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Objectives People with Huntington's disease ( HD) can exhibit interpersonal difficulties and deficits in recognizing emotional facial expressions. We investigated whether individuals with HD exhibit impairments in the understanding of other people's mental states, an aspect of Theory of Mind (ToM). Materials and methods Sixteen patients with HD and sixteen healthy controls completed two ToM tasks. One task involved recognising socially inappropriate behaviour and the other task required participants to judge complex mental states from photographs of people's eyes alone. To assess relationships between executive function and To M, participants completed measures of verbal fluency, working memory and inhibition. The Problem Behaviours Assessment-short form (Neuropsychiatry Neuropsychol Behav Neurol, 14, 2001and 219) was completed twice using information from patients and their close relatives (where possible) to identify relationships between To M impairment and behavioural problems. Results Patients with HD made significantly more errors on To M tasks than controls, exhibiting difficulties in judging the social appropriateness of story character's behaviour and problems inferring complex mental states from photographs of people's eyes. Patients with HD also exhibited executive dysfunction. However, there was little evidence that executive impairments were related to To M deficits. No correlations were apparent between problem behaviours and To M errors. Conclusions HD is associated with deficits in To M. Furthermore, some of patients' ToM difficulties appear independent of executive dysfunction. [ABSTRACT FROM AUTHOR]

Nimmagadda SR, Agrawal N, Worrall-Davies A, Markova I, Rickards H. Determinants of irritability in Huntington's disease. Objectives: Irritability is a common and disabling problem associated with Huntington's disease (HD). However, the underlying causes of such irritability remain unclear. This study investigates the association of irritability in HD with possible aetiological factors including dysexecutive syndrome, depression, anxiety (state and trait) and movement disorder. Methods: Thirty patients with genetically confirmed HD and their carers were recruited from a regional HD neuropsychiatry service. Patients completed two self-reported questionnaires (Irritability, Anxiety and Depression Scale and State Trait Anxiety Inventory). Their carers filled in the Burns Irritability Scale. Patients were also administered the Behavioural Assessment of Dysexecutive Syndrome (BADS), Montgomery and Asberg Depression Rating Scale (MADRS) and the Motor component of the Unified Huntington's Disease Rating Scale (UHDRS). Results: Both self-rated and carer-rated irritability scales showed significant positive correlation with trait anxiety. The self-rated irritability scales also showed significant positive correlation with state anxiety and depression. No association was observed between irritability and dysexecutive syndrome or motor impairment. Conclusions: Trait anxiety might serve as a predictor for irritability in HD. Irritability is unrelated to motor or cognitive features of HD indicating that it is an independent neuropsychiatric manifestation of HD. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to the article "Hungtington's Disease Out of the Closet?," by Michael Rawlins in the October 23, 2010 issue.