Rate of caudate atrophy in presymptomatic and symptomatic stages of Huntington's disease

Previous research by our group demonstrated a longitudinal change in caudat e volume for symptomatic subjects with Huntington's disease (HD), and sugge sted that volume of the caudate may be a useful outcome measure for therape utic studies in symptomatic patients. The current study was designed to det ermine whether longitudinal change in caudate atrophy could be documented i n presymptomatic carriers of the HD gene mutation, and to compare rate of c hange in these subjects with rate of change in mildly and moderately affect ed symptomatic patients. We measured caudate volumes on serial magnetic res onance image scans from 30 patients at three stages of HD: 10 presymptomati c; 10 with mild symptoms, as indicated by scores on the Quantified Neurolog ical Exam (QNE) less than or equal to 35; and 10 with moderate symptoms (QN E >45). The mean interscan interval was 36 months. When analyzed separately , both symptomatic groups and the presymptomatic group demonstrated a signi ficant change in caudate volume over time. Amount of change over time did n ot differ significantly among the three groups. We conclude that change in caudate volume may be a useful outcome measure for assessing treatment effe ctiveness in both presymptomatic and symptomatic subjects.