Objective: To investigate perceptual decision making and reflexion impulsivity in preclinical and manifest patients with Huntington’s disease (HD).

Background: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disease caused by an expansion of CAG trinucleotides on chromosome 4 and is characterized by motor, cognitive, behavioural abnormalities, and mood disturbances. Although cognitive dysfunction is part of the core clinical syndrome of HD impulsivity and decision making has not been systematically studied in patients with HD and preclinical HD mutation carriers.

Methods: A total of 90 non demented subjects (25 manifest HD patients, 26 preclinical patients, and 39 healthy controls) were included in this study. We used the Beads task to assess reflection impulsivity and irrational decision making.

Results: HD patients made decisions with a higher degree of uncertainty than healthy controls and preclinical mutation carriers (both p-values < 0.001).There was, however, no difference between mutation carriers and healthy controls (p = 1.0). Furthermore, HD patients made more choices against the evidence than mutation carriers and healthy controls (both p-values <0.001). Again, there were no differences between the mutation carriers and the healthy controls (all p-values = 1.0).

Conclusions: We found that HD patients jumped to conclusions, gathered significantly less evidence and made more irrational decisions than all other groups. This behavioural pattern has been also found in patients with behavioural addictions and substance abuse. In contrast, there was no difference between preclinical HD mutation carriers and controls. Our data suggest that reflection impulsivity affects subjects with manifest HD but is not present in preclinical HD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/decision-making-in-huntingtons-disease/