BACKGROUND: Huntington's disease (HD) is an autosomal dominant neurodegenerative disease caused by a trinucleotide (CAG) repeat expansion in huntingtin (HTT) on chromosome 4. Anticipation can cause longer repeat expansions in children of HD patients. Juvenile Huntington's disease (JHD), defined as HD arising before age 20, accounts for 5-10% of HD cases, with cases arising in the first decade accounting for approximately 1%. Clinically, JHD differs from the predominately choreiform adult onset Huntington's disease (AOHD) with variable presentations, including symptoms such as myoclonus, seizures, Parkinsonism, and cognitive decline. OBJECTIVE: The neuropathologic changes of AOHD are well characterized, but there are fewer reports that describe the neuropathology of JHD. Here we report a case of a six-year-old boy with paternally-inherited JHD caused by 169 CAG trinucleotide repeats who presented at age four with developmental delay, dysarthria, and seizures before dying at age 6. The boy's clinical presentation and neuropathological findings are directly compared to those of his father, who presented with AOHD and 54 repeats. METHODS: A full autopsy was performed for the JHD case and a brain-only autopsy was performed for the AOHD case. Histochemically- and immunohistochemically-stained slides were prepared from formalin-fixed, paraffin-embedded tissue sections. RESULTS: Both cases had neuropathology corresponding to Vonsattel grade 3. The boy also had cerebellar atrophy with huntingtin-positive inclusions in the cerebellum, findings not present in the father. CONCLUSIONS: Autopsies of father and son provide a unique opportunity to compare and contrast the neuropathologic findings of juvenile and adult onset HD while also providing the first immunohistochemical evidence of cerebellar involvement in JHD. Additionally this is the first known report to include findings from peripheral tissue in a case of JHD.
BACKGROUND:Huntington's disease (HD) is an autosomal dominant neurodegenerative disease caused by a trinucleotide (CAG) repeat expansion in huntingtin (HTT) on chromosome 4. Anticipation can cause longer repeat expansions in children of HDpatients. Juvenile Huntington's disease (JHD), defined as HD arising before age 20, accounts for 5-10% of HD cases, with cases arising in the first decade accounting for approximately 1%. Clinically, JHD differs from the predominately choreiform adult onset Huntington's disease (AOHD) with variable presentations, including symptoms such as myoclonus, seizures, Parkinsonism, and cognitive decline. OBJECTIVE: The neuropathologic changes of AOHD are well characterized, but there are fewer reports that describe the neuropathology of JHD. Here we report a case of a six-year-old boy with paternally-inherited JHD caused by 169 CAGtrinucleotide repeats who presented at age four with developmental delay, dysarthria, and seizures before dying at age 6. The boy's clinical presentation and neuropathological findings are directly compared to those of his father, who presented with AOHD and 54 repeats. METHODS: A full autopsy was performed for the JHD case and a brain-only autopsy was performed for the AOHD case. Histochemically- and immunohistochemically-stained slides were prepared from formalin-fixed, paraffin-embedded tissue sections. RESULTS: Both cases had neuropathology corresponding to Vonsattel grade 3. The boy also had cerebellar atrophy with huntingtin-positive inclusions in the cerebellum, findings not present in the father. CONCLUSIONS: Autopsies of father and son provide a unique opportunity to compare and contrast the neuropathologic findings of juvenile and adult onset HD while also providing the first immunohistochemical evidence of cerebellar involvement in JHD. Additionally this is the first known report to include findings from peripheral tissue in a case of JHD.
Authors: Eduardo E Arteaga-Bracho; Maria Gulinello; Michael L Winchester; Nandini Pichamoorthy; Jenna R Petronglo; Alicia D Zambrano; Julio Inocencio; Chirstopher D De Jesus; Joseph O Louie; Solen Gokhan; Mark F Mehler; Aldrin E Molero Journal: Neurobiol Dis Date: 2016-09-10 Impact factor: 5.996
Authors: Amber L Southwell; Simon C Warby; Jeffrey B Carroll; Crystal N Doty; Niels H Skotte; Weining Zhang; Erika B Villanueva; Vlad Kovalik; Yuanyun Xie; Mahmoud A Pouladi; Jennifer A Collins; X William Yang; Sonia Franciosi; Michael R Hayden Journal: Hum Mol Genet Date: 2012-09-21 Impact factor: 6.150
Authors: Ricardo Mouro Pinto; Larissa Arning; James V Giordano; Pedram Razghandi; Marissa A Andrew; Tammy Gillis; Kevin Correia; Jayalakshmi S Mysore; Debora-M Grote Urtubey; Constanze R Parwez; Sarah M von Hein; H Brent Clark; Huu Phuc Nguyen; Eckart Förster; Allison Beller; Suman Jayadaev; C Dirk Keene; Thomas D Bird; Diane Lucente; Jean-Paul Vonsattel; Harry Orr; Carsten Saft; Elisabeth Petrasch-Parwez; Vanessa C Wheeler Journal: Hum Mol Genet Date: 2020-08-29 Impact factor: 6.150