Drug treatment of moving disorders and neuropsychiatric symptoms accompanying Huntington’s disease: a systematic review
Tomasz Sobów, Jarosław Sławek
Huntington’s disease (HD) belongs to a large group of neurodegenerative diseases caused by a genetic defect consisting in an increased number of repetitive sequences of DNA within the altered gene in the chromosome 4 encoding huntingtin. The consequence of this mutation is selective destruction of neurons mainly within the caudate nucleus, putamen, globus pallidus and also other structures, including thalamus and white matter. Apart of involuntary movements, symptoms include other neurological signs (e.g. parkinsonism), disturbed cognitive functions (dementia) and various psychiatric disorders. In spite of a significant progress in understanding HD pathogenesis, no effective cause-oriented treatment has been developed to date. Currently available therapies include attempts at correction of individual symptoms, which, as in the case of Parkinson’s disease, is handicapped by mutual interdependence of neurological and mental state, as well as by effects of administered drugs, both psychotropic and those targeted on particular neurological signs. In the paper we present an evidence based review of available modalities for symptomatic treatment of motor disorders (involuntary movements, parkinsonism, dystonias), other neurological symptoms, mental disorders (depression, psychoses) and disturbances of cognitive functions associated with HD. Separately discussed are attempts at administration of neuroprotective drugs (including creatine, unsaturated fatty acids and minocycline), which are recommended expecting to correct the natural course of the disease.