Antidopaminergic treatment is associated with reduced chorea and irritability but impaired cognition in Huntington's disease (Enroll-HD).

Szczegóły
Abstrakt

Tytuł:: Antidopaminergic treatment is associated with reduced chorea and irritability but impaired cognition in Huntington's disease (Enroll-HD).
Autorzy:: Harris KL; Department of Clinical Neurosciences, The University of Cambridge, Cambridge, United Kingdom .
Kuan WL; Department of Clinical Neurosciences, The University of Cambridge, Cambridge, United Kingdom.
Mason SL; Department of Clinical Neurosciences, Cambridge Centre for Brain Repair, Cambridge, Cambridgeshire, United Kingdom.
Barker RA; Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, and MRC-WT Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom.
Źródło:: Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2020 Jun; Vol. 91 (6), pp. 622-630. Date of Electronic Publication: 2020 Mar 30.
Typ publikacji:: Journal Article; Observational Study; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: London : BMJ Publishing Group
Original Publication: London : British Medical Association
MeSH Terms:: Chorea/*drug therapy
Cognition/*drug effects
Cognition Disorders/*chemically induced
Dopamine Antagonists/*therapeutic use
Huntington Disease/*drug therapy
Irritable Mood/*drug effects
Adult ; Aged ; Databases, Factual ; Dopamine Antagonists/administration & dosage ; Dopamine Antagonists/adverse effects ; Female ; Humans ; Male ; Middle Aged
References:: J Neurol Neurosurg Psychiatry. 2001 Sep;71(3):310-4. (PMID: 11511702)
Front Neurol. 2019 Jul 03;10:710. (PMID: 31333565)
PLoS One. 2017 Mar 21;12(3):e0173872. (PMID: 28323838)
J Am Coll Cardiol. 2017 Jan 24;69(3):345-357. (PMID: 28104076)
Curr Pharm Des. 2006;12(20):2473-86. (PMID: 16842171)
Brain. 2015 Jul;138(Pt 7):1907-18. (PMID: 25953777)
Brain. 1996 Oct;119 ( Pt 5):1633-45. (PMID: 8931586)
Psychosomatics. 2006 Jan-Feb;47(1):70-2. (PMID: 16384811)
Prog Neurobiol. 2002 May;67(1):53-83. (PMID: 12126656)
Schizophr Res. 2006 Jul;85(1-3):222-31. (PMID: 16679001)
N Engl J Med. 2000 Sep 28;343(13):973-4. (PMID: 11012330)
J Huntingtons Dis. 2015;4(2):131-40. (PMID: 26397894)
PeerJ. 2018 Dec 7;6:e6038. (PMID: 30568856)
Neuropsychiatry Neuropsychol Behav Neurol. 2001 Jan;14(1):69-72. (PMID: 11234911)
J Neuropathol Exp Neurol. 1998 May;57(5):369-84. (PMID: 9596408)
Int J Geriatr Psychiatry. 2019 May;34(5):657-665. (PMID: 30672026)
Ann Neurol. 1997 May;41(5):689-92. (PMID: 9153534)
J Neurophysiol. 1989 Apr;61(4):799-813. (PMID: 2723721)
Neuropsychiatr Dis Treat. 2007;3(5):545-51. (PMID: 19381278)
Neuropsychiatry Neuropsychol Behav Neurol. 2001 Oct-Dec;14(4):219-26. (PMID: 11725215)
J Neurol Neurosurg Psychiatry. 2015 Oct;86(10):1143-9. (PMID: 25515501)
JAMA. 2016 Jul 5;316(1):40-50. (PMID: 27380342)
Neuroimage. 2006 May 1;30(4):1332-9. (PMID: 16439159)
Parkinsonism Relat Disord. 2016 Apr;25:58-64. (PMID: 26898966)
J Neurol Neurosurg Psychiatry. 2007 Sep;78(9):939-43. (PMID: 17178819)
Ann Neurol. 2004 Jun;55(6):879-83. (PMID: 15174024)
J Neurol Neurosurg Psychiatry. 1984 Aug;47(8):844-7. (PMID: 6236286)
Biol Psychiatry. 2011 Jun 15;69(12):e113-25. (PMID: 21531388)
J Clin Psychopharmacol. 1999 Jun;19(3):209-21. (PMID: 10350027)
Mov Disord Clin Pract. 2016 Jun 22;4(2):212-224. (PMID: 30363395)
Brain. 1997 Dec;120 ( Pt 12):2207-17. (PMID: 9448576)
Cortex. 2013 May;49(5):1292-303. (PMID: 22721958)
J Clin Psychopharmacol. 2001 Apr;21(2):245-6. (PMID: 11270928)
Neuropsychologia. 2015 Apr;70:80-9. (PMID: 25700742)
Parkinsonism Relat Disord. 2019 Mar;60:111-117. (PMID: 30201420)
Neurology. 1985 Oct;35(10):1450-4. (PMID: 3162109)
Curr Opin Neurobiol. 1993 Dec;3(6):950-7. (PMID: 8124079)
Neurology. 2006 Feb 14;66(3):366-72. (PMID: 16476934)
Int J Neuropsychopharmacol. 2017 Dec 1;20(12):1036-1046. (PMID: 29106542)
Ann Clin Psychiatry. 2008 Jan-Mar;20(1):1-3. (PMID: 18297579)
Grant Information:: MC_PC_12009 United Kingdom MRC_ Medical Research Council; MC_PC_17230 United Kingdom MRC_ Medical Research Council; MR/S005528/1 United Kingdom MRC_ Medical Research Council; 203151/Z/16/Z United Kingdom WT_ Wellcome Trust
Substance Nomenclature:: 0 (Dopamine Antagonists)
Entry Date(s):: Date Created: 20200402 Date Completed: 20201109 Latest Revision: 20230201
Update Code:: 20240105
PubMed Central ID:: PMC7279191
DOI:: 10.1136/jnnp-2019-322038
PMID:: 32229581
: Czasopismo naukowe

Objectives: Alterations in dopamine neurotransmission underlie some of the clinical features of Huntington's disease (HD) and as such are a target for therapeutic intervention, especially for the treatment of chorea and some behavioural problems. However, justification for such an intervention is mainly based on case reports and small open label studies and the effects these drugs have on cognition in HD remain unclear.
Methods: In this study, we used the Enroll-HD observational database to assess the effects of antidopaminergic medication on motor, psychiatric and cognitive decline, over a 3-year period. We first looked at the annual rate of decline of a group of HD patients taking antidopaminergic medication (n=466) compared with an untreated matched group (n=466). The groups were matched on specified clinical variables using propensity score matching. Next, we studied a separate group of HD patients who were prescribed such medications part way through the study (n=90) and compared their rate of change before and after the drugs were introduced and compared this to a matched control group.
Results: We found that HD patients taking antidopaminergic medication had a slower progression in chorea and irritability compared with those not taking such medications. However, this same group of patients also displayed significantly greater rate of decline in a range of cognitive tasks.
Conclusion: In conclusion we found that antidopaminergic treatment is associated with improvements in the choreic movements and irritability of HD but worsens cognition. However, further research is required to prospectively investigate this and whether these are causally linked, ideally in a double-blind placebo-controlled trial.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Informacja