Functional brain correlates of neuropsychiatric symptoms in presymptomatic Huntington's disease: The IMAGE-HD study

Neuropsychiatric disturbances are common in Huntingtons Disease (HD) and have been observed in genepositive individuals several years prior to the onset of motor symptoms. The neural mechanism underpinning the development of neuropsychiatric problems in HD remain unclear. Objective: To investigate whether neural activity during working memory is associated with neuropsychiatric symptoms in premanifest Huntingtons Disease. Methods: functional magnetic resonance imaging (fMRI) data from Pre-HD far from onset (pre-HDfar , n = 18), pre-HD close to onset (pre-HDclose , n = 17), and controls (n = 32) were analysed. Correlations were performed between fMRI activity in three regions of interest [bilateral dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC)] and neuropsychiatric scores. Results: In the pre-HDclose group, increased symptoms of obsessive compulsion and depression were associated with decreased blood-oxygen-level-dependent (BOLD) fMRI activity in the right DLPFC and ACC during 1-BACK and 2-BACK working memory conditions. In the pre-HDfar group increased symptoms of depression was associated with decreased right DLPFC BOLD fMRI activity during 2-BACK working memory only. Conclusions: The findings suggest that association between neuropsychiatric function and fMRI activity is more readily detectable at higher working memory loads, and becomes more pronounced in those closer to onset.