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Obsessive-Compulsive and Perseverative Behaviors in Huntington's Disease
Mayke Oosterloo1, David Craufurd2,3, Hanneke Nijsten4
1Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Insights
Obsessive-compulsive behaviors (OCBs) and perseverative behaviors (PBs) are common in Huntington
Area of Science:
- Neuroscience
- Genetics
- Psychiatry
Background:
- Huntington's disease (HD) is characterized by prevalent neuropsychiatric symptoms.
- The prevalence and progression of obsessive-compulsive behaviors (OCBs) and perseverative behaviors (PBs) in HD are not well understood.
Purpose of the Study:
- To review the existing literature on OCBs and PBs in individuals with Huntington's disease gene expansion carriers (HDGECs).
Main Methods:
- A literature search of the PubMed database was conducted up to 2017.
- Search terms included synonyms for Huntington's disease and terms related to OCBs and PBs.
Main Results:
- Prevalence rates for OCBs ranged from 5% to 52%, and for PBs up to 75%, varying by disease stage and measurement scale.
- OCBs were more frequent in premanifest and manifest HDGECs compared to controls.
- OCBs and PBs correlated with disease duration and severity but decreased in advanced stages.
Conclusions:
- OCBs and PBs are characteristic neuropsychiatric features of HD.
- Distinguishing between OCBs and PBs is crucial for effective management and treatment in HDGECs.
Background:
Neuropsychiatric symptoms are highly prevalent in Huntington's disease (HD). However, little is known of the prevalence and course of obsessive-compulsive behaviors (OCBs) and perseverative behaviors (PBs) during the progression of the disease.
Objective:
This review provides a summary of the literature on OCBs and PBs in HD gene expansion carriers (HDGECs).
Methods:
Pubmed database was searched for articles on OCBs and PBs in HD up to 2017. We used search terms, all synonyms for HD, and various terms for OCBs and PBs.
Results:
We found 5 case series and 11 original articles that describe a prevalence range of 5 to 52% for OCBs and up to 75% for PBs depending on disease stage and measurement scale used. Premanifest HDGECs report more OCBs compared to controls, and manifest HDGECs report a higher rate of OCBs compared to premanifest HDGECs. OCBs and PBs are associated with a longer disease duration and disease severity in manifest HDGECs, but decrease in the most advanced stages. When HDGECs come closer to estimated motor onset, the companion ratings on OCBs appear to be higher than the self-ratings of HDGECs.
Conclusions:
Both OCBs and PBs are characteristic neuropsychiatric features of HD. Perseveration is probably best distinguished from OCBs as it occurs without the individual's full awareness or insight into their presence (and the behavior may not be distressing). Although these behaviors are seldom distinguished, we conclude that differentiating OCBs from PBs in HD is beneficial for the management and treatment of these symptoms in HDGECs.