Structural MRI Correlates of Anosognosia in Huntington’s Disease

• Published in: Journal of Huntington's disease Vol. 13; no. 3; pp. 315 - 320
• Main Authors: Hinkle, Jared T., Wildermuth, Erin, Tong, Xiao J., Ross, Christopher A., Bang, Jee
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2024; IOS Press BV
• Subjects: Adult; Agnosia - diagnostic imaging; Agnosia - etiology; Agnosia - pathology; Anatomy; Basal forebrain; Brain - diagnostic imaging; Brain - pathology; Correlation analysis; Cortex (cingulate); Cortex (motor); Female; Forebrain; Globus pallidus; Globus Pallidus - diagnostic imaging; Globus Pallidus - pathology; Humans; Huntington Disease - diagnostic imaging; Huntington Disease - pathology; Huntington's disease; Huntingtons disease; Magnetic Resonance Imaging; Male; Middle Aged; Neurodegeneration; Putamen; Substantia nigra; PREDICT-HD; TRACK-HD; Huntington’s disease; FrSBe; Anosognosia; globus pallidus
• ISSN: 1879-6397; 1879-6397; 1879-6400
• DOI: 10.3233/JHD-240010

Background: Anosognosia, or unawareness of symptoms, is common in Huntington’s disease (HD), but the neuroanatomical basis of this is unknown. Objective: To identify neuroanatomical correlates of HD anosognosia using structural MRI data. Methods: We leveraged a pre-processed dataset of 570 HD participants across the well-characterized PREDICT-HD and TRACK-HD cohort studies. Anosognosia index was operationalized as the score discrepancies between HD participants and their caregivers on the Frontal Systems Behavior Scale (FrSBe). Results: Univariate correlation analyses identified volumes of globus pallidus, putamen, caudate, basal forebrain, substantia nigra, angular gyrus, and cingulate cortex as significant correlates of anosognosia after correction for multiple comparisons. A multivariable model constructed with stepwise regression that included volumetric data showed globus pallidus volume alone explained more variance in anosognosia severity than motor impairment or CAP score alone. Conclusions: Anosognosia appears to be related to degeneration affecting both cortical and subcortical areas. Globus pallidus neurodegeneration in particular appears to be a key process of importance.