Objective: To examine the relationship between circadian and sleep disruptions and depressive symptoms and suicidal ideation in people with Huntington’s Disease (PwHD) using scale-based and actigraphy assessments.

Background: In PwHD, preliminary data suggests that sleep disturbances and disruptions in circadian rhythms are linked to some of the psychiatric symptoms in this condition, such as depression, anxiety, and suicidal ideation¹. This presents an intriguing area for the development of novel clinical biomarkers, especially given the high prevalence of depression in PwHD². However, the link between sleep and circadian rhythm disturbances and other symptoms in PwHD remains largely unexplored.

Method: This longitudinal observational study will include 45 participants: 15 PwHD and depression, 15 PwHD without depression, and 15 healthy volunteers. After pre-screening, participants will complete a baseline clinical visit including cognitive assessments (Stroop Colour Test, Symbol Digit Modalities Test, Trail Making Test, Category Fluency, Paced Tapping Test, Tower of London, and HVLT-R), psychiatric assessments (Hospital Anxiety and Depression Scale and Problem Behaviours Assessment–Short), Unified Huntington’s Disease Rating Scale, and sleep questionnaires (Munich Chronotype Questionnaire, Pittsburgh Sleep Quality Index, and HD Sleep Questionnaire). Sleep–wake patterns will also be measured using eight days of home actigraphy. All assessments will be repeated at a one-year follow-up visit. Scale-based data will be linked to available neuroimaging in the form of magnetic resonance imaging.

Results: The hypothesis is that circadian rhythm disruption and instability will show significant associations with increased depressive symptoms and higher levels, as well as greater severity, of suicidal ideation in PwHD. Moreover, we expect to find an association between circadian and sleep disruption and motor and cognitive symptoms in PwHD. It is expected that neuroimaging will reveal volumetric changes in areas commonly affected by depression in PwHD with disrupted circadian patterns, such as the hippocampus and hypothalamus.

Conclusion: Findings from this study might demonstrate potential in targeting circadian and sleep regulation to improve mood, cognition, and overall quality of life in PwHD.

References: 1. Herzog-Krzywoszanska, Radoslawa, and Lukasz Krzywoszanski. “Sleep Disorders in Huntington’s Disease.” Frontiers in Psychiatry, vol. 10, 2019, p. 221.
2. Epping, Eric A., and Jane S. Paulsen. “Depression in the Early Stages of Huntington Disease.” Neurodegenerative Disease Management, vol. 1, no. 5, Oct. 2011, pp. 407–14.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-the-relationship-between-circadian-disruption-depression-and-suicidal-ideation-in-people-with-huntingtons-disease-mind-clock-study/