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Home-HD Symptoms

Denial & Unawareness
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Published by HOPES
(Huntington's Outreach Project for Education, at Stanford University)

The term "denial" is most commonly used to describe the inability to accept the reality of a distressing circumstance. HD sufferers may deny having HD or may be unable to recognize their disabilities.

However, such denial is not under the individual's control, so unawareness may be a more accurate term for people with HD.

As a result of the HD mutation, circuits connecting the caudate nucleus, frontal and parietal lobes may incur damage, resulting in a lack of self-awareness.

People with HD may be unable to recognize disabilities or evaluate their own behavior. The inability to evaluate one's own performance may cause individuals to be unaware of mistakes that are evident to others. (see figure info and mismatched socks)

Damage to these neural connections may also impair the ability to experience a range of subtle emotions and see another's point of view, making social and personal relationships more difficult.

A lack of awareness often plays a role in seemingly irrational behaviors. For example, a person may become upset if he or she is not allowed to go back to work or live independently, because of the unawareness of failing capabilities.

However, a person may be willing to talk about his or her capabilities, but unable to acknowledge that failing capabilities are the result of HD.

Unawareness, a cognitive as well as a behavioral symptom, is currently accepted as an untreatable component of HD.