Differential Response to ECT of Psychotic and Affective Symptoms in Huntington’s Disease: A Case Report

Petit, Anne-Cécile; Hozer, Franz; Youssov, Katia; Lavaud, Pierre; Hardy, Patrick; Mouaffak, Fayçal

doi:10.1176/appi.neuropsych.15040084

Cited by 17 publications

(21 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many of the referrals for depression alone were from some of the earliest reports, which lacked a clear description of the referral characteristics. 6,7 The remainder of patients had numerous coexisting factors such as paranoia, delusions and other manifestations of psychosis, including hallucinations 1,2,4,5,[8][9][10][11] . Coexistent motor symptoms were present in 20 patients [1][2][3]5,9,10,[12][13][14][15] (including our case), with chorea being the most commonly used term.…”

Section: Resultsmentioning

confidence: 99%

Electroconvulsive therapy for severe depression, psychosis and chorea in a patient with Huntington's disease: case report and review of the literature

Mowafi

MILLARD

2020

BJPsych Bull

View full text Add to dashboard Cite

Aims and method The psychiatric manifestations of Huntington's disease are myriad and difficult to control. The use of electroconvulsive therapy (ECT) is not commonly considered for this condition. We describe a patient with severe depression, psychomotor retardation, delusions and weight loss who responded to ECT with good control of her symptoms. Results Both our case and the literature appear to confirm the efficacy of ECT in the treatment of depression in Huntington's disease and suggest that other psychiatric manifestations of Huntington's are also responsive. Clinical implications ECT is an effective and safe treatment that should be considered earlier in the course of the disease in cases that show limited response to pharmacological therapy. It should also be considered as an adjunct to medical therapy that may simplify polypharmacy and allow better control in patients with debilitating psychiatric manifestations of the disease. There is limited and conflicting evidence for its efficacy in chorea.

show abstract

Section: Resultsmentioning

confidence: 99%

Electroconvulsive therapy for severe depression, psychosis and chorea in a patient with Huntington's disease: case report and review of the literature

Mowafi

MILLARD

2020

BJPsych Bull

View full text Add to dashboard Cite

show abstract

“…There is a few but encouraging number of reports on the efficacy of ECT for psychiatric disorders in patients with HD. This includes a case series of seven patients demonstrating the use of ECT to improve depressive and psychotic symptoms in patients with HD,15 a case report detailing the use of ECT for agitation in a patient with HD16 and another case report describing its effectiveness in achieving full remission of major depressive disorder symptoms and partial improvement in movement disorder symptoms in a patient with HD but no response to his psychotic symptoms 17. It is possible that ECT remains a safe and effective treatment in the management of psychiatric illnesses in patients with HD, and this area requires further research.…”

Section: Discussionmentioning

confidence: 99%

Worsening of movement disorder following treatment with electroconvulsive therapy in a patient with Huntington’s disease

Abeysundera¹,

Campbell

Sarma

2019

BMJ Case Rep

View full text Add to dashboard Cite

This paper describes a patient who presented with treatment-resistant depression with comorbid anxiety symptoms in the context of Huntington’s disease (HD) and developed worsening movement disorder symptoms after commencing electroconvulsive therapy (ECT) for depression. The aim of this case report is to provide medical practitioners with a greater awareness of the possibility of worsening movement disorders when using ECT for depression in a patient with HD.

show abstract

“…However, our analyses revealed that among HD patients with a history of psychosis, psychotic symptoms preceded the clinical diagnosis of HD in the majority of patients (55.3%). A few studies have pointed out that psychotic symptoms in HD may occur before the clinical diagnosis ( 35 , 36 ). Early psychotic symptoms and inappropriate behaviors have been described in juvenile HD ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

The Clinical Picture of Psychosis in Manifest Huntington's Disease: A Comprehensive Analysis of the Enroll-HD Database

et al. 2018

View full text Add to dashboard Cite

Background: Psychotic symptoms have been under-investigated in Huntington's disease (HD) and research is needed in order to elucidate the characteristics linked to the unique phenotype of HD patients presenting with psychosis.Objective: To evaluate the frequency and factors associated with psychosis in HD.Methods: Cross-sectional study including manifest individuals with HD from the Enroll-HD database. Both conventional statistical analysis (Stepwise Binary Logistic Regression) and five machine learning algorithms [Least Absolute Shrinkage and Selection Operator (LASSO); Elastic Net; Support Vector Machines (SVM); Random Forest; and class-weighted SVM] were used to describe factors associated with psychosis in manifest HD patients.Results: Approximately 11% of patients with HD presented history of psychosis. Logistic regression analysis indicated that younger age at HD clinical diagnosis, lower number of CAG repeats, history of [alcohol use disorders, depression, violent/aggressive behavior and perseverative/obsessive behavior], lower total functional capacity score, and longer time to complete trail making test-B were associated with psychosis. All machine learning algorithms were significant (chi-square p < 0.05) and capable of distinguishing individual HD patients with history of psychosis from those without a history of psychosis with prediction accuracy around 71–73%. The most relevant variables were similar to those found in the conventional analyses.Conclusions: Psychiatric and behavioral symptoms as well as poorer cognitive performance were related to psychosis in HD. In addition, psychosis was associated with lower number of CAG repeats and younger age at clinical diagnosis of HD, suggesting that these patients may represent a unique phenotype in the HD spectrum.

show abstract

Differential Response to ECT of Psychotic and Affective Symptoms in Huntington’s Disease: A Case Report

Cited by 17 publications

References 11 publications

Electroconvulsive therapy for severe depression, psychosis and chorea in a patient with Huntington's disease: case report and review of the literature

Electroconvulsive therapy for severe depression, psychosis and chorea in a patient with Huntington's disease: case report and review of the literature

Worsening of movement disorder following treatment with electroconvulsive therapy in a patient with Huntington’s disease

The Clinical Picture of Psychosis in Manifest Huntington's Disease: A Comprehensive Analysis of the Enroll-HD Database

Contact Info

Product

Resources

About