F45 Apathy associated with impaired recognition of happy facial expressions in huntington’s disease

Background Previous research has demonstrated an association between emotion recognition and apathy in a number of neurological conditions involving fronto-striatal pathology, including Parkinson’s disease and brain injury. Aims 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 HD participants from the TRACK-HD study who had an apathy score u003e1 on the Problem Behaviours Assessment – short version (PBA-S), 67 HD participants who reported no apathy, and 107 controls matched for age, sex and level of education. During their baseline visit, participants completed a battery of cognitive tests that include an emotion recognition task, the Hospital Depression and Anxiety Scale (HADS), and the PBA-s. Results Compared to the non-apathetic HD group and the control group, the apathetic HD group were impaired on the recognition of happy facial expressions, after controlling for depression symptomology (HADS) and general disease progression (UHDRS total motor score). This was despite no difference between the apathetic and non-apathetic groups 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 fronto-striatal pathways may broadly explain associations between emotion recognition and apathy found across a number of patient groups, further work is needed to determine what relationships exist between the recognition of specific emotions, distinct subtypes of apathy, and underlying neuropathology.