Toward a Holistic Perspective of Huntington’s Disease

Huntington’s disease (HD) is a genetic neurodegenerative disorder, most widely recognized by motor symptoms such as chorea. However, other features such as emotional changes, cognitive dysfunction, and social impairments may sometimes be more problematic for those affected and their families. This chapter explains the difficulties associated with HD across motor, cognitive, emotional, and social domains. Evidence from experimental tasks is supplemented by self-report and interview data to help provide an informative and ecologically valid picture of how HD affects everyday life. Many psychiatric or behavioral features appear multidimensional in nature, and the features of HD may interact across domains, such that it can be hard to identify a single root cause of disability when considering performance impairments on assessments thought to measure cognition, emotion, or social behavior. Even motor functions may be impacted by cognitive or sensory deficits. Current diagnostic and treatment aims tend to center on motor and prominent psychiatric symptoms, neglecting the more complex, and sometimes subtle, albeit far-reaching disabilities in cognition, emotional experience, and social interaction. While genetic trials continue to seek an elusive cure, research is needed to best address the existing needs of both patients and their families, via targeted, individualized multidisciplinary therapeutics that focus on helping those already affected by HD to live well.