Huntington’s Disease: Symptoms, Treatment, Causes

Huntington’s disease is a neurological (brain) condition that causes involuntary movement, changes to emotions, behavior, and thinking. Huntington’s is a genetic disease that worsens over time. Currently, there’s no cure for Huntington’s, but certain medications, diet changes, and exercise can temporarily manage symptoms.

The symptoms of Huntington’s disease get progressively worse with time. Symptoms begin at ages 35-45 and are widespread, affecting your movement and ability to think.

Early Symptoms

At the beginning, your symptoms may be subtle. About two-thirds of people with Huntington’s disease first notice neurological changes, while others experience psychiatric (mental) changes. Any motor (movement) symptoms may be minor. At this stage in the disease, there won’t be any major changes to your quality of life or routine.

Common early symptoms of Huntington’s disease include:

• Clumsiness
• General forgetfulness
• Agitation or irritability
• Apathy (lack of enthusiasm) or anxiety
• Depression
• Delusions and paranoia 
• Irregular eye movements

Mid-Stage Symptoms

The changes in your brain affect your movement more in the middle stage of Huntington’s disease. These involuntary movements become more frequent, noticeable, and harder to stop. They are constant when awake and worsen with stress. Movement changes continue to worsen in the first 10 years of the disease.

While most people remain fairly independent, symptoms in this stage dramatically affect quality of life, making it difficult to work or maintain a social life.

Symptoms you may experience are:

• Twisting or jerking motions 
• A staggering, swaying walk
• Difficulty with your balance
• Trouble initiating movement
• Slow reaction time
• Trouble controlling speed when moving
• Challenges with speech
• Weight loss
• Increase in appetite
• Outbursts of anger or aggression

Later Symptoms

As the disease continues, the twisting, persistent involuntary movements turn to rigidness and slowed movement. In this stage, people with Huntington’s disease can’t care for themselves or work.

Symptoms in the later stage of Huntington’s disease include:

When you have Huntington’s disease, the cells in your nervous system and brain start to break down. The breakdown of your nervous cells affects your ability to move voluntarily, think clearly, and control your emotions.

Huntington’s disease is an inherited disorder. If your parent has the disease, you have a 50% chance of developing it. A mutation in the gene that makes the huntingtin protein, a protein that plays a role in brain cell function, causes the disease to pass down through families.

Risk Factors

There are several risk factors for Huntington’s disease. If your family member has the disease, you are likely to develop it. People of European descent are more likely to have a family history of Huntington’s disease because certain genes that cause the disease are more common.

A neurologist (a doctor specialized in conditions of the brain and nervous system) can diagnose Huntington’s disease. They may ask you about your family’s history with the disease. The doctor will also likely check how you move, if there are any changes in how you think or learn, and look for any changes in your emotions or behavior.

A healthcare provider will diagnose Huntington’s disease based on the following tests:

• Molecular genetic testing: This test may confirm whether you’re a carrier of Huntington’s based on family history and if you’re likely to have symptoms.
• Imaging: This includes magnetic resonance imaging (MRI), which checks for brain damage caused by the disease.
• Unified Huntington’s disease rating scale (UHDRS): This is a tool your doctor may use to check your movements, behavior, and emotions.

There’s no known cure for Huntington’s disease. Treatment focuses on managing symptoms and improving your quality of life.

Prescription Medications

Several prescription medications are effective for relieving some symptoms of Huntington’s disease. 

Medications primarily focus on improving movement and mood. Medications include:

• Neuroleptics for involuntary movements
• Anti-Parkinson medication for stiffness and difficulty moving
• Psychotropic medication for depression or aggression

Alternative Support

People with Huntington’s disease may need additional support to stay independent for as long as possible. This may include using assistive equipment (tools designed for people with disabilities) for tasks like cooking, bathing, or walking. Some people may also benefit from at-home nursing services.

Diet

Some people may need a specialized diet to help with weight management and reduce their risk of choking. The Mediterranean diet may improve Huntington’s disease symptoms. The diet focuses on eating more fruits, vegetables, nuts, fish, and extra virgin olive oil.

Movement

Remaining active may help with depression and movement. Physical therapy may also help with balance, your ability to breathe,  and raise your walking speed.

You could try:

• Strength training
• Walking on a treadmill or outside
• Yoga, pilates, or tai chi
• Dance
• Swimming

Movement can be as simple as breathing or balance exercises. If you’re able to perform these activities in a group setting, it can reduce the isolation you may experience with this condition.

There’s no way to prevent Huntington’s disease. People with a family history may consider genetic counseling and/or genetic testing:

• Genetic counseling involves meeting with a specialist who reviews your family history, explains your risk, and discusses whether testing is right for you. Counseling helps you understand the benefits, risks, and emotional impact of knowing your genetic status before deciding whether to be tested
• Genetic testing actually analyzes your DNA to see if you carry the specific mutation that causes Huntington’s disease.

When Huntington’s disease reaches later stages, your body becomes more rigid and your movements slow down. You may have a hard time swallowing or speaking. At this point, choking becomes more common.

Some people with Huntington’s disease may develop dementia. Huntington’s disease dramatically diminishes the ability to process information quickly and attention, but it may not necessarily impact memory. This sets Huntington’s-related dementia apart from the other forms of dementia.

While there is no cure, there are ways to manage your symptoms through lifestyle changes, medications, and testing. Researchers are also working to find ways to better support the Huntington’s community.

If you have Huntington’s disease, it’s important to have a support system in place. Reaching out to your doctor for guidance and having support from friends and family can improve your overall quality of life with this condition.