Huntington's disease (HD), an uncurable neurodegenerative disorder, is caused by CAG repeat expansion in the HD gene encoding mutant huntingtin protein. DNA damage response is implicated in HD pathogenesis. We used multiple approaches to assess normal and mutant HTT interactomes in the context of genotoxic stress. We show that double-strand break (DSB) repair response is impaired in HD neurons, which are more vulnerable to DSB-induced stress. We found that S1181 phosphorylation of HTT is regulated by DSB, and can be carried out by DNA-PK. Functional interaction of HTT with a major DSB kinase DNA-PKcs and association of both proteins with nuclear speckles suggest a role of HTT in DSB repair mechanism; however, physiological outcome of these interactions remains to be examined. We revealed HTT interactions with other proteins associated with nuclear speckles, TCERG1 and MED15, whose loci are genetic modifiers for HD, and with chromatin remodeling complex BAF. These interactions may position HTT as an important scaffolding intermediary providing integrated regulation of gene expression and RNA processing in the context of DNA repair mechanisms.

Huntington disease (HD) is a neurodegenerative disorder characterized by progressive motor dysfunction. Traditional open-field tests quantify spontaneous locomotor parameters; however, fine mouse motor signatures, particularly disease stage-specific changes in HD motor symptoms and pharmacodynamic responses to therapeutic treatments. Here, we employed a computer vision-aided behavioral flow analysis designed to quantify fine, HD-relevant motor dysfunction in the zQ175DN HD mouse model, ranging from early HD-like motor signatures to well-defined motor deficits. Markerless pose estimation and Keypoint-MoSeq segmented standard top-view open-field recordings into recurrent behavioral syllables, which were then organized into higher-order clusters and transition networks. Disease stage-dependent changes in syllable occurrence, syllable duration, behavioral-state composition, and transition structure were identified. These analyses are not possible with traditional open-field assays. Syllable-duration features provided the strongest genotype discrimination, and HD-like motor features were also characterized by hub remodeling and transition-network disorganization. These features were integrated into an HD motor dysfunction (HDMD) score based on age- or HD progress-matched wild-type (WT) -standardized absolute deviations. The HDMD score distinguished HD mice from WT across multiple symptomatic stages and correlated with HD pathology and disease severity. Effect-size and power analyses suggested improved efficiency for detecting potential therapeutic effects. This framework requires only standard top-view recordings and may also support retrospective analysis of existing open-field video datasets. Overall, the HDMD framework provides a practical strategy for identifying fine motor changes in HD mice, aiding study design and preclinical efficacy assessment in HD drug development.

Schizophrenia is a heterogeneous disorder, and likely results from multiple pathophysiological mechanisms. Protein aggregation, resulting from disruption of protein homeostasis (proteostasis), has been implicated in many diseases, including cancer, cardiac and pulmonary diseases, muscle diseases, and neurodegenerative disorders, but is a relatively new pathophysiological hypothesis for schizophrenia. Genetic findings implicate proteostasis in schizophrenia, and individual proteins associated with the disorder may undergo aggregation. While there is some evidence of associations between genetic variants and protein aggregation, the extent to which genetic variations influence protein aggregation remains unknown. We have previously reported increased protein insolubility and increased ubiquitination of the insoluble protein fraction, two markers of protein aggregation, in human postmortem brains from a subset of patients with schizophrenia. In the present study, we investigate whether protein aggregation is observed in an independent model system, olfactory neuronal cells derived from living patients with schizophrenia, and examine the relationship between aggregation and patient clinical and cognitive status. We demonstrate that, as in postmortem brain, olfactory neurons from a subset of patients with schizophrenia exhibit protein aggregation, identified by increased protein insolubility and ubiquitination of the insoluble protein fraction, and by ubiquitin positive protein aggregates. Patients with protein aggregation exhibit more severe cognitive deficits than those without aggregation, as revealed by between-group comparisons and correlational analyses. Understanding the mechanisms of the aggregation process, the factors that differentiate individuals who develop aggregates from those who do not, and the relationship between aggregation and cell function, has important implications for the pathophysiology of schizophrenia, and may provide insight into disease heterogeneity and novel therapeutic targets.

Background We previously reported lower baseline arteriolar cerebral blood volumes (CBVa) in almost all gray matter regions in a cohort of individuals with schizophrenia of varying ages and disease duration. The extent to which decreased CBVa is also present in recent-onset schizophrenia, and how this impacts neurovascular coupling, remains to be determined. In this study, we sought to determine the extent of CBVa deficits in recent-onset schizophrenia and the relationship of CBVa to region-specific resting-state neural activity.Methods Using 7 T MRI, CBVa was measured in 90 regions using 3D inflow-based vascular-space-occupancy (iVASO) imaging in 16 individuals with recent-onset schizophrenia (disease duration: x = 1.18 +/- 1.4 years) and 12 age-matched controls. Resting-state functional MRI (rs-fMRI) was used to determine fractional amplitudes of low-frequency fluctuations (fALFF) and intrinsic connectivity (ICC) in spontaneous blood oxygen level-dependent (BOLD) signal. The region-specific relationship between CBVa and fALFF was determined as an index of neurovascular coupling.Results Compared with healthy participants, CBVa was lower in individuals with schizophrenia in almost all brain regions, with a global effect size of 0.23 and regional effect sizes up to 0.41. Individuals with schizophrenia also exhibited lower fALFF diffusely across cortical and subcortical gray matter regions. Ratios of mean regional CBVa to fALFF and ICC were significantly lower in patients in numerous brain regionsConclusion These findings indicate that early-stage schizophrenia is characterized by widespread microvascular abnormalities and associated resting-state deficits in neural activity, suggesting that abnormalities in neurovascular coupling may contribute to the pathophysiology of schizophrenia.

The loss of striatal medium spiny neurons is a hallmark of Huntington’s disease (HD). To identify potential disease-modifying treatments, we previously developed a human neuronal model by immortalizing and differentiating HD patient-derived iPSCs into highly homogeneous striatal precursor neurons (ISPNs). Using a 96-well screening platform, and two rounds of re-screening, we tested a kinase inhibitor library and identified 5 compounds that protected HD ISPNs from mutant huntingtin (mHTT)-induced toxicity. Among these, we prioritized the PKC-α/β1 inhibitor GO6976, which rescued HD ISPNs from mHTT toxicity in a dose-dependent manner. Further, we found increased phosphorylation of PKC-α and PKC-β1 in HD cells and tissues, while their overexpression was toxic to HD ISPNs. Knockdown of PKC-α/β1 protected the neurons, and both isoforms interacted and colocalized with HTT. These results suggest that PKC-α/β1 plays a role in HD neurodegeneration, and that inhibiting their activity may offer a potential therapeutic approach for HD. ![Figure][1] Highlights ### Competing Interest Statement This work has been reported to NIH (iEdison 4134401-24-0173) and Johns Hopkins Technology Ventures (JHTV C18643). The authors declare no other competing interests. NIH, NS129563 (M.J.); NS104320, NS086452 (C.R.); NS135139, NS124084 (W.D.); P30AG0066507 (J.T.). [1]: pending:yes

Pridopidine is a selective sigma-1 receptor (S1R) agonist in clinical development for Huntington's Disease (HD) and Amyotrophic Lateral Sclerosis (ALS). Activation of the S1R by pridopidine is neuroprotective in multiple preclinical models of neurodegenerative disease. The sigma-2 receptor (S2R) is evolutionarily and structurally unique from the S1R. Nevertheless, the S1R and S2R share an overlapping yet distinct ligand binding profile. Inhibition of the S2R is neuroprotective and S2R antagonists are in clinical development for Alzheimer's Disease (AD), ⍺-synucleinopathies, and dry age-related macular degeneration. In this study, we hypothesized that simultaneous activation of the S1R by pridopidine and inhibition of the S2R by the selective S2R antagonist FA10 might provide enhanced protection against mutant huntingtin (mHTT) expression in an in vitro model of neurodegeneration. Consistent with previous studies, pridopidine reduced neuronal cell death in a mouse primary neuron mHTT model. Similarly, we found that inhibition of the S2R by FA10 was also sufficient to protect against mHTT induced neurodegeneration in this model. The combination treatment of pridopidine and FA10 achieved greater efficacy than either compound alone, even at lower concentrations. The combination of these compounds may allow for lower efficacious doses leading to improved safety profiles and reduced off-target effects. This novel combinatorial approach, in which the S1R is activated while simultaneously inhibiting the S2R may prove to be a highly effective therapeutic strategy for HD and other neurodegenerative diseases.

Dentatorubral and pallidoluysian atrophy (DRPLA) is an autosomal dominant neurodegenerative disorder, caused by a CAG expansion in the atrophin-1 gene. The clinical features include chorea, ataxia, incoordination, emotional changes and dementia, progressing to early mortality. The atrophin-1 protein sequence contains a putative N-terminal nuclear localization signal (NLS) and a putative C-terminal nuclear export signal (NES). To investigate whether nuclear localization of atrophin-1 plays a role in the pathogenesis of DRPLA, we designed alterations of the NLS and NES by site-directed mutagenesis. We generated transgenic mice expressing mutant full-length atrophin-1 (repeat length = 65) with alteration of either the nuclear export signal (At65QmNES, predicted to result in a higher ratio of nuclear to cytosolic atrophin-1 than in control), or the nuclear localization signal (At65QmNLS, predicated to retain more cytosolic atrophin-1), respectively. With equivalent levels of atrophin-1 expression, At65QmNES mice displayed more nuclear accumulation of atrophin-1 and its fragments than At65QmNLS or control mice expressing endogenous normal Atrophin-1. Moreover, At65QmNES mice had a shorter life span and more severe locomotor defects than did At65QmNLS (and non-transgenic control) mice. Additionally, we found that At65QmNES caused more pathology in mouse brains than did At65QmNLS. These results provide evidence that nuclear localization enhances the phenotype of mutant atrophin-1-linked neuropathology. In addition, our findings indicate that the AT65QmNES transgenic mouse will be a valuable model for future studies of DRPLA pathogenesis and potential therapeutics.

Rationale Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene play an important role in Parkinson's disease (PD) pathogenesis, and downregulation of LRRK2 has become a promising therapy for PD. Here, we developed a synthetic biology strategy for the self-assembly and delivery of small interfering RNAs (siRNAs) of LRRK2 into the substantia nigra via small extracellular vesicles (sEVs) using a genetic circuit (in the form of naked DNA plasmid) to attenuate PD-like phenotypes in mouse model. Methods We generated the genetic circuit encoding both a neuron-targeting rabies virus glycoprotein (RVG) tag and a LRRK2 siRNA under the control of a cytomegalovirus (CMV) promoter, and assessed its therapeutic effects using LRRK2R1441G mouse models of PD. Results After intravenous injection, the genetic circuit was taken up by the host liver to reprogram liver cells to produce and self-assemble LRRK2 siRNAs into sEVs, and then the sEV-enclosed LRRK2 siRNAs were further transferred by the endogenous circulating system of sEVs and guided by the RVG tag to the substantia nigra. Intravenous injection of this genetic circuit reduced total and phosphorylated LRRK2 levels in the substantia nigra, and attenuated PD-like phenotypes in two mouse models by rescuing LRRK2R1441G-induced dopaminergic neurodegeneration and reducing microgliosis. Conclusion This study provides an efficient therapeutic strategy to attenuate LRRK2-induced neurodegeneration and neuroinflammation in PD mouse models, and may open a new avenue to safely deliver siRNA into brain after peripheral intravenous injection and facilitate PD treatment.

Background:Anosognosia, or unawareness of symptoms, is common in Huntington's disease (HD), but the neuroanatomical basis of this is unknown. Objective:To identify neuroanatomical correlates of HD anosognosia using structural MRI data. Methods:We leveraged a pre-processed dataset of 570 HD participants across the well-characterized PREDICT-HD and TRACK-HD cohort studies. Anosognosia index was operationalized as the score discrepancies between HD participants and their caregivers on the Frontal Systems Behavior Scale (FrSBe). Results:Univariate correlation analyses identified volumes of globus pallidus, putamen, caudate, basal forebrain, substantia nigra, angular gyrus, and cingulate cortex as significant correlates of anosognosia after correction for multiple comparisons. A multivariable model constructed with stepwise regression that included volumetric data showed globus pallidus volume alone explained more variance in anosognosia severity than motor impairment or CAP score alone. Conclusions:Anosognosia appears to be related to degeneration affecting both cortical and subcortical areas. Globus pallidus neurodegeneration in particular appears to be a key process of importance.

Huntington's Disease (HD), a progressive neurodegenerative disorder with no disease-modifying therapies, is caused by a CAG repeat expansion in the HD gene encoding polyglutamine-expanded huntingtin (HTT) protein. Mechanisms of HD cellular pathogenesis and cellular functions of the normal and mutant HTT proteins are still not completely understood. HTT protein has numerous interaction partners, and it likely provides a scaffold for assembly of multiprotein complexes many of which may be altered in HD. Previous studies have implicated DNA damage response in HD pathogenesis. Gene transcription and RNA processing has also emerged as molecular mechanisms associated with HD. Here we used multiple approaches to identify HTT interactors in the context of DNA damage stress. Our results indicate that HTT interacts with many proteins involved in the regulation of interconnected DNA repair/remodeling and RNA processing pathways. We present evidence for a role for HTT in double strand break repair mechanism. We demonstrate HTT functional interaction with a major DNA damage response kinase DNA-PKcs and association of both proteins with nuclear speckles. We show that S1181 phosphorylation of HTT is regulated by DSB, and can be carried out (at least in vitro) by DNA-PK. Furthermore, we show HTT interactions with RNA binding proteins associated with nuclear speckles, including two proteins encoded by genes at HD modifier loci, TCERG1 and MED15, and with chromatin remodeling complex BAF. These interactions of HTT may position it as an important scaffolding intermediary providing integrated regulation of gene expression and RNA processing in the context of DNA repair mechanisms.

Huntington’s disease (HD) is an autosomal dominant neurodegenerative disease caused by a single mutation in the huntingtin gene (HTT). Normal HTT has a CAG trinucleotide repeat at its N-terminal within the range of 36. However, once the CAG repeats exceed 37, the mutant gene (mHTT) will encode mutant HTT protein (mHTT), which results in neurodegeneration in the brain, specifically in the striatum and other brain regions. Since the mutation was discovered, there have been many research efforts to understand the mechanism and develop therapeutic strategies to treat HD. HTT is a large protein with many post-translational modification sites (PTMs) and can be modified by phosphorylation, acetylation, methylation, sumoylation, etc. Some modifications reduced mHTT toxicity both in cell and animal models of HD. We aimed to find the known kinase inhibitors that can modulate the toxicity of mHTT. We performed an in vitro kinase assay using HTT peptides, which bear different PTM sites identified by us previously. A total of 368 kinases were screened. Among those kinases, cyclin-dependent kinases (CDKs) affected the serine phosphorylation on the peptides that contain S1181 and S1201 of HTT. We explored the effect of CDK1 and CDK5 on the phosphorylation of these PTMs of HTT and found that CDK5 modified these two serine sites, while CDK5 knockdown reduced the phosphorylation of S1181 and S1201. Modifying these two serine sites altered the neuronal toxicity induced by mHTT. Roscovitine, a CDK inhibitor, reduced the p-S1181 and p-S1201 and had a protective effect against mHTT toxicity. We further investigated the feasibility of the use of roscovitine in HD mice. We confirmed that roscovitine penetrated the mouse brain by IP injection and inhibited CDK5 activity in the brains of HD mice. It is promising to move this study to in vivo for pre-clinical HD treatment.

Huntington’s disease (HD) is a monogenic disorder that is caused by a CAG repeat expansion in the HTT gene. However, beyond the CAG repeat size other genes also contribute to variations in neurodegeneration of the cortex and striatum as well as the timing of disease onset1,2. The standard method to find genetic modifiers of HD has been the use of genome-wide association studies (GWAS) of large numbers of unrelated patients1,3-5. Previous efforts in this vein have identified single nucleotide variants (SNVs) significantly associated with pathways involved in DNA damage and handling that modify HD age of onset (AO)1,3-8. However, many of these associations have small effect sizes, and typically it is not known whether the SNVs identified with GWAS are the basis for the modifying effect. Here, to augment modifier GWAS, we set out to identify variants that may modify AO in HD by performing family-based studies. We performed whole genome sequencing in families with HD in which individuals with similar CAG expansions showed variation in AO (ranging from a 3- to 20-year difference). We examined the segregation of every variant in the genome and associated the occurrence of those variants with AO. Focusing on rare and uncommon variants, we used a priori knowledge to examine the proximity of our top variants to previously reported GWAS loci. Further, we developed an HD impact scoring system to rank each variant and highlight those most likely to be impactful in the context of influencing the pathology associated with the CAG repeat expansion mutation. Pathway enrichment analysis of these genes revealed numerous pathways previously implicated in HD, as well as novel pathways that may be important in disease onset. Finally, we showed that a putative AO modifier in the ovarian-tumor-domain-containing deubiquitinase 3 (OTUD3) gene correlated with an altered rate of degeneration in patient-derived neurons, and that knockdown of OTUD3 accelerated degeneration in a human cell model of HD, validating our approach. This family-based strategy creates a novel resource for the HD community and establishes a framework that could be applied to study genetic modifiers of many other rare familial diseases.

Huntington's disease is caused by a CAG repeat expansion in the Huntingtin gene (HTT), coding for polyglutamine in the Huntingtin protein, with longer CAG repeats causing earlier age of onset. The variable 'Age' × ('CAG'-L), where 'Age' is the current age of the individual, 'CAG' is the repeat length and L is a constant (reflecting an approximation of the threshold), termed the 'CAG Age Product' (CAP) enables the consideration of many individuals with different CAG repeat expansions at the same time for analysis of any variable and graphing using the CAG Age Product score as the X axis. Structural MRI studies have showed that progressive striatal atrophy begins many years prior to the onset of diagnosable motor Huntington's disease, confirmed by longitudinal multicentre studies on three continents, including PREDICT-HD, TRACK-HD and IMAGE-HD. However, previous studies have not clarified the relationship between striatal atrophy, atrophy of other basal ganglia structures, and atrophy of other brain regions. The present study has analysed all three longitudinal datasets together using a single image segmentation algorithm and combining data from a large number of subjects across a range of CAG Age Product score. In addition, we have used a strategy of normalizing regional atrophy to atrophy of the whole brain, in order to determine which regions may undergo preferential degeneration. This made possible the detailed characterization of regional brain atrophy in relation to CAG Age Product score. There is dramatic selective atrophy of regions involved in the basal ganglia circuit-caudate, putamen, nucleus accumbens, globus pallidus and substantia nigra. Most other regions of the brain appear to have slower but steady degeneration. These results support (but certainly do not prove) the hypothesis of circuit-based spread of pathology in Huntington's disease, possibly due to spread of mutant Htt protein, though other connection-based mechanisms are possible. Therapeutic targets related to prion-like spread of pathology or other mechanisms may be suggested. In addition, they have implications for current neurosurgical therapeutic approaches, since delivery of therapeutic agents solely to the caudate and putamen may miss other structures affected early, such as nucleus accumbens and output nuclei of the striatum, the substantia nigra and the globus pallidus.

Huntington's disease (HD) is a progressive neurodegenerative disorder caused by a CAG repeat expansion in the HD gene, coding for huntingtin protein (HTT). Mechanisms of HD cellular pathogenesis remain undefined and likely involve disruptions in many cellular processes and functions presumably mediated by abnormal protein interactions of mutant HTT. We previously found HTT interaction with several protein arginine methyl-transferase (PRMT) enzymes. Protein arginine methylation mediated by PRMT enzymes is an important post-translational modification with an emerging role in neurodegeneration. We found that normal (but not mutant) HTT can facilitate the activity of PRMTs in vitro and the formation of arginine methylation complexes. These interactions appear to be disrupted in HD neurons. This suggests an additional functional role for HTT/PRMT interactions, not limited to substrate/enzyme relationship, which may result in global changes in arginine protein methylation in HD. Our quantitative analysis of striatal precursor neuron proteome indicated that arginine protein methylation is significantly altered in HD. We identified a cluster highly enriched in RNA-binding proteins with reduced arginine methylation, which is essential to their function in RNA processing and splicing. We found that several of these proteins interact with HTT, and their RNA-binding and localization are affected in HD cells likely due to a compromised arginine methylation and/or abnormal interactions with mutant HTT. These studies reveal a potential new mechanism for disruption of RNA processing in HD, involving a direct interaction of HTT with methyl-transferase enzymes and modulation of their activity and highlighting methylation of arginine as potential new therapeutic target for HD.

Changes in the brain of patients with Huntington's disease (HD) begin years before clinical onset, so it remains critical to identify biomarkers to track these early changes. Metrics derived from tensor modeling of diffusion-weighted MRIs (DTI), that indicate the microscopic brain structure, can add important information to regional volumetric measurements. This study uses two large-scale longitudinal, multicenter datasets, PREDICT-HD and IMAGE-HD, to trace changes in DTI of HD participants with a broad range of CAP scores (a product of CAG repeat expansion and age), including those with pre-manifest disease (i.e., prior to clinical onset). Utilizing a fully automated data-driven approach to study the whole brain divided in regions of interest, we traced changes in DTI metrics (diffusivity and fractional anisotropy) versus CAP scores, using sigmoidal and linear regression models. We identified points of inflection in the sigmoidal regression using change-point analysis. The deep gray matter showed more evident and earlier changes in DTI metrics over CAP scores, compared to the deep white matter. In the deep white matter, these changes were more evident and occurred earlier in superior and posterior areas, compared to anterior and inferior areas. The curves of mean diffusivity vs. age of HD participants within a fixed CAP score were different from those of controls, indicating that the disease has an additional effect to age on the microscopic brain structure. These results show the regional and temporal vulnerability of the white matter and deep gray matter in HD, with potential implications for experimental therapeutics.