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March 22, 2022; 98 (12) Disputes & Debates: Editors' Choice

Reader Response: Timing and Impact of Psychiatric, Cognitive, and Motor Abnormalities in Huntington Disease

Thomas D. Bird, Herwig Lange, Travis Cruickshank, Matthias Dose, Clare Eddy, Mayke Oosterloo, Jane S. Paulsen, Ralf Reilmann, Hugh Rickards, Raymund A.C. Roos, Adolf Weindl
First published March 21, 2022, DOI: https://doi.org/10.1212/WNL.0000000000200161
Thomas D. Bird
(Seattle)
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Herwig Lange
(Muenster, Germany)
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Travis Cruickshank
(Perth, Australia)
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Matthias Dose
(Munich)
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Clare Eddy
(Birmingham, UK)
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Mayke Oosterloo
(Maastricht, the Netherlands)
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Jane S. Paulsen
(Madison, WI)
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Ralf Reilmann
(Muenster, Germany)
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Hugh Rickards
(Birmingham, UK)
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Raymund A.C. Roos
(Leiden, the Netherlands)
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Adolf Weindl
(Munich)
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Reader Response: Timing and Impact of Psychiatric, Cognitive, and Motor Abnormalities in Huntington Disease
Thomas D. Bird, Herwig Lange, Travis Cruickshank, Matthias Dose, Clare Eddy, Mayke Oosterloo, Jane S. Paulsen, Ralf Reilmann, Hugh Rickards, Raymund A.C. Roos, Adolf Weindl
Neurology Mar 2022, 98 (12) 514-515; DOI: 10.1212/WNL.0000000000200161

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McAllister et al.1 made an important contribution to knowledge of Huntington disease (HD), finding that 42% of >6,000 persons with HD have onset of a psychiatric or cognitive symptom before motor symptoms, and these nonmotor symptoms can be functionally debilitating. Their conclusion that “nonmotor symptoms should not be used to make a clinical diagnosis of HD,”1 due to their common frequency in the general population, seems excessively broad and negative. Certainly, one should be cautious and not use depression as a diagnostic factor. However, our clinical experience indicates that psychiatric, behavioral, or cognitive symptoms should play a diagnostic role in patients with a positive genetic test.

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  • © 2022 American Academy of Neurology
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