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Huntington's disease (HD) patients exhibit abnormal gait patterns early in the disease. Haloperidol treatment effectively reduces chorea but does not improve the distinct gait abnormalities or ataxia in HD patients.
Area of Science:
- Neurology
- Movement Disorders
- Biomechanical Analysis
Background:
- Huntington's disease (HD) is a neurodegenerative disorder.
- Gait disturbances and ataxia are common symptoms in HD.
- The effect of haloperidol on gait in HD is not well understood.
Purpose of the Study:
- To investigate gait abnormalities in Huntington's disease patients.
- To assess the impact of haloperidol on gait and ataxia.
- To determine if ataxia in HD is related to chorea or treatable with haloperidol.
Main Methods:
- Filmed and analyzed gait in 13 HD patients before and after haloperidol dosage adjustment.
- Blind scoring of chorea and ataxia severity from videotapes.
- Biomechanical analysis of gait parameters including velocity, stride length, and cadence.
Main Results:
- Gait was abnormal in 12 of 13 patients, with early symptoms (<5 years) also showing gait issues.
- Observed gait characteristics: wide-based station, lateral swaying, spontaneous knee flexion, variable cadence, and parkinsonian features.
- Haloperidol reduced chorea but did not alter gait patterns or improve ataxia.
Conclusions:
- Ataxia in HD is an early, distinct, and variable symptom unrelated to chorea.
- Haloperidol does not improve gait abnormalities or ataxia in Huntington's disease.
- Gait analysis reveals significant biomechanical alterations in HD patients.
Abstract:
We investigated 13 patients with Huntington's disease and assessed gait by filming and by gait analyzer before and after increasing haloperidol dosage, until chorea was suppressed or side effects intervened. The severity of chorea and ataxia was scored blindly from videotapes. Gaits were abnormal in 12 of 13 patients and 5 of 6 patients who had symptoms for less than 5 years. Clinical characteristics included wide-based station, lateral swaying, spontaneous knee flexion, variable cadence, and parkinsonian features. Biomechanical analysis illustrated that gait characteristics varied in each walk, with a mean decrease in velocity, stride length, and cadence. Haloperidol treatment decreased chorea but did not affect gait patterns. Ataxia occurs early in the disease, has a distinct but variable pattern, is unrelated to chorea, and is not improved by haloperidol.