy, obsessive-compulsive behaviors), psychosis, cognitive decline, and dementia.
Behavioural changes are often the first symptoms of Huntington's disease. These changes often include: a lack of emotions and not recognising the needs of others. periods of aggression, excitement, depression, antisocial behaviour and anger.
The most common psychiatric disorder associated with Huntington's disease is depression. This isn't simply a reaction to receiving a diagnosis of Huntington's disease. Instead, depression appears to occur because of injury to the brain and subsequent changes in brain function.
Huntington's disease impairs the functioning of the brain, which can result in apathy, trouble organizing, impulsivity, irritability and anger, unawareness, disinhibition, preservation, and other psychiatric symptoms. These emotional and behavioral symptoms can further complicate the caregiver's role.
Common emotional and behavioral difficulties among persons with HD include depression, anxiety, irritability-anger, aggression, perseveration, disinhibition, and apathy (5–14).
For individuals who are at risk of carrying the HD gene, testing can be performed before symptoms occur. Information from brain scans such as computed tomography (CT), electroencephalography (EEG) and magnetic resonance imaging (MRI) may be part (magnetic resonance imaging) and may be reviewed as part of the diagnosis.
Neuropsychiatric symptoms (NPS), including apathy, depression, sleep disorders, hallucinations, delusions, psychosis, agitation, and aggression, are exceedingly prevalent [4, 5].
These symptoms include agitation, aggression, delusions, hallucinations, paranoia, wandering, depression, apathy, disinhibition, and sleep disturbances (table 1). One or more of these symptoms are observed in 60 to 90 percent of patients with dementia; the prevalence increases with disease severity [2-6].
The classic clinical triad in HD is (1) progressive movement disorder, most commonly chorea; (2) progressive cognitive disturbance culminating in dementia; and (3) various behavioral disturbances that often precede diagnosis and can vary depending on the state of disease.
Huntington's disease (HD) is an autosomal-dominant, neurodegenerative disease characterized by a triad of symptoms and signs: (1) psychiatric syndromes; (2) a movement disorder; and (3) cognitive impairment.
Neuropsychiatric symptoms are a common accompaniment of dementia. These include agitation, depression, apathy, delusions, hallucinations, and sleep impairment.
Multiple factors contribute to neuropsychiatric disorder susceptibility. These factors include genetic predisposition, developmental insult, brain injury and natural (or disease-state) aging. Together these factors can influence the molecular, physiological and structural characteristics of the brain.
It is important to understand that while people are born with the mutated gene for HD, in most cases they will not develop the symptoms until later in life. Therefore someone can be without symptoms or presymptomatic for a number of years.
Mood and behavioral changes
Agitation, irritability, and aggression are other possible personality changes. Some patients may experience hallucinations and delusions that can severely affect their day-to-day interactions. Living with Huntington's can induce feelings of anxiety, depression, apathy, and frustration.
Huntington's is a dominant genetic disease. With these diseases, you are almost never an invisible carrier like you can be with recessive genetic diseases. You usually can't pass on a gene that causes the disease because you don't have it.
The disease attacks areas of the brain that help to control voluntary (intentional) movement, as well as other areas. People living with HD develop uncontrollable dance-like movements (chorea) and abnormal body postures, as well as problems with behavior, emotion, thinking, and personality.
A common and particularly detrimental neuropsychiatric alteration in HD gene carriers is irritability, which frequently manifests as abrupt and unpredictable outbursts of anger.
During the early stages of HD, irritability, depression, anxiety and aggression are common behavior symptoms. In the later stages, individuals tend to be less irritable and aggressive, as apathy and a lack of concern become more pronounced.
The hallmark of HD, and common to other polyglutamine disorders, is the presence of aggregates in the brain. These were initially considered crucial in HD pathology.
Many people with Huntington disease develop involuntary jerking or twitching movements known as chorea. As the disease progresses, these movements become more pronounced. Affected individuals may have trouble walking, speaking, and swallowing.