β-Blockers May Slow Huntington Disease Manifestation/Progression

For people with premotor-manifest Huntington disease (preHD) and motor-manifest HD (mmHD), treatment with β-blockers may delay the onset and progression of motor and functional symptoms. The results of an observational, longitudinal multicenter study of people from the Enroll-HD platform database, published in JAMA Neurology, suggest that β-blockers may have therapeutic potential for HD.

Enroll-HD is a global database of longitudinal data from >150 study sites. In this study, 174 β-blocker users with preHD and 149 β-blocker users with mmHD were matched to 174 non-β–blocker users with preHD and 149 non-β–blocker users with mmHD, respectively. Researchers evaluated the risk of receiving a motor diagnosis of HD over time for the participants with preHD and motor, functional, and cognitive outcomes for people with mmHD.

Compared with those who did not use β-blockers:

• β-blocker users with preHD showed a significantly reduced annualized hazard of receiving a motor diagnosis of HD (hazard ratio [HR], .66; 95% CI, .46 to .94; P=.02).
• β-blocker users with mmHD showed slower mean annualized worsening in:
  • Total motor score (mean difference [MD], -.45; 95% CI, -.85 to -.06; q=.025)
  • Functional capacity score (MD, .10; 95% CI, .02 to .18; q=.025)
  • Symbol digit modalities test score (MD, .33; 95% CI, .10 to .56; q=.017)

The authors, who are affiliated with the University of Iowa, suggest that the apparent effects of β-blockers in people with preHD and mmHD may be related to norepinephrine signaling. They also note that the impact of β-blockers on anxiety symptoms may play a role in the timing of clinical diagnosis and progression of HD.