A1 Refereed original research article in a scientific journal

Comparison of mid-age-onset and late-onset Huntington's disease in Finnish patients




AuthorsJussi O. T. Sipilä, Tommi Kauko, Markku Päivärinta, Kari Majamaa

PublisherSPRINGER HEIDELBERG

Publication year2017

JournalJournal of Neurology

Journal name in sourceJOURNAL OF NEUROLOGY

Journal acronymJ NEUROL

Volume264

Issue10

First page 2095

Last page2100

Number of pages6

ISSN0340-5354

eISSN1432-1459

DOIhttps://doi.org/10.1007/s00415-017-8600-2

Web address https://link.springer.com/article/10.1007/s00415-017-8600-2

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/27786782


Abstract
The phenotype of juvenile Huntington's disease (HD) differs clearly from that of adult-onset HD, but information about differences between mid-age-onset HD and late-onset HD (LOHD) is scarce. A national cohort of 206 patients with adult-onset HD was identified using national registries and patient records. LOHD was defined as age >= 60 years at HD diagnosis. Genetic disease burden was assessed using CAG age product (CAP) score. LOHD comprised 25% of the adult-onset HD cohort giving a point prevalence of 2.38/100,000 in the Finnish population at least 60 years of age. The proportion of LOHD out of new HD diagnoses increased from 21% in 1991-2000 to 33% in 2001-2010. At the time of diagnosis, patients with LOHD had 10.4 units (95% CI 4.8-15.9; p = 0.0003) higher CAP scores, more severe motor impairment and slightly more severe functional impairment than that in patients with mid-age-onset HD. There was no difference in the rate of disease progression or survival between LOHD and mid-age-onset patients. The lifespans of deceased patients were shorter in mid-age-onset HD (p < 0.001) and LOHD (p = 0.002) than their life expectancies. Causes of death differed between the two patient groups (p = 0.025). LOHD comprises a quarter of Finnish HD patients and the proportion appears to be increasing. Our results did not reveal differences in the phenotype between mid-age-onset HD and LOHD, but prospective studies are needed.

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