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Ments (can present with chorea - choreathetosis) ballismus • ballismus - abrupt high amplitude movements (violent) dystonia • dystonia - movements of proximal muscles of trunk, often more sustained than those in chorea myoclonus • myoclonus - brief, simple movements (more common in early onset of hd) akinesia • akinesia - loss of motor function, reduced manual dexterity, dysarthria, dysphagia, balance problems, loss of ability initiate voluntary movements most common + 2 other behavioral disorders of hd • most common = depression • ocd, schizophrenia-like thought disorder subcortical/striatal degeneration • targets medium spiny gabaergic projection neurons (90% of neurons in caudate/putamen) o loss in gradient fashion from tail of caudate, proceeding anteriorly from medial-dorsal to lateral ventral areas of striatum • targets other components of bg (globus pallidus, subthalamic nucleus) • glial cells also lost - accelerating loss of medium spiny neurons --> increased glial index in striatum over course of disease subcortical degeneration clinical correlates • correlation with sx - loss of striatal projections in snpr --> dysregulation of superior colliculus --> abnormal saccades • correlation w/ sx - choriform movements most likely caused by imbalance between direct/indirect striatopallidal circuits indirect circuit affected first due to loss of medium spiny o neurons projection to gppex --> abnormal activity of cortical motor circuits --> chorea cortical degeneration o mostly layer vi (deepest) - with small amounts of degeneration of layers iii and v o not associated with neuronal cell loss in striatum o accompanying loss of white matter, brain volume can be reduced by as much as 20% in late stages of disease abnormalities in polyglutamine expansion • normal alleles of it15 gene (hd gene) contain 9-24 cag repeats (glutamine) • patients have alleles with expanded stretch repeats of 40-121 repeats huntingtin o found predominantly in cytoplasm + associated with vesicles/microtubules o important for efficient trafficking of vesicles + organelles in neurons o htt expression enriched in brain + testis, expressed in every cell of the body o no obvious difference in level of htt expression observed in striatum and less affected brain regions correlation between age of onset + triple repeat length • triplet repeat length can vary from generation to generation, from cell to cell o males can transmit larger. Generic viagra buy uk viagra online generic viagra fast shipping slimming tablets female viagra Generic viagra europe generic viagra buy generic viagra viagra 20 mg cheap classicmotocrossimages.com/mbs-viagra-cheap-pills-ji/ Does viagra work young women how to order viagra online from india does generic viagra work good viagra online viagra for daily use free trial can you use viagra and viagra at the same time slimming tablets female viagra viagra for sale viagra side effects pictures viagra online where can i buy non prescription viagra generic viagra online viagra tadalafil 20 mg lilly notariagaray.es/sqo-557718/ can you buy viagra online in canada viagra viagra dose conversion notariagaray.es/sqo-556266/ generic viagra for cheap http://notariagaray.es/sqo-558792/ duration of action viagra http://notariagaray.es/sqo-556672/ notariagaray.es/sqo-556961/