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Cerebellar degeneration correlates with motor symptoms in Huntington disease
Author(s) -
SinghBains Malvindar K.,
Mehrabi Nasim F.,
Sehji Tvesa,
Austria Micah D. R.,
Tan Adelie Y. S.,
Tippett Lynette J.,
Dragunow Mike,
Waldvogel Henry J.,
Faull Richard L. M.
Publication year - 2019
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.25413
Subject(s) - neuropathology , cerebellum , huntington's disease , postmortem studies , basal ganglia , neuroscience , purkinje cell , cerebellar degeneration , psychology , degeneration (medical) , pathology , disease , degenerative disease , medicine , central nervous system disease , central nervous system
Objective Huntington disease (HD) is an autosomal dominant neurodegenerative disorder characterized by variable motor and behavioral symptoms attributed to major neuropathology of mainly the basal ganglia and cerebral cortex. The role of the cerebellum, a brain region involved in the coordination of movements, in HD neuropathology has been controversial. This study utilizes postmortem human brain tissue to investigate whether Purkinje cell degeneration in the neocerebellum is present in HD, and how this relates to disease symptom profiles. Methods Unbiased stereological counting methods were used to quantify the total number of Purkinje cells in 15 HD cases and 8 neurologically normal control cases. Based on their predominant symptoms, the HD cases were categorized into 2 groups: “motor” or “mood.” Results The results demonstrated a significant 43% loss of Purkinje cells in HD cases with predominantly motor symptoms, and no cell loss in cases showing a major mood phenotype. There was no significant correlation between Purkinje cell loss and striatal neuropathological grade, postmortem delay, CAG repeat in the IT15 gene, or age at death. Interpretation This study shows a compelling relationship between Purkinje cell loss in the HD neocerebellum and the HD motor symptom phenotype, which, together with our previous human brain studies on the same HD cases, provides novel perspectives interrelating and correlating the variable cerebellar, basal ganglia, and neocortical neuropathology with the variability of motor/mood symptom profiles in the human HD brain. ANN NEUROL 2019;85:396–405.