More robust and accurate methods are needed to characterize disease extent and progression of Huntington's disease in order to develop disease-modifying therapies. Here we used voxel-based morphometry to evaluate patterns of regional brain atrophy in premanifest and early manifest HD patients relative to healthy controls. We found typical wide-spread sub-cortical and cortical gray matter atrophy in early manifest patients and observed similar though less pronounced atrophy in premanifest patients. As the presence of volume loss prior to symptom onset remains controversial, this work contributes to existing evidence of atrophy initiating as early as the premanifest disease stage.
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