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Published on: March 17, 2019
Apathy and Impulsivity Co-Occur in Huntington's Disease
Lee-Anne Morris1,2, Kyla-Louise Horne1,2, Laura Paermentier2
1Department of Medicine, University of Otago, Christchurch, New Zealand.
Insights
Apathy and impulsivity frequently co-occur in Huntington's disease (HD), impacting quality of life. These behavioral changes are intrinsically linked in individuals with premanifest to mild HD.
Area of Science:
- Neuroscience
- Behavioral Science
- Genetics
Background:
- Apathy is a recognized behavioral change in Huntington's disease (HD).
- Impulsivity in HD is less documented, and its co-occurrence with apathy remains uninvestigated.
Purpose of the Study:
- To determine if apathy and impulsivity co-occur in individuals with HD.
- To investigate the association of these behaviors with quality of life in HD patients.
Main Methods:
- 42 individuals with HD (premanifest to mild motor stages) and 20 controls completed apathy and impulsivity scales.
- Principal component analysis reduced apathy and impulsivity measures to single metrics.
- Correlations and regression models analyzed associations between apathy, impulsivity, and quality of life, controlling for covariates.
Main Results:
- A significant correlation (r=0.6, p<0.001) was found between apathy and impulsivity in HD patients.
- This association persisted after controlling for depressive symptoms, motor severity, and cognitive function.
- Apathy and depressive symptoms were linked to reduced quality of life.
Conclusions:
- Apathy and impulsivity co-occur in individuals with premanifest to mild HD.
- These co-occurring behaviors significantly impact patient wellbeing.
- Evidence suggests an intrinsic link between apathy and impulsivity in HD.
Background:
Apathy is a debilitating behavioral change in Huntington's disease (HD), but impulsivity in HD has not been well documented, and the co-occurrence of these behaviors in HD has not been investigated.
Objective:
Our objective was to determine whether apathy and impulsivity co-occur in people with HD and their associations with quality of life.
Methods:
Carriers of Huntington's gene expansion (premanifest to mild motor manifest disease; n = 42) along with healthy controls (n = 20) completed measures of apathy (Apathy Evaluation Scale and Apathy Motivation Index) and impulsivity (Barratt Impulsiveness Scale-11 and UPPS-P impulsivity scale), along with mood, cognition, clinical, and quality of life measures. Apathy and impulsivity measures were each reduced to a single metric per patient using principal component analysis. Correlations and multiple linear regression models determined associations between apathy and impulsivity and the potential influence of other covariates.
Results:
Apathy and impulsivity were significantly correlated (r = 0.6, p < 0.001, 95% CI [0.36, 0.76]) in HD, with this association remaining after controlling for depressive symptoms, motor disease severity, and cognitive function. Furthermore, apathy and depressive symptoms were associated with poorer quality of life.
Conclusions:
Apathy and impulsivity co-occur in individuals with premanifest to mild manifest HD and have a significant impact on wellbeing. We add to a growing evidence body that apathy and impulsivity may be intrinsically linked.
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