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Longitudinal trajectories of apathy in Huntington's disease: a 6-year follow-up study

Emilie Poulsen1,2, Rebecca K Hendel3, Birna Ásbjörnsdóttir3

  • 1Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. emilie.najbjerg.birkebaek.poulsen@regionh.dk.

Journal of Neurology
|April 21, 2026
PubMed

Insights

Apathy in Huntington

Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Apathy is a frequent and disabling neuropsychiatric symptom in Huntington's disease (HD).
  • The long-term progression of apathy in HD gene expansion carriers (HDGECs) is not well understood.
  • Understanding apathy's trajectory is crucial for managing HD symptoms.

Purpose of the Study:

  • To examine the 6-year changes in apathy among HDGECs using a multidimensional approach.
  • To investigate the relationship between apathy changes and cognition, motor symptoms, and depression in HDGECs.

Main Methods:

  • Longitudinal study of 82 HDGECs (premanifest and manifest) over 6 years.
  • Apathy assessed using Lille Apathy Rating Scale (LARS) and Problem Behaviors Assessment-short (PBA-s).
  • Cognition, motor function, and depression were also evaluated.

Main Results:

  • Total apathy scores significantly increased over 6 years, with small but measurable changes.
  • Premanifest HDGECs showed a decline in Action Initiation; manifest HDGECs had broader apathy worsening.
  • Individual apathy trajectories were highly variable, indicating heterogeneity in progression.

Conclusions:

  • Apathy in HD demonstrates a modest but significant increase over 6 years, with considerable individual variation.
  • Changes in Action Initiation were noted, and apathy appears to be an independent feature from depression and cognition.
  • Multidimensional assessment is valuable for understanding the heterogeneous progression of apathy in HD.
Abstract

Keywords:
ApathyHuntington’s diseaseLongitudinal studyNeuropsychiatric symptoms

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