Abstract Details

Title Changes in Gray Matter Volume Predict Longitudinal Development of Apathy in Huntington’s Disease

Topic Movement Disorders

Presentation(s) S11 - Huntington's Disease, Tardive Dyskinesia, and Functional Movement Disorders (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Objective To identify vulnerability in gray matter volume (GMV) at the whole-brain level that may predict longitudinal apathy development in Huntington’s disease (HD).

Background Apathy, the most prevalent neuropsychiatric symptom in HD, constitutes a significant burden on patients and caregivers. Neurobiologically, the multidimensional nature of apathy results in a complex network of subcortical and cortical territories. However, no study has yet employed a whole-brain approach to examine underlying regional vulnerabilities that sub-serve changes in apathy over time in HD.

Design/Methods Forty-five HD individuals (31 female) were scanned and evaluated for apathy using the short-Problem Behavior Assessment, comprising the baseline cohort. Longitudinal assessment resulted in two sub-groups of 33 participants each, the first with an additional apathy assessment and scan at 18±6mon follow-up, and the second with the baseline scan and longitudinal apathy evaluation over three to six visits (mean inter-assessment duration of 1.13±0.17yr). We performed longitudinal voxel-based morphometry to identify regions where GMV atrophy may describe increasing apathy. We next employed a linear mixed regression model to elucidate whether initial and specific GMV was predictive of apathy symptom development over time at the individual level.

Results Apathy demonstrated a significant relationship with disease burden, acting as a biomarker of disease progression. Utilizing longitudinal VBM, we revealed that increases in apathy severity were significantly related with specific GMV atrophy in the right middle cingulate cortex (rMCC). Furthermore, vulnerability in the rMCC volume at baseline successfully predicted those individuals that would develop apathy symptoms over time better than disease burden alone.

Conclusions This study highlights that individual differences in apathy symptomology in HD may be explained by variability in atrophy and initial vulnerabilities in the rMCC, a region implicated in action-initiation. These findings thus serve to facilitate the early detection of apathy and identification of therapeutic targets in neurodegenerative disease as well as in otherwise healthy populations.

Authors/Disclosures
Audrey E. DePaepe PRESENTER	No disclosure on file
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Saul Martinez-Horta	No disclosure on file
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Jaime Kulisevsky, MD, PhD (Sant Pau Hospital)	Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Esteve. Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Britannia. Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AC Immune. Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bial. Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zambon. Dr. Kulisevsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Britannia.
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