A 37-year-old woman is brought to the physician for worsening depressive mood and irritability. Her mood changes began several months ago. Her husband has also noticed shaky movements of her limbs and trunk for the past year. The patient has no suicidal ideation. She has no history of serious illness and takes no medications. Her father died by suicide at the age of 45 years. Her temperature is 37.0°C (98.6°F), pulse is 76/min, and blood pressure is 128/72 mm Hg. She speaks slowly and quietly and only looks at the floor. She registers 3/3 words but can recall only one word 5 minutes later. Examination shows irregular movements of the arms and legs at rest. Extraocular eye movements are normal. Muscle strength is 5/5 throughout, and deep tendon reflexes are 2+ bilaterally. The loss of neurons supplying which of the following neurotransmitters is most specific for this patient's disease process?

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Quizplus · Accepted Answer

Eductional Objective: Huntington disease is an autosomal dominant neurodegenerative disease that leads to the accumulation of abnormal, toxic huntingtin protein in neural cells.  Inhibitory GABAergic neurons in the caudate nuclei are most susceptible, and their loss is responsible for the characteristic manifestations of Huntington disease (eg, chorea, behavioral abnormalities).

A 37-Year-Old Woman Is Brought to the Physician for Worsening