Huntington’s disease is a monogenetic, neurodegenerative movement disorder that is amenable to predictive genetic testing. Here, we investigated whether longitudinal diffusion-weighted imaging of the basal ganglia could be used to detect early microstructural changes in participants with presymptomatic Huntington’s disease (preHD). We found the first results showing significant longitudinal changes in the microstructure of the basal ganglia within a preclinical HD population. We further showed that, while FA and MD might be less sensitive to longitudinal changes than volumetric measures, they provide mechanistic insights into the underlying physiopathological process that are complementary to the monotonic, non-specific changes in the volume of the basal ganglia.
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