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Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

  • Katherine Osborne-Crowley (a1), Sophie C. Andrews (a2), Izelle Labuschagne (a3), Akshay Nair (a1), Rachael Scahill (a1), David Craufurd (a4) (a5), Sarah J. Tabrizi (a1), Julie C. Stout (a2) and the TRACK-HD Investigators (a1) (a2) (a3) (a4) (a5)...


Objectives: Previous research has demonstrated an association between emotion recognition and apathy in several neurological conditions involving fronto-striatal pathology, including Parkinson’s disease and brain injury. In line with these findings, we aimed to determine whether apathetic participants with early Huntington’s disease (HD) were more impaired on an emotion recognition task compared to non-apathetic participants and healthy controls. Methods: We included 43 participants from the TRACK-HD study who reported apathy on the Problem Behaviours Assessment – short version (PBA-S), 67 participants who reported no apathy, and 107 controls matched for age, sex, and level of education. During their baseline TRACK-HD visit, participants completed a battery of cognitive and psychological tests including an emotion recognition task, the Hospital Depression and Anxiety Scale (HADS) and were assessed on the PBA-S. Results: Compared to the non-apathetic group and the control group, the apathetic group were impaired on the recognition of happy facial expressions, after controlling for depression symptomology on the HADS and general disease progression (Unified Huntington’s Disease Rating Scale total motor score). This was despite no difference between the apathetic and non-apathetic group on overall cognitive functioning assessed by a cognitive composite score. Conclusions: Impairment of the recognition of happy expressions may be part of the clinical picture of apathy in HD. While shared reliance on frontostriatal pathways may broadly explain associations between emotion recognition and apathy found across several patient groups, further work is needed to determine what relationships exist between recognition of specific emotions, distinct subtypes of apathy and underlying neuropathology. (JINS, 2019, 25, 453–461)


Corresponding author

Correspondence and reprint requests to: Katherine Osborne-Crowley, Huntington’s Disease Centre, University College London, Institute of Neurology, and National Hospital for Neurology and Neurosurgery, London, UK. E-mail:


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TRACK-HD Investigators: Australia—C. Campbell, M. Campbell, E. Frajman, C. Milchman, A. O’Regan (Monash University, Victoria). Canada—A. Coleman, R. Dar Santos, J. Decolongon, A. Sturrock (University of British Columbia, Vancouver). France—E. Bardinet, C. Jauffret, D. Justo, S. Lehericy, C. Marelli, K. Nigaud, P. Pourchot, R. Valabrègue (APHP, Hôpital Salpêtriere, Paris). Germany—N. Bechtel, S. Bohlen, R. Reilmann (University of Münster, Münster); A. Hoffman, P. Kraus (University of Bochum, Bochum); B. Landwehrmeyer (University of Ulm). Netherlands—S.J.A. van den Bogaard, E.M. Dumas, J. van der Grond, E.P. t’Hart, C. Jurgens, M.-N. Witjes-Ane (Leiden University Medical Centre, Leiden). United Kingdom—N. Arran, J. Callaghan, C. Stopford (St Mary’s Hospital, Manchester); C. Frost, R. Jones (London School of Hygiene and Tropical Medicine, London); C. Berna, H. Crawford, N. Fox, C. Gibbard, N. Hobbs, N. Lahiri, I. Malone, R. Ordidge, G. Owen, A. Patel, T. Pepple, J. Read, M. Say, R. Scahill, D. Whitehead, E. Wild (University College London, London); S. Keenan (Imperial College London, London); D.M. Cash (IXICO, London); S. Hicks, C. Kennard (Oxford). United States—T. Acharya, E. Axelson, H. Johnson, D. Langbehn, C. Wang (University of Iowa, Iowa City, IA); S. Lee, W. Monaco, H. Rosas (Massachusetts General Hospital, Harvard, MA); C. Campbell, S. Queller, K. Whitlock (Indiana University, IN); B. Borowsky, A. Tobin (CHDI).



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Apathy Associated With Impaired Recognition of Happy Facial Expressions in Huntington’s Disease

  • Katherine Osborne-Crowley (a1), Sophie C. Andrews (a2), Izelle Labuschagne (a3), Akshay Nair (a1), Rachael Scahill (a1), David Craufurd (a4) (a5), Sarah J. Tabrizi (a1), Julie C. Stout (a2) and the TRACK-HD Investigators (a1) (a2) (a3) (a4) (a5)...


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