Social cognition profile in early Huntington disease: Insight from neuropsychological assessment and structural neuroimaging

Background Huntington's disease (HD) is traditionally associated with motor, cognitive, and neuropsychiatric symptoms. Recent observations suggest that disturbances in social cognition may feature prominently in HD, potentially contributing to behavioral challenges.Objective This study aims to explore the onset and neural mechanisms underlying social cognition disturbances in HD, which are not yet well understood despite increasing recognition of these symptoms.Methods This study compared 20 individuals in the early stages of HD with 20 healthy controls across a range of cognitive tests, in-depth social cognition assessments, and structural MRI evaluations.Results The findings revealed alterations in various aspects of social cognition, particularly cognitive and affective Theory of Mind, in the early HD group. Some of these alterations correlated with the neurodegeneration of the striatum (caudate), suggesting that social cognition deficits may serve as early indicators of disease progression.Conclusions This research underscores the importance of integrating social cognition evaluations into the clinical assessment of HD and hints at a complex interplay between these deficits and the broader neuropsychological impact of the disease. The results thus advocate for a more holistic approach to understanding and managing HD, considering the potential interdependencies between social cognition and other cognitive functions.