Neuropsychiatric comorbidities in Huntington’s and Parkinson’s Disease: A United States claims database analysis

OBJECTIVE: Huntington’s disease is a rare, genetic, neurodegenerative disease characterized by a triad of cognitive, behavioral, and motor symptoms. The condition gradually results in increasing disability, loss of independence, and ultimately death. Our objective was to use United States claims data (which offer valuable insight into the natural history of disease) to compare the prevalent comorbidities of people with Huntington’s disease against matched controls with Parkinson’s disease or with no major neurodegenerative diseases (general population controls). We also assess medication use in people with Huntington’s disease. METHODS: This was a retrospective, observational study using data from the IBM MarketScan(®) Databases. Cases and controls were matched 1:1, and comorbidities were analyzed in each group during 2017. Medications were also assessed in the Huntington’s disease cohort. Eligible cases had ≥ 2 diagnostic codes for Huntington’s disease; controls had ≥ 2 codes for Parkinson’s disease (with no record of Huntington’s disease), or, for general population controls, no record of Huntington’s disease, Parkinson’s disease, amyotrophic lateral sclerosis, or dementia. RESULTS: A total of 587 matched individuals were assessed in each cohort. Depression and anxiety were more common in Huntington’s disease versus Parkinson’s disease (odds ratios: 1.51 and 1.16, respectively). Other conditions more common in Huntington’s disease included dementia, communication/speech problems, dysphagia, and falls. The use of antidepressant (59.9%) and antipsychotic (39.5%) medications was frequent among Huntington’s disease cases. INTERPRETATION: These data highlight the prevalence of psychiatric, cognitive, communication, swallowing, and mobility problems in people with Huntington’s disease, underscoring the need for holistic expert care of these individuals.