People with Huntington’s disease not only experience physical changes, marked by a loss of movement control, but also cognitive and behavioral changes. 

The behavioral changes vary from patient to patient, but often include apathy, marked by a loss of motivation to start or finish activities. Patients may be irritable or depressed. They may lack inhibition, and do or say things that one would normally find embarrassing.

People with Huntington’s may also be less able to control their emotions, possibly leading to outbursts of screaming, swearing, slamming doors, hitting walls, or the like.

Patterns of behavior can change as the disease progresses. For example, a Huntington’s patient may show less initiative and become less aware of the feelings of others as the disease progresses. In the later disease stages, conversely, irritability and aggression may give way to apathy and disinterest.

How does the disease affect the brain?

Huntington’s disease causes the deterioration and death of cells in certain areas of the brain. Because each area is linked to one or a handful of behaviors, damage to an area leads to changes in the behavior it governs.

One brain region, called the caudate nucleus (or just the caudate), is where some of the heaviest nerve damage occurs in Huntington’s disease. The caudate nucleus can be thought of as an information processing center. It organizes and regulates information it receives from other parts of the brain, and then sends it on to the frontal lobes, which are the executive or command center for many cognitive functions.

The disrupted information flow may make it difficult for people with the disease to organize or prioritize activities, or to multi-task. Damage to the caudate may also impair a patient’s ability to control their feelings, resulting in outbursts over seemingly minor events. 

Coping with behavioral changes

Conditions such as depression, anxiety or irritability in Huntington’s patients may be treated with medications, psychotherapy and counseling.

In addition, caregivers can try different strategies to manage behavioral issues.

For example, because patients can have difficulty starting a conversation or answering a question, caregivers can help by asking simple “yes” or “no” questions and giving a person time to respond.

Breaking down tasks into manageable components and focusing on one thing at a time may also be helpful. Caregivers might want to keep a record of when challenging behaviors occur, so possible triggers can be identified and avoided. Such a tracking system might also show what strategies are working best.

A predictable routine is also thought to be helpful, with regular times set for meals, bedtime and other activities. This reduces the amount of information the patient needs to process, and may reduce anxiety and irritability.

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Huntington’s Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.