Maurage Pierre, Heeren Alexandre, Lahaye Magali, Jeanjean Anne, Guettat Lamia, Verellen-Dumoulin Christine, Halkin Stéphane, Billieux Joël, Constant Eric
Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain.
Department of Pediatric Hematology and Oncology, Saint-Luc University Hospital.
Neuropsychology. 2017 May;31(4):424-436. doi: 10.1037/neu0000321. Epub 2017 Feb 27.
Huntington's disease (HD) is characterized by motor and cognitive impairments including memory, executive, and attentional functions. However, because earlier studies relied on multidetermined attentional tasks, uncertainty still abounds regarding the differential deficit across attentional subcomponents. Likewise, the evolution of these deficits during the successive stages of HD remains unclear. The present study simultaneously explored 3 distinct networks of attention (alerting, orienting, executive conflict) in preclinical and clinical HD.
Thirty-eight HD patients (18 preclinical) and 38 matched healthy controls completed the attention network test, an integrated and theoretically grounded task assessing the integrity of 3 attentional networks.
Preclinical HD was not characterized by any attentional deficit compared to controls. Conversely, clinical HD was associated with a differential deficit across the 3 attentional networks under investigation, showing preserved performance for alerting and orienting networks but massive and specific impairment for the executive conflict network. This indexes an impaired use of executive control to resolve the conflict between task-relevant stimuli and interfering task-irrelevant ones.
Clinical HD does not lead to a global attentional deficit but rather to a specific impairment for the executive control of attention. Moreover, the absence of attentional deficits in preclinical HD suggests that these deficits are absent at the initial stages of the disease. In view of their impact on everyday life, attentional deficits should be considered in clinical contexts. Therapeutic programs improving the executive control of attention by neuropsychology and neuromodulation should be promoted. (PsycINFO Database Record
亨廷顿舞蹈症（HD）的特征为运动和认知障碍，包括记忆、执行和注意力功能。然而，由于早期研究依赖于多因素决定的注意力任务，关于注意力子成分的差异缺陷仍存在诸多不确定性。同样，这些缺陷在HD连续阶段的演变仍不清楚。本研究同时探讨了临床前和临床HD中3个不同的注意力网络（警觉、定向、执行冲突）。
38名HD患者（18名临床前患者）和38名匹配的健康对照完成了注意力网络测试，这是一项综合且基于理论的任务，用于评估3个注意力网络的完整性。
与对照组相比，临床前HD没有任何注意力缺陷。相反，临床HD与所研究的3个注意力网络的差异缺陷相关，表现为警觉和定向网络的表现保留，但执行冲突网络存在大量且特定的损害。这表明在解决与任务相关的刺激和干扰任务无关的刺激之间的冲突时，执行控制的使用受损。
临床HD不会导致整体注意力缺陷，而是导致注意力执行控制的特定损害。此外，临床前HD不存在注意力缺陷表明这些缺陷在疾病的初始阶段不存在。鉴于其对日常生活的影响，在临床环境中应考虑注意力缺陷。应推广通过神经心理学和神经调节改善注意力执行控制的治疗方案。（PsycINFO数据库记录）
