Compensation in preclinical Huntington's Disease: evidence from the Track-On HD study

Stefan Kloppel, Sarah Gregory, Elisa Scheller, Lora Minkova, Adeel Razi, Alexandra Durr, Raymund A C Roos, Blair R Leavitt, Marina Papoutsi, Bernhard G Landwehrmeyer, Ralf Reilmann, Beth Borowsky, Hans J Johnson, James A Mills, Gail N Owen, Julie C Stout, Rachael I Scahill, Jeffrey D Long, Geraint Rees, Sarah J TabriziAllison Coleman, Joji Decolongon, Mannie Fan, Tamara Koren, Celine Jauffret, Damian Justo, Stephane Lehericy, Kevin Nigaud, Romain Valabregue, Anne Schoonderbeek, Ellen P 't Hart, Helen Crawford, Eileanoir B Johnson, Joy Read, C Berna, Davina Hensman Moss, David O Craufurd, N Weber, Izelle Labuschagne, Michael Orth

Research output: Contribution to journalArticleResearchpeer-review

70 Citations (Scopus)


Background: Cognitive and motor task performance in premanifest Huntington s disease (HD) gene-carriers is often within normal ranges prior to clinical diagnosis, despite loss of brain volume in regions involved in these tasks. This indicates ongoing compensation, with the brain maintaining function in the presence of neuronal loss. However, thus far, compensatory processes in HD have not been modeled explicitly. Using a new model, which incorporates individual variability related to structural change and behavior, we sought to identify functional correlates of compensation in premanifest-HD gene-carriers. Methods: We investigated the modulatory effects of regional brain atrophy, indexed by structural measures of disease load, on the relationship between performance and brain activity (or connectivity) using task-based and resting-state functional MRI. Findings: Consistent with compensation, as atrophy increased performance-related activity increased in the right parietal cortex during a working memory task. Similarly, increased functional coupling between the right dorsolateral prefrontal cortex and a left hemisphere network in the resting-state predicted better cognitive performance as atrophy increased. Such patterns were not detectable for the left hemisphere or for motor tasks. Interpretation: Our findings provide evidence for active compensatory processes in premanifest-HD for cognitive demands and suggest a higher vulnerability of the left hemisphere to the effects of regional atrophy
Original languageEnglish
Pages (from-to)1420 - 1429
Number of pages10
Issue number10
Publication statusPublished - 2015

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