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Published on: September 20, 2018
Clinical Manifestations
Lee-Anne Morris1, Sanjay Manohar2, Kyla-Louise Horne3
1University of Otago, Christchurch, Canterbury, New Zealand.
Insights
In Huntington's disease (HD), apathy and impulsivity overlap specifically in goal-directedness, not other dimensions. This relationship remained stable over one year in people with HD.
Area of Science:
- Neuroscience
- Behavioral Science
- Genetics
Background:
- Apathy and impulsivity frequently co-occur in Huntington's disease (HD).
- These behavioral syndromes are complex and multidimensional.
- Understanding their relationship and stability over time is crucial for HD management.
Purpose of the Study:
- To investigate which specific dimensions of apathy and impulsivity drive their co-occurrence in HD.
- To assess the temporal stability of these dimensions in HD.
Main Methods:
- Participants with HD and controls completed apathy and impulsivity scales at baseline and one-year follow-up.
- Principal component analysis was used to identify underlying components of apathy and impulsivity.
- Linear mixed models examined group and timepoint differences.
Main Results:
- Three key components emerged: goal-directedness (attention, planning, initiation, perseverance), and two others with opposing dimensions.
- Individuals with HD showed deficits primarily in the goal-directedness component compared to controls.
- All components were stable over time and correlated with personality factors (conscientiousness, extraversion, neuroticism).
Conclusions:
- The overlap between apathy and impulsivity in HD is specifically linked to goal-directedness.
- Other dimensions of apathy and impulsivity do not overlap in HD.
- Findings highlight the importance of targeting goal-directedness in HD interventions.
Background:
Apathy and impulsivity co-occur in Huntington's disease (HD), but these debilitating behavioural syndromes are multidimensional constructs, raising the question of which specific dimensions drive this relationship, and the stability of the co-occurring dimensions across time.
Methods:
People with HD and controls completed multidimensional apathy and impulsivity scales at baseline and one-year follow-up. A principal component analysis was performed on pooled data (n = 109) to identify components and factor loadings of subscales. Linear mixed models were used to examine differences in components between groups and timepoints.
Results:
Three meaningful components emerged. Component one comprised positive loading for dimensions of apathy and impulsivity pertaining to goal-directedness, namely attention, planning, initiation and perseverance. In contrast, other dimensions of apathy and impulsivity loaded onto components two and three in opposite directions. People with HD only scored worse than controls on the goal-directedness component. All components remained stable over time and each showed remarkable similarity to a factor from the five-factor personality model, specifically conscientiousness (component one), extraversion (component two) and neuroticism (component three).
Conclusions:
The clinical overlap between apathy and impulsivity in HD relates to goal-directedness, whilst other dimensions of these constructs do not overlap.
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