Reduction in Cerebral Atrophy Associated with Ethyl-Eicosapentaenoic Acid Treatment in Patients with Huntington's Disease

Ultra-pure ethyl-eicosapentaenoic acid (ethyl-EPA), a semi-synthetic ethyl ester of eicosapentaenoic acid, is associated with clinical improvement in motor functioning in Huntington's disease. The aim was to determine the extent to which it might reduce the rate of progress of cerebral atrophy. High-resolution cerebral magnetic resonance imaging scans were acquired at baseline, 6 months and 1 year in up to 34 patients with stage I or II Huntington's disease who took part in a randomized, double-blind, placebo-controlled trial of ethyl-EPA. For each subject and each pair of structural images, the two-timepoint brain volume change was calculated in a double-blind manner. Significant group-level reductions in brain atrophy were observed in the head of the caudate nucleus and the posterior thalamus. These findings show that treatment with ethyl-EPA is associated with significant reduction in brain atrophy, particularly in the caudate and thalamus. No other drug tested in Huntington's disease has shown this effect.

Download Full-text

Structural brain changes in patients with Huntington's disease participating in a randomized, double-blind, placebo-controlled trial of ethyl-eicosapentaenoic acid

Annals of General Psychiatry ◽

10.1186/1744-859x-9-s1-s151 ◽

2010 ◽

Vol 9 (S1) ◽

Author(s):

Basant K Puri ◽

Graeme M Bydder ◽

Mehar S Manku ◽

Anthony Clarke ◽

Christian F Beckmann

Keyword(s):

Eicosapentaenoic Acid ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Controlled Trial ◽

Double Blind ◽

Double Blind Placebo ◽

Brain Changes ◽

Structural Brain

Download Full-text

Pridopidine for the treatment of motor function in patients with Huntington's disease (MermaiHD): a phase 3, randomised, double-blind, placebo-controlled trial

The Lancet Neurology ◽

10.1016/s1474-4422(11)70233-2 ◽

2011 ◽

Vol 10 (12) ◽

pp. 1049-1057 ◽

Cited By ~ 105

Author(s):

Justo Garcia de Yebenes ◽

Bernhard Landwehrmeyer ◽

Ferdinando Squitieri ◽

Ralf Reilmann ◽

Anne Rosser ◽

...

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Motor Function ◽

Controlled Trial ◽

Phase 3 ◽

Double Blind ◽

Double Blind Placebo

Download Full-text

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

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-322038 ◽

2020 ◽

Vol 91 (6) ◽

pp. 622-630

Author(s):

Kate L Harris ◽

Wei-Li Kuan ◽

Sarah L Mason ◽

Roger A Barker

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Case Reports ◽

Controlled Trial ◽

Rate Of Change ◽

Control Group ◽

Open Label ◽

Double Blind ◽

Before And After ◽

Rate Of Decline

ObjectivesAlterations 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.MethodsIn 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.ResultsWe 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.ConclusionIn 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.

Download Full-text

Reduction in brain atrophy associated with Ethyl-Eicosapentaenoic Acid in Patients with Huntington's disease

European Psychiatry ◽

10.1016/j.eurpsy.2008.01.305 ◽

2008 ◽

Vol 23 ◽

pp. S196 ◽

Cited By ~ 1

Author(s):

B.K. Puri ◽

G.M. Bydder ◽

A. Clarke ◽

M.S. Manku ◽

C.F. Beckmann

Keyword(s):

Eicosapentaenoic Acid ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Brain Atrophy

Download Full-text

Ethyl-eicosapentaenoic acid (ethyl-EPA) was shown to be associated with a significant reduction in brain atrophy among patients with Huntington's disease

Inpharma Weekly ◽

10.2165/00128413-200816600-00037 ◽

2008 ◽

Vol &NA; (1660) ◽

pp. 11

Author(s):

&NA;

Keyword(s):

Eicosapentaenoic Acid ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Brain Atrophy

Download Full-text

A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington’s disease

Neurology ◽

10.1212/wnl.57.3.397 ◽

2001 ◽

Vol 57 (3) ◽

pp. 397.1-404 ◽

Cited By ~ 214

Author(s):

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Controlled Trial ◽

Coenzyme Q ◽

Functional Decline ◽

Double Blind ◽

Clinical Trial Research ◽

Parallel Group ◽

To Receive ◽

Primary Measure

Objectives: To determine whether chronic treatment with coenzyme Q10 or remacemide hydrochloride slows the functional decline of early Huntington’s disease (HD).Methods: The authors conducted a multicenter, parallel group, double-blind, 2 × 2 factorial, randomized clinical trial. Research participants with early HD (n = 347) were randomized to receive coenzyme Q10 300 mg twice daily, remacemide hydrochloride 200 mg three times daily, both, or neither treatment, and were evaluated every 4 to 5 months for a total of 30 months on assigned treatment. The prespecified primary measure of efficacy was the change in total functional capacity (TFC) between baseline and 30 months. Safety measures included the frequency of clinical adverse events.Results: Neither intervention significantly altered the decline in TFC. Patients treated with coenzyme Q10 showed a trend toward slowing in TFC decline (13%) over 30 months (2.40- versus 2.74-point decline, p = 0.15), as well as beneficial trends in some secondary measures. There was increased frequency of nausea, vomiting, and dizziness with remacemide and increased frequency of stomach upset with coenzyme Q10.Conclusions: Neither remacemide nor coenzyme Q10, at the dosages studied, produced significant slowing in functional decline in early HD.

Download Full-text