Why Certain Symptoms Occur In HD
Movement Disorder Medicines
Anxiety-Antidepressant Medications
Antidepressant Adverse Effects
Warnings~Adolescents Under 25
Sertraline ~Zoloft
Anti-psychotic Medications
Prozac, Luvox, Paxil, Zoloft & Celexa
Olanzipine & Risperidone and blood tests
Cutting Prescriptions
Sites That Help the Medicine Go Down
Vitamins & Minerals
Why Certain Symptoms Occur In HD
Tests Commonly Used -Neuropsychological Examination
Symptom vs Medication
Speech & Swallowing Difficulties~Lynn Rhodes
Swallowing Problem Warning Signs
Swallowing Tests
Nutrition and HD~Anna Gaba (Recipes)
HD & Diet~HSA Fact Sheet 7
HD~Swallowing & Nutrition
Weight Gain
5 Levels Difficulty In Swallowing
Feeding Tube~Advanced Stages of HD
Feeding Tube~Jean Miller
One more word on feeding tubes
PEG Tubes and baby foods
Feeding Tubes-More Info
HD~Falling/Safety Issues
HD~Cognitive/Decision Making/Impulsivity
Cognitive-Short Tips
Denial of HD
HD~Irritability/Temper Outbursts
Managing behavioral problems
Depression - Treatment Resistant Patient
HD~Mania, Obsessive Disorders
HD~Hallucinations & Psychosis
HD~Rigidity, Spasticity, and Dystonia
Adaptive Products
Teen Suicide~Let's Talk Facts
Stress Explained-Easy/Fun Format
How To Help Someone Chronically Ill
Legal Planning for Incapacity
Out-of-Home Care Options FAQ
Preparing for Emergencies
The Brain - How it Functions (in understandable language)
The Huntington's Society of Canada wrote:
The website you sent me was the correct one for the article on the brain, and our Director
of Communications is now going to try to get permission for us to use it with our HD families.
I think that it's really good, and it will be helpful for kids as well as for adults who do not
have a medical background.  So thank you very much for all your help!
This article is from  the HDSA Arizona Chapter website:
From discussions, we've seen more "sensorary" functions such as itching, hot and/cold,
noises/hearing. etc as directly related to HD symptoms.Others, such as Kelly in later stage, had occipital/vision changes or sensitivity to light.
Mayo Clinic Scottsdale
13400 E. Shea Boulevard  
Scottsdale, Arizona 85259

Why Do Certain Symptoms Occur In Huntington's Disease (HD)
- A Tour Through the Brain.
John N. Caviness, M.D.
Medical Advisor to HDSA-AZ board
Mayo Clinic Scottsdale
April 11, 2001

George Huntington described Huntington's disease (HD) is 1872.  He took note of the involuntary
movement (chorea) that occurred in families.  Family members seemed to inherit the disorder in a
certain pattern that we now call autosomal dominant.  These movements caused decreased
control of voluntary movements and balance.  In addition, the mental abilities of people with HD
Today, we know that HD comes from the abnormal genetic code in a certain location
on chromosome four.  We hope that this knowledge will allow a cure for HD to be
found.  Even so, why do certain symptoms occur in HD?  It is important to have an
understanding  of why these symptoms occur in people with HD.  Recognizing the
symptom allows one to better  adapt and deal with it.
The brain sits in the skull and has a jelly-like consistency.  Over its surface, there are many folds
and crevices. Multiple folds are grouped together under the term, "lobe."  The lobes of the brain
have names and take on certain functions.  These functions are not completely understood and
often have more than one location, but some general statements can be made:
Frontal lobe                        Concentration, Judgement, Planning, Motor  Coordination
Parietal lobe                       Sensory function, perception, recognition of  space relations
Temporal lobe                    Memory, emotional control, language
Occipital lobe                    Vision
In HD, there is a tendency for the frontal and temporal lobes to be affected.  Nothing is absolute
and each case is different.  However, after realizing that the frontal and temporal lobes experience
major problems with executing their function in HD, some common symptoms in HD become
more understandable. 
Some of the common symptoms in HD are coordination problems, concentration difficulties, less
judgement, planning difficulties, decrease memory ability, emotional withdrawal, and less
emotional control.  These symptoms are at least partially tied to dysfunction of the frontal and
temporal lobes. 
Sensory function, perception of touch and recognition of space relations are usually not affected
or minimally involved in HD.
Deeper in the brain, below the lobes, are places referred to subcortical nuclei.  These centers
have to do with motor execution and control, among other functions.  These are also affected in
HD and their dysfunction can create involuntary movements, abnormal swallowing, balance
problems, and speech difficulty.
Of course, the best way to treat a disease is to treat its basic cause.  This is the approach being
taken by many researchers in HD.  Studies, such as PHAROS which is an observational study for
persons at-risk for the HD gene, is being performed at Mayo Clinic Scottsdale as part of the
Huntington's Disease Study group, will help attain that goal.
NOTE:    To find out more about the HD Study Group and on-going
clinical trials, go to
Following is from the Blake Medical Center
On the left hand side, under "Family & Friends" click on "Virtual Body"
The Human Brain
Human Heart
Digestive Tract
The  Human Brain
The human brain controls every action, thought, and process of the body; but what makes the brain function? 
A network of nearly one hundred billion individual cells called neurons, or nerve cells, allows the brain to think,
remember, hear a symphony, enjoy a sunset, love and imagine.  Neurons tell our bodies to move, breathe,
and create.  The amazing network of neurons that forms the human brain makes it the most complicated brain
on the planet.
This system is based on electrochemical impulses.  Like a computer, these impulses travel along circuits.  Unlike
computers, these signals are created chemically.  These chemical transmissions are called neurotransmitters,
and they are responsible for the incredibly rapid communication between neurons.  The speed and accuracy
of these neurotransmissions are what let us react to the world around us, and ultimately, to survive.
Faulty functioning of this communication between neurons may be responsible for all sorts of illnesses, from
depression to Parkinson's disease.  An overabundance of neurotransmitters has been linked to schizophrenia. 
Various medications that increase or decrease neurotransmitters are now available and have been shown to
be effective in treating some of these conditions.

The basic nutrient employed by neurons is glucose, a simple sugar.  In order to metabolize the glucose, neurons
need lots of oxygen.  While the brain is only two percent of the body's weight, it uses twenty percent of its
oxygen.  Because the liver actively makes glucose from carbohydrates, fats and sugars, there is rarely any
shortages of glucose for the brain.  However, the brain needs Thiamine or vitamin B1 in order to process glucose.
Neurotransmitters, the chemical messengers of the brain are produced by the various nutrients in our food. 
These neurotransmitters include serotonin, epinephrine, norepinephrine, dopamine and acetylcholine.  The
brain can continue processing these even if a person does not eat for a while, but nutrition contributes greatly
to one's brain functions.
Milk and cauliflower contain choline, which helps produce acetylcholine, which aids in the transmission of impulses. 
Lecithin, the substance that helps to make choline, can be found in soybeans, peanuts, egg yolks, butter and liver.
Proteins contain amino acids such as phenylaianine and tyrosine, which help form such neurotransmitters as
epinephrine, norepinephrine and dopamine.  These influence our emotions, and too much epinephrine can cause
excitability, irritability and anxiety.
Tryptophan, the amino acid responsible for the production of serotonin, is abundant in turkey, as well as in
other meats and fish.  Serotonin is thought to be the neurotransmitter responsible for perception and sleep
function.  In order to increase the amount of tryptophan received by the brain, one must combine carbohydrates
and proteins.  This is because carbohydrates increase the body's release of insulin, which transports other
amino acids from the blood into cells, leaving a higher concentration of tryptophan in the blood for the brain.
Voluntary & Involuntary Brain Functions
In addition to allowing us to make deliberate decisions, the brain controls those body functions over which we
have no control.  The lower area of the brain known as the medulla controls heart rate, breathing, vomiting,
salivation, coughing and other automatic functions.  These automatic functions are a great advantage.  Imagine
having to tell yourself to breathe, or tell your heart to beat!  Because of the importance of these functions,
damage to this area of the brain and spinal chord is very dangerous.
Cerebral Cortex
Contains about 85% of the nerve cells in the brain and the human cortex has become increasingly complex in
comparison to other species.  It is divided into Temporal, Frontal, Parietal and Occipital lobes.  The cerebral
cortex contains the gray matter of the brain and the prefrontal area of the cerebral cortex comprises a larger
portion of the human brain then the brains of other species.  Yet, the prefrontal cortex develops more slowly
in humans than it does in monkeys.  Large numbers of neuronal connections develop in the human brain
between 7 and 12 months.
Frontal Lobe
The frontal lobe controls planning of movements and some aspects of memory. 
Parietal Lobe
Controls body sensations like the sense of touch.
Occipital Lobe
Controls visual functions.
Temporal Lobe
Controls hearing and some advanced visual processing.

"suggests that the right frontal lobe "is the glue holding together a sense of self."
Hence damages to that area of the brain in HD could contribute to personality changes?

Brain area holding 'sense of self' found

NEW YORK, Sep 24 2001 (Reuters Health) - "I think, therefore I am" may be a sound philosophy.
But if a certain part of the brain isn't working right, you might not be sure who you are,
scientists have found.

They say the right frontal lobe appears to be key in holding on to a sense of self--from political
persuasions to fashion sense. In a study of men and women with damage to that brain area,
they found that six out of seven went through profound personality and lifestyle changes.

University of California researchers studied 72 patients with frontotemporal dementia (FTD),
a type of mental decline that affects the brain's frontal and temporal lobes. When the left side
of the brain is more affected than the right, patients have trouble with language. When the
problem is predominantly on the right, patients' behavior is often disturbed.

"Remarkably," the authors write in the September 11th issue of Neurology, "we have observed that
patients with predominantly right frontal FTD often evolve dramatic changes in well-established
patterns of religion, political philosophy, dress and style."

In this study, seven of the 72 patients had predominantly right frontal FTD. Six of these patients
--but only one of the remaining patients--showed a strong "change in self."

Religious conversions, shifts in morals, wardrobe makeovers and turnarounds in temperament were
among the changes, according to Dr. Bruce L. Miller, of the University of California, San Francisco,
and his colleagues.

One woman in her 50s developed an alternate personality she called "Jenny"--a person she described
as "irritable, aggressive and domineering." Another woman shifted her political inclinations in her
60s, adopting an animal-rights, anti-conservative stance.

Another woman who had always been "meticulously health conscious" took to sodas and junk food and
starting smoking. And a conservative businessman sold his business at age 40, took odd jobs from
which he was repeatedly fired, and shed his "puritanical" views on sex for more "experimental" ones.

All of this, according to Miller's team, suggests that the right frontal lobe "is the glue holding together
a sense of self."

They note that patients with FTD on the left side tend to lose their comprehension of words like
"Catholic" or "Republican," but they do not shed such identities.

While knowledge of who we are is stored throughout the brain, the report indicates, the right frontal
lobe appears to contain the "activator" for using and maintaining that knowledge.

SOURCE: Neurology 2001 September.