Highlights & Basics
- Huntington disease is an autosomal dominant neurodegenerative disorder.
- Often presents in midlife but may appear at any age.
- Clinical manifestations include chorea, cognitive decline, loss of coordination, and personality change.
- The duration of disease is approximately 20 years from time of diagnosis to time of death.
- Pretest genetic counseling should be arranged prior to ordering genetic testing.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
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Citations
Bean L, Bayrak-Toydemir P; American College of Medical Genetics and Genomics. Standards and guidelines for clinical genetics laboratories, 2014 edition: technical standards and guidelines for Huntington disease. Genet Med. 2014 Dec;16(12):e2.[Abstract][Full Text]
Anderson KE, van Duijn E, Craufurd D, et al. Clinical management of neuropsychiatric symptoms of Huntington disease: expert-based consensus guidelines on agitation, anxiety, apathy, psychosis and sleep disorders. J Huntingtons Dis. 2018;7(3):355-66.[Abstract][Full Text]
Bachoud-Lévi AC, Ferreira J, Massart R, et al. International guidelines for the treatment of Huntington's disease. Front Neurol. 2019;10:710.[Abstract][Full Text]
Quinn L, Kegelmeyer D, Kloos A, et al. Clinical recommendations to guide physical therapy practice for Huntington disease. Neurology. 2020 Feb 4;94(5):217-28.[Abstract][Full Text]
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31. Herzog-Krzywoszanska R, Krzywoszanski L. Sleep disorders in Huntington's disease. Front Psychiatry. 2019;10:221.[Abstract][Full Text]
32. Anderson KE, van Duijn E, Craufurd D, et al. Clinical management of neuropsychiatric symptoms of Huntington disease: expert-based consensus guidelines on agitation, anxiety, apathy, psychosis and sleep disorders. J Huntingtons Dis. 2018;7(3):355-66.[Abstract][Full Text]
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37. Blekher T, Johnson SA, Marshall J, et al. Saccades in presymptomatic and early stages of Huntington disease. Neurology. 2006 Aug 8;67(3):394-9.[Abstract]
38. Gordon AM, Quinn L, Reilmann R, et al. Coordination of prehensile forces during precision grip in Huntington's disease. Exp Neurol. 2000 May;163(1):136-48.[Abstract]
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45. Stevanin G, Fujigasaki H, Lebre AS, et al. Huntington's disease-like phenotype due to trinucleotide repeat expansions in the TBP and JPH3 genes. Brain. 2003 Jul;126(Pt 7):1599-603.[Abstract][Full Text]
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48. Al-Tahan AY, Divakaran MP, Kambouris M, et al. A novel autosomal recessive 'Huntington's disease-like' neurodegenerative disorder in a Saudi family. Saudi Med J. 1999 Jan;20(1):85-9.[Abstract]
49. Kambouris M, Bohlega S, Al-Tahan A, et al. Localization of the gene for a novel autosomal recessive neurodegenerative Huntington-like disorder to 4p15.3. Am J Hum Genet. 2000 Feb;66(2):445-52.[Abstract][Full Text]
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52. Isaacs JD, Rakshi J, Baker R, et al. Chorea associated with thyroxine replacement therapy. Mov Disord. 2005 Dec;20(12):1656-7.[Abstract]
53. Dike GL. Chorea gravidarum: a case report and review. Md Med J. 1997 Sep;46(8):436-9.[Abstract]
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57. Machado A, Chien HF, Deguti MM, et al. Neurological manifestations in Wilson's disease: report of 119 cases. Mov Disord. 2006 Dec;21(12):2192-6.[Abstract]
58. Shoulson I, Fahn S. Huntington disease: clinical care and evaluation. Neurology. 1979 Jan;29(1):1-3.[Abstract]
59. Huntington Study Group. Unified Huntington's Disease Rating Scale: reliability and consistency. Mov Disord. 1996 Mar;11(2):136-42.[Abstract]
60. Crozier S, Robertson N, Dale M. The psychological impact of predictive genetic testing for Huntington's disease: a systematic review of the literature. J Genet Couns. 2015 Feb;24(1):29-39.[Abstract][Full Text]
61. Ross CA, Reilmann R, Cardoso F, et al. Movement Disorder Society Task Force Viewpoint: Huntington's Disease Diagnostic Categories. Mov Disord Clin Pract. 2019 Sep;6(7):541-6.[Abstract][Full Text]
62. Mühlbӓck A, van Walsem M, Nance M, et al. What we don't need to prove but need to do in multidisciplinary treatment and care in Huntington's disease: a position paper. Orphanet J Rare Dis. 2023 Jan 30;18(1):19.[Abstract][Full Text]
63. Bachoud-Lévi AC, Ferreira J, Massart R, et al. International guidelines for the treatment of Huntington's disease. Front Neurol. 2019;10:710.[Abstract][Full Text]
64. Mestre T, Ferreira J, Coelho MM, et al. Therapeutic interventions for symptomatic treatment in Huntington's disease. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006456.[Abstract][Full Text]
65. Ferreira JJ, Rodrigues FB, Duarte GS, et al. An MDS evidence-based review on treatments for Huntington's disease. Mov Disord. 2022 Jan;37(1):25-35.[Abstract][Full Text]
66. Bonelli RM. Mirtazapine in suicidal Huntington's disease. Ann Pharmacother. 2003 Mar;37(3):452.[Abstract]
67. Ford MF. Treatment of depression in Huntington's disease with monoamine oxidase inhibitors. Br J Psychiatry. 1986 Nov;149:654-6.[Abstract]
68. Folstein S, Abbott MH, Chase GA, et al. The association of affective disorder with Huntington's disease in a case series and in families. Psychol Med. 1983 Aug;13(3):537-42.[Abstract]
69. Zenodo. Extended evidence-based guidance on psychological interventions for psychological difficulties in individuals with Huntington's disease, Parkinson's disease, motor neurone disease, and multiple sclerosis. Mar 2021 [internet publication].[Full Text]
70. British Psychological Society. Psychological interventions for people with Huntington's disease, Parkinson's disease, motor neurone disease, and multiple sclerosis. Jan 2021 [internet publication].[Full Text]
71. Cusin C, Franco FB, Fernandez-Robles C, et al. Rapid improvement of depression and psychotic symptoms in Huntington's disease: a retrospective chart review of seven patients treated with electroconvulsive therapy. Gen Hosp Psychiatry. 2013 Nov-Dec;35(6):678.e3-5.[Abstract]
72. Mowafi W, Millard J. Electroconvulsive therapy for severe depression, psychosis and chorea in a patient with Huntington's disease: case report and review of the literature. BJPsych Bull. 2021 Apr;45(2):97-104.[Abstract][Full Text]
73. Royuela Rico A, Gil-Verona JA, Macías Fernández JA. A case of obsessive symptoms in Huntington's disease [in Spanish]. Actas Esp Psiquiatr. 2003 Nov-Dec;31(6):367-70.[Abstract]
74. De Marchi N, Daniele F, Ragone MA. Fluoxetine in the treatment of Huntington's disease. Psychopharmacology (Berl). 2001 Jan 1;153(2):264-6.[Abstract]
75. Paleacu D, Anca M, Giladi N. Olanzapine in Huntington's disease. Acta Neurol Scand. 2002 Jun;105(6):441-4.[Abstract]
76. Squitieri F, Cannella M, Piorcellini A, et al. Short-term effects of olanzapine in Huntington disease. Neuropsychiatry Neuropsychol Behav Neurol. 2001 Jan;14(1):69-72.[Abstract]
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78. Anderson KE, Marshall FJ. Behavioral symptoms associated with Huntington's disease. Adv Neurol. 2005;96:197-208.[Abstract]
79. Fisher CA, Sewell K, Brown A, et al. Aggression in Huntington's disease: a systematic review of rates of aggression and treatment methods. J Huntingtons Dis. 2014;3(4):319-32.[Abstract][Full Text]
80. Mahant N, McCusker EA, Byth K, et al. Huntington's disease: clinical correlates of disability and progression. Neurology. 2003 Oct 28;61(8):1085-92.[Abstract]
81. Reilmann R. Pharmacological treatment of chorea in Huntington's disease - good clinical practice versus evidence-based guideline. Mov Disord. 2013 Jul;28(8):1030-3.[Abstract][Full Text]
82. Fasano A, Bentivoglio AR. Tetrabenazine. Expert Opin Pharmacother. 2009 Dec;10(17):2883-96.[Abstract]
83. Chen JJ, Ondo WG, Dashtipour K, et al. Tetrabenazine for the treatment of hyperkinetic movement disorders: a review of the literature. Clin Ther. 2012 Jul;34(7):1487-504.[Abstract]
84. Huntington Study Group. Tetrabenazine as antichorea therapy in Huntington disease: a randomized controlled trial. Neurology. 2006 Feb 14;66(3):366-72.[Abstract]
85. Frank S. Tetrabenazine as anti-chorea therapy in Huntington disease: an open-label continuation study. Huntington Study Group/TETRA-HD Investigators. BMC Neurol. 2009 Dec 18;9:62.[Abstract][Full Text]
86. Coppen EM, Roos RA. Current pharmacological approaches to reduce chorea in Huntington's disease. Drugs. 2017 Jan;77(1):29-46.[Abstract][Full Text]
87. Lucetti C, Gambaccini G, Bernardini S, et al. Amantadine in Huntington's disease: open-label video-blinded study. Neurol Sci. 2002 Sep;23 Suppl 2:S83-4.[Abstract]
88. Lucetti C, Del Dotto P, Gambaccini G, et al. IV amantadine improves chorea in Huntington's disease: an acute randomized, controlled study. Neurology. 2003 Jun 24;60(12):1995-7.[Abstract]
89. Verhagen Metman L, Morris MJ, Farmer C, et al. Huntington's disease: a randomized, controlled trial using the NMDA-antagonist amantadine. Neurology. 2002 Sep 10;59(5):694-9.[Abstract]
90. Burgunder JM, Guttman M, Perlman S, et al. An International survey-based algorithm for the pharmacologic treatment of chorea in Huntington's disease. PLoS Curr. 2011 Aug 30;3:RRN1260.[Abstract][Full Text]
91. Reuter I, Hu MT, Andrews TC, et al. Late onset levodopa responsive Huntington's disease with minimal chorea masquerading as Parkinson plus syndrome. J Neurol Neurosurg Psychiatry. 2000 Feb;68(2):238-41.[Abstract][Full Text]
92. Racette BA, Perlmutter JS. Levodopa responsive parkinsonism in an adult with Huntington's disease. J Neurol Neurosurg Psychiatry. 1998 Oct;65(4):577-9.[Abstract][Full Text]
93. Bird MT, Paulson GW. The rigid form of Huntington's chorea. Neurology. 1971 Mar;21(3):271-6.[Abstract]
94. Li Y, Hai S, Zhou Y, et al. Cholinesterase inhibitors for rarer dementias associated with neurological conditions. Cochrane Database Syst Rev. 2015 Mar 3;(3):CD009444.[Abstract][Full Text]
95. Beglinger LJ, Adams WH, Langbehn D, et al. Results of the citalopram to enhance cognition in Huntington disease trial. Mov Disord. 2014 Mar;29(3):401-5.[Abstract]
96. Quinn L, Kegelmeyer D, Kloos A, et al. Clinical recommendations to guide physical therapy practice for Huntington disease. Neurology. 2020 Feb 4;94(5):217-28.[Abstract][Full Text]
97. Khalil H, Quinn L, van Deursen R, et al. What effect does a structured home-based exercise programme have on people with Huntington's disease? A randomized, controlled pilot study. Clin Rehabil. 2013 Jul;27(7):646-58.[Abstract]
98. Cook C, Page K, Wagstaff A, et al; European Huntington's Disease Network. Occupational therapy for people with Huntington's disease: best practice guidelines. Jan 2012 [internet publication].[Full Text]
99. Quinn L, Busse M; European Huntington's Disease Network. Physiotherapy clinical guidelines for Huntington's disease. Neurodegen Dis Manage. 2012;2(1):21-31.[Full Text]
100. Hamilton A, Ferm U, Heemskerk AW, et al; European Huntington's Disease Network. Management of speech, language and communication difficulties in Huntington's disease. Neurodegen Dis Manage. 2012;2(1):67-77.[Full Text]
101. Brotherton A, Campos L, Rowell A, et al; Nutritional management of individuals with Huntington's disease: nutritional guidelines. Neurodegen Dis Manage. 2012;2(1):33-43.[Full Text]
102. Farag M, Salanio DM, Hearst C, et al. Advance care planning in Huntington's disease. J Huntingtons Dis. 2023;12(1):77-82.[Abstract]
103. Taylor LP, Besbris JM, Graf WD, et al. Clinical guidance in neuropalliative care: an AAN position statement. Neurology. 2022 Mar 8;98(10):409-16.[Abstract][Full Text]
104. Tarolli CG, Chesire AM, Biglan KM. Palliative care in Huntington disease: personal reflections and a review of the literature. Tremor Other Hyperkinet Mov (N Y). 2017;7:454.[Abstract][Full Text]
105. Frank S, Stamler D, Sung V, et al. Deutetrabenazine effect on total motor score in patients with Huntington disease (First-HD) (S27.008). Neurology. 2016 Apr 5;86(16 Suppl):S27.008.[Full Text]
106. Claassen D, Frank S, Stamler D, et al. Rating swallowing function in patients with Huntington disease enrolled in the First-HD study (S25.006). Neurology. 2016 Apr 5;86(16 Suppl):S25.006.[Full Text]
107. Furr Stimming E, Claassen DO, Kayson E, et al. Safety and efficacy of valbenazine for the treatment of chorea associated with Huntington's disease (KINECT-HD): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2023 Jun;22(6):494-504.[Abstract]
108. Tabrizi SJ, Leavitt BR, Landwehrmeyer GB, et al. Targeting Huntingtin expression in patients with Huntington's disease. N Engl J Med. 2019 Jun 13;380(24):2307-16.[Abstract][Full Text]
109. Rodrigues FB, Quinn L, Wild EJ. Huntington's disease clinical trials corner: January 2019. J Huntingtons Dis. 2019;8(1):115-25.[Abstract][Full Text]
110. ClinicalTrials.gov. GENERATION HD2. A study to evaluate the safety, biomarkers, and efficacy of tominersen compared with placebo in participants with prodromal and early manifest Huntington's disease. Feb 2025 [internet publication].[Full Text]
111. PTC Therapeutics. Interim PIVOT-HD results demonstrate evidence of favorable CNS biomarker and clinical effects at month 12 in Huntington's disease patients. Jun 2024 [internet publication].[Full Text]
112. ClinicalTrials.gov. Safety and Proof-of-Concept (POC) study with AMT-130 in adults with early manifest Huntington disease. ClinicalTrials.gov identifier NCT04120493. 10 Dec 2021 [internet publication].[Full Text]
113. Verny C, Bachoud-Lévi AC, Durr A, et al. A randomized, double-blind, placebo-controlled trial evaluating cysteamine in Huntington's disease. Mov Disord. 2017 Jun;32(6):932-6.[Abstract]
114. Reilmann R, Squitieri F, Priller J, et al. Safety and tolerability of selisistat for the treatment of Huntington's disease: results from a randomized, double-blind, placebo-controlled phase II trial (S47.004). Neurology. 2014 Apr 8;82(10 Suppl):S47.004.[Full Text]
115. Niccolini F, Haider S, Reis Marques T, et al. Altered PDE10A expression detectable early before symptomatic onset in Huntington's disease. Brain. 2015 Oct;138(Pt 10):3016-29.[Abstract][Full Text]
116. Beaumont V, Zhong S, Lin H, et al. Phosphodiesterase 10A inhibition improves cortico-basal ganglia function in Huntington's disease models. Neuron. 2016 Dec 21;92(6):1220-37.[Abstract][Full Text]
117. Group HS. Brief report: Pfizer Amaryllis trial ends: negative results lead to termination of extension study. 2016 [internet publication].[Full Text]
118. Rodrigues FB, Abreu D, Damásio J, et al. Survival, mortality, causes and places of death in a European Huntington's Disease Prospective Cohort. Mov Disord Clin Pract. 2017 Sep-Oct;4(5):737-42.[Abstract][Full Text]
119. Hamilton JM, Wolfson T, Peavy GM, et al; Huntington Study Group. Rate and correlates of weight change in Huntington's disease. J Neurol Neurosurg Psychiatry. 2004 Feb;75(2):209-12.[Abstract][Full Text]
120. van der Burg JM, Björkqvist M, Brundin P. Beyond the brain: widespread pathology in Huntington's disease. Lancet Neurol. 2009 Aug;8(8):765-74.[Abstract]
121. Furby H, Siadimas A, Rutten-Jacobs L, et al. Natural history and burden of Huntington's disease in the UK: a population-based cohort study. Eur J Neurol. 2022 Aug;29(8):2249-57.[Abstract][Full Text]
122. Djoussé L, Knowlton B, Cupples LA, et al. Weight loss in early stage of Huntington's disease. Neurology. 2002 Nov 12;59(9):1325-30.[Abstract]
123. Hunt VP, Walker FO. Dysphagia in Huntington's disease. J Neurosci Nurs. 1989 Apr;21(2):92-5.[Abstract]
124. Wheelock VL, Tempkin T, Marder K, et al. Predictors of nursing home placement in Huntington disease. Neurology. 2003 Mar 25;60(6):998-1001.[Abstract]
125. Wesson M, Boileau NR, Perlmutter JS, et al. Suicidal ideation assessment in individuals with premanifest and manifest Huntington disease. J Huntingtons Dis. 2018;7(3):239-49.[Abstract][Full Text]
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131. National Institute for Health and Care Excellence. Urinary incontinence in neurological disease: assessment and management. Oct 2023 [internet publication].[Full Text]
132. Bonelli RM, Wenning GK. Pharmacological management of Huntington's disease: an evidence-based review. Curr Pharm Des. 2006;12(21):2701-20.[Abstract]
133. Novak MJ, Tabrizi SJ. Huntington's disease. BMJ. 2010 Jun 30;340:c3109.[Abstract]
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