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A systematic review and meta-analysis of depression and apathy frequency in adult-onset Huntington's disease
Melanie L Clark1, Julie Abimanyi-Ochom2, Ha Le2
1Deakin University, Deakin Health Economics, School of Health and Social Development, Geelong, Victoria 3220, Australia; Neurosciences Unit, North Metropolitan Health Services Mental Health Public Health Dental Services, Perth, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia.
Insights
Depression and apathy are common in Huntington's disease (HD), affecting 38% and 40% of individuals, respectively. Gene-positive individuals showed higher rates, with apathy slightly more prevalent than depression.
Area of Science:
- Neuroscience
- Genetics
- Psychiatry
Background:
- Depression and apathy significantly impact functional capacity in Huntington's disease (HD).
- The precise frequency of these conditions in HD populations remains largely unquantified.
- Understanding these frequencies is crucial for comprehensive patient care and management strategies.
Approach:
- A systematic literature search was performed across 21 databases up to June 2021.
- Meta-analyses utilized clinician-rated assessments for depression and apathy in adult-onset HD.
- The analysis included individuals from HD-affected families and gene-positive HD patients.
Key Points:
- Lifetime prevalence of depression in adults affected by or at-risk for HD was 38%.
- Lifetime prevalence of apathy in adults affected by or at-risk for HD was 40%.
- In gene-positive individuals, apathy (48%) was slightly more common than depression (43%).
Conclusions:
- Depression and apathy are highly prevalent in individuals with Huntington's disease.
- Apathy appears to be marginally more common than depression in gene-positive HD patients.
- Further research differentiating juvenile-onset and adult-onset HD cohorts is recommended to refine phenotypic profiles.
Abstract:
Depression and apathy are associated with decreased functional capacity in Huntington's disease (HD) but frequency of depression and apathy in HD is largely unknown. Systematic literature searching was conducted across 21 databases until 30 June 2021. Inclusion criteria was limited to clinician-rated assessments of depression and apathy and adult-onset HD. Inverse-variance heterogeneity meta-analyses were conducted exploring depression and apathy frequency within individuals from families affected by HD, and within individuals with confirmed HD gene-positive status. Screening identified 289 articles for full-text review; nine remained for meta-analysis. Depression frequency in the lifetime in adults affected by or at-risk for HD was 38%, I2 = 99%. Apathy frequency in the lifetime in adults affected by or at-risk for HD was 40%, I2 = 96%. The robustness of the findings improved when limiting the analysis to gene-positive individuals only where apathy was found to be slightly more common than depression, 48% and 43% respectively. Future studies may consider reporting results from juvenile-onset HD and adult-onset HD cohorts separately to further explore phenotypic profiles.
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