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Characterizing White Matter in Huntington's Disease.

Sarah Gregory1, Eileanoir Johnson1, Lauren M Byrne1

  • 1University College London Huntington's Disease Centre, Department of Neurodegenerative Disease University College London Queen Square Institute of Neurology, University College London London United Kingdom.

Movement Disorders Clinical Practice
|January 24, 2020
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Summary

Early white matter changes in Huntington's disease (HD) involve reduced integrity and increased axonal degeneration. These findings correlate with disease progression and mutant huntingtin protein levels, offering insights into HD pathology.

Keywords:
Huntington's diseaseMRIneurofilament light (NfL)white matter

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Area of Science:

  • Neuroscience
  • Neurology
  • Biomarkers

Background:

  • Understanding early white matter (WM) changes in Huntington's disease (HD) is crucial for elucidating disease spread from the striatum.
  • Early detection of WM alterations can provide insights into the neurodegenerative processes in HD.

Purpose of the Study:

  • To provide a detailed characterization of pathology-related WM changes in HD.
  • To examine WM microstructure using diffusion-weighted imaging and investigate underlying biological properties and damage markers.
  • To correlate WM changes with biofluid markers like neurofilament light and mutant huntingtin protein.

Main Methods:

  • Utilized diffusion magnetic resonance imaging (dMRI) to measure fractional anisotropy (FA) and diffusivity in HD gene carriers and controls.
  • Employed neurite orientation dispersion and density imaging (NODDI) to assess axonal density and organization.
  • Analyzed T1/T2-weighted MRI for iron and myelin-contrast measures, alongside cerebrospinal fluid (CSF) and plasma neurofilament light (NfL) and CSF mutant huntingtin protein (mHTT) levels.

Main Results:

  • HD gene carriers showed reduced FA and increased diffusivity compared to controls, correlating with disease progression and mHTT levels.
  • HD gene carriers exhibited reduced myelin-contrast and iron in the striatum.
  • Axonal breakdown was linked to increased WM degeneration, indicated by reduced FA and increased axonal orientation.

Conclusions:

  • Findings offer a comprehensive characterization of HD-related microstructural brain changes.
  • Reduced FA and increased axonal orientation correlate with biofluid markers, suggesting axonal breakdown contributes to WM degeneration.
  • Higher T2 signal and lower myelin-contrast in the striatum may indicate localized demyelination in HD.