Capturing Behavioral Symptoms in Huntington's Disease Using the Huntington's Disease‐Behavioral Questionnaire

BACKGROUND: The Huntington's Disease Behavioral Questionnaire (HD-BQ) captures behavioral symptoms arising from cognitive, psychiatric, and functional domains. Recognizing the high prevalence of anosognosia in HD, the HD-BQ incorporates patient- and companion-reported versions. OBJECTIVE: Examine the utility of the HD-BQ in capturing behavioral symptoms in HD. METHODS: The HD-BQ was administered to 71 manifest HD patients and their companions, plus 71 healthy controls (HC). Differences in HD-BQ scores were examined using Mann-Whitney U and Wilcoxon signed-ranks tests. RESULTS: HD patients reported more severe behavioral symptoms than HC (p < 0.001). Companions reported more widespread and severe symptoms than patients (Z = -3.7, p < 0.001). The largest discrepancies were observed for cognitive items-difficulty shifting thoughts or activities (p < 0.001), concentrating (p = 0.002), keeping track of commitments (p = 0.006), judgment (p = 0.004), and indecisiveness (p = 0.022). CONCLUSIONS: The HD-BQ captures a wide range of behavioral disturbances in HD. Companions consistently reported more frequent and severe symptoms than patients, likely reflecting patients' anosognosia.