Excessive response to provocation rather than disinhibition mediates irritable behaviour in Huntington's disease.

Background: Irritable and impulsive behaviour are common in Huntington's disease (HD: an autosomal dominant disorder causing degeneration in cortico-striatal networks). However, the cognitive mechanisms underlying these symptoms remain unclear, and previous research has not determined if common mechanisms underpin both symptoms. Here we used established and novel tasks to probe different aspects of irritable and impulsive behaviour to determine the neural mechanisms involved.

Different depression: motivational anhedonia governs antidepressant efficacy in Huntington's disease.

Depression is more common in neurodegenerative diseases such as Huntington's disease than the general population. Antidepressant efficacy is well-established for depression within the general population: a recent meta-analysis showed serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants and mirtazapine outperformed other antidepressants. Despite the severe morbidity, antidepressant choice in Huntington's disease is based on Class IV evidence.

Acute symptomatic seizures.

Acute symptomatic seizures occur in close temporal proximity to a documented neurological or systemic insult. They are a common reason for seeking an emergency neurological opinion. We discuss their important causes, treatment and prognosis, discuss a practical approach to their clinical assessment and investigation, and offer thoughts on treatment.