Dell'Angelica Derek, Singh Karan, Colwell Christopher S, Ghiani Cristina A
Department of Psychiatry and Biobehavioural Sciences, Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
Biomedicines. 2024 Aug 6;12(8):1777. doi: 10.3390/biomedicines12081777.
Huntington's Disease (HD) is a neurodegenerative disorder caused by an autosomal-dominant mutation in the huntingtin gene, which manifests with a triad of motor, cognitive and psychiatric declines. Individuals with HD often present with disturbed sleep/wake cycles, but it is still debated whether altered circadian rhythms are intrinsic to its aetiopathology or a consequence. Conversely, it is well established that sleep/wake disturbances, perhaps acting in concert with other pathophysiological mechanisms, worsen the impact of the disease on cognitive and motor functions and are a burden to the patients and their caretakers. Currently, there is no cure to stop the progression of HD, however, preclinical research is providing cementing evidence that restoring the fluctuation of the circadian rhythms can assist in delaying the onset and slowing progression of HD. Here we highlight the application of circadian-based interventions in preclinical models and provide insights into their potential translation in clinical practice. Interventions aimed at improving sleep/wake cycles' synchronization have shown to improve motor and cognitive deficits in HD models. Therefore, a strong support for their suitability to ameliorate HD symptoms in humans emerges from the literature, albeit with gaps in our knowledge on the underlying mechanisms and possible risks associated with their implementation.
亨廷顿舞蹈症(HD)是一种由亨廷顿基因的常染色体显性突变引起的神经退行性疾病,其表现为运动、认知和精神衰退三联征。HD患者常出现睡眠/觉醒周期紊乱,但昼夜节律改变是其病因病理的内在因素还是结果仍存在争议。相反,众所周知,睡眠/觉醒障碍可能与其他病理生理机制共同作用,会加重疾病对认知和运动功能的影响,给患者及其照顾者带来负担。目前,尚无治愈方法来阻止HD的进展,然而,临床前研究正在提供确凿证据,表明恢复昼夜节律的波动有助于延缓HD的发病并减缓其进展。在此,我们重点介绍基于昼夜节律的干预措施在临床前模型中的应用,并深入探讨其在临床实践中的潜在转化应用。旨在改善睡眠/觉醒周期同步性的干预措施已显示可改善HD模型中的运动和认知缺陷。因此,尽管我们对其潜在机制以及实施过程中可能存在的风险了解不足,但文献中有力支持了这些干预措施适用于改善人类HD症状的观点。