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Attentional Impairments in Huntington's Disease: A Specific Deficit for the Executive Conflict

机译：亨廷顿疾病的注意力损伤：执行冲突的特定赤字

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Objective: Huntington's disease (HD) is characterized by motor and cognitive impairments including memory, executive, and attentional functions. However, because earlier studies relied on multidetermined attentional tasks, uncertainty still abounds regarding the differential deficit across attentional subcomponents. Likewise, the evolution of these deficits during the successive stages of HD remains unclear. The present study simultaneously explored 3 distinct networks of attention (alerting, orienting, executive conflict) in preclinical and clinical HD. Method: Thirty-eight HD patients (18 preclinical) and 38 matched healthy controls completed the attention network test, an integrated and theoretically grounded task assessing the integrity of 3 attentional networks. Results: Preclinical HD was not characterized by any attentional deficit compared to controls. Conversely, clinical HD was associated with a differential deficit across the 3 attentional networks under investigation, showing preserved performance for alerting and orienting networks but massive and specific impairment for the executive conflict network. This indexes an impaired use of executive control to resolve the conflict between task-relevant stimuli and interfering task-irrelevant ones. Conclusion: Clinical HD does not lead to a global attentional deficit but rather to a specific impairment for the executive control of attention. Moreover, the absence of attentional deficits in preclinical HD suggests that these deficits are absent at the initial stages of the disease. In view of their impact on everyday life, attentional deficits should be considered in clinical contexts. Therapeutic programs improving the executive control of attention by neuropsychology and neuromodulation should be promoted.
机译：目的：亨廷顿的疾病（HD）的特点是电动机和认知障碍，包括记忆，行政和注意力功能。然而，因为早期的研究依赖于多选的注意力任务，所以不确定性仍然有关注意力子组件的差异缺陷。同样地，在高清连续阶段期间这些缺陷的演变仍然不清楚。本研究同时探讨了临床前和临床高清中的3个不同的注意力（警报，定向，执行冲突）。方法：三十八名高清患者（18例临床前）和38名匹配的健康控制完成了注意力网络测试，一个集成和理论接地的任务，评估了3个注意力网络的完整性。结果：与对照相比，突出的HD未表征任何引入缺损。相反，临床高清与在调查中的3个注意力网络上的差异缺陷有关，显示了警报和定向网络的保存性能，但对执行冲突网络的巨大和特定减值。这索引了对执行控制的损害，以解决任务相关刺激和干扰任务 - 无关的冲突。结论：临床高清不会导致全球造成赤字，而是对执行监督的执行控制特定减值。此外，临床前高清缺乏注意力缺陷表明这些缺陷在疾病的初始阶段不存在。鉴于他们对日常生活的影响，应在临床环境中考虑注意力赤字。应促进治疗计划通过神经心理学和神经调节改善注意力的监督。

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