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. 2015 Dec 18;5(3):517-29.
doi: 10.1159/000441942. eCollection 2015 Sep-Dec.

Non-Verbal and Verbal Fluency in Prodromal Huntington's Disease

Tarja-Brita Robins Wahlin  1 , Mary A Luszcz  2 , Åke Wahlin  3 , Gerard J Byrne  4
Affiliations

Non-Verbal and Verbal Fluency in Prodromal Huntington's Disease

Tarja-Brita Robins Wahlin et al. Dement Geriatr Cogn Dis Extra. .

Abstract

Background: This study examines non-verbal (design) and verbal (phonemic and semantic) fluency in prodromal Huntington's disease (HD). An accumulating body of research indicates subtle deficits in cognitive functioning among prodromal mutation carriers for HD.

Methods: Performance was compared between 32 mutation carriers and 38 non-carriers in order to examine the magnitude of impairment across fluency tasks. The predicted years to onset (PYTO) in mutation carriers was calculated by a regression equation and used to divide the group according to whether onset was predicted as less than 12.75 years (HD+CLOSE; n = 16) or greater than 12.75 years (HD+DISTANT; n = 16).

Results: The results indicate that both non-verbal and verbal fluency is sensitive to subtle impairment in prodromal HD. HD+CLOSE group produced fewer items in all assessed fluency tasks compared to non-carriers. HD+DISTANT produced fewer drawings than non-carriers in the non-verbal task. PYTO correlated significantly with all measures of non-verbal and verbal fluency.

Conclusion: The pattern of results indicates that subtle cognitive deficits exist in prodromal HD, and that less structured tasks with high executive demands are the most sensitive in detecting divergence from the normal range of functioning. These selective impairments can be attributed to the early involvement of frontostriatal circuitry and frontal lobes.

Keywords: Cognition; Executive functioning; Neuropsychology; Non-verbal fluency; Phonemic fluency; Prodromal Huntington's disease; Semantic fluency.

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Figures

Fig. 1
Fig. 1
Hypothetical Design Fluency drawings that represent neither actual objects nor nameable abstract forms.
Fig. 2
Fig. 2
Mean fluency z-scores for carriers relative to non-carriers. Error bars represent standard errors around the mean. * p < 0.05.
Fig. 3
Fig. 3
Performance across fluency tasks for the gene carriers by PYTO. a Non-verbal fluency (r = 0.35, p = 0.048). b Phonemic fluency (r = 0.49, p < 0.01). c Semantic fluency (r = 0.43, p = 0.01). The regression line is the non-linear quadratic component.
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