Talk:Huntington's disease

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Good article Huntington's disease was a nominee for Natural sciences good article, but did not meet the good article criteria at the time. There are suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
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from peer review

  • The "Epidemiology" section could use some expansion if the data is available. Is it more prevalent in certain populations or ethnic groups?

from elsewhere including discussion

  • images
    • graphs of age of onset vs distribution of CAG repeats
    • maybe the huntingtin molecule - (possibly as main image)
    • image of areas of brain affected
    • Epidemiology global map of prevalence
    • Graph of research papers over time
  • history section as prose?
  • More suggestions in Talk:Huntington's disease#GA review

Contents

[edit] Discussion archive

Previous discussion topics can be found in the archive /Archive 1

[edit] Disagreement on Sharp cut off taken from todo ( prev from peer review)

It would be interesting to expand on the age-of-onset phenomenon, which I think is a matter of interest in popular descriptions of the disease. IIRC [If I Remember Correctly ? Leevanjackson] it has been suggested that the "sharp cutoff" in number of repeats needed to create disease is an effect of human lifespan - ie 30 repeats don't cause disease because the aggregation is slow enough that the person dies before it has a neurodegenerative effect. Unfortunately I can't find the paper I'm thinking of, but here is a related paper that expands on the biophysical origins of the effect.

  1. what is this "sharp cut off" point that is mentioned? This is definitly NOT the case. There are two overlapping populations. The normal group with a peak at 16 CAG repeats and the HD group with a peak at 40 CAG repeats, with some overlap around 36 repeats. There is also a mater of instability. Those in the "normal" range show very little instability in repeat length from generation to generation, while those in the HD range and those in the intermediate range, show instability, particularly in paternal transmission (anticipation). (see Harper and Jones, 2003, in Bates et al, 2003: Huntington's disease, 3rd Ed, Oxford Monographs on Medical Genetics).D666D 22:47, 26 September 2007 (UTC)
  2. I have found the refernce and summarised in a table which answers this question. LeeVJ (talk) 17:50, 29 April 2008 (UTC)

[edit] Epidemiology incongruity

Found this unsigned comment hidden in wring section LeeVJ (talk) 00:47, 8 May 2008 (UTC) There is a incongruity with one of the citations for the article. At the intro, it is stated that HD is a genetic neurological disorder inherited by approximately 3 to 7 per 100,000 people of Western European descent, varying geographically, down to 1 per 1,000,000 of Asian and African descent. It says that this bit of information was retrieved from its source on May 22, 2008. If I am not mistaken, I accessed this article today--that is May 3. Someone ought to check this out.

Have checked it, links to correct article, there must have been a bug with the citation generator - well spotted though! LeeVJ (talk) 22:08, 13 May 2008 (UTC)

[edit] HD Management - Nutrition

In this article, it is said, "Most HD sufferers need two to three times the calories of the average person to maintain body weight", yet I have never seen any source that validates this. The largest supplement I have come across suggested by any particular study is 473 kcal/d in the study by Trejo et al. Conorcosgrave (talk) 17:52, 24 November 2007 (UTC)

Part of answer: 24hr energy expenditure increased 11% due to movements. ( Gaba AM, Zhang K, Marder K, Moskowitz CB, Werner P, Boozer CN (June 2005). "Energy balance in early-stage Huntington disease". Am. J. Clin. Nutr. 81 (6): 1335–41. PMID 15941884.  )LeeVJ (talk) 10:30, 2 May 2008 (UTC)

[edit] Commercial links ?

Since there are many trials and companies performing trials, didn't seem right to pick one out or list them all in main article, so maybe a list of companies conducting HD research is needed - need to trawl through manuals of style to find out if this is the wikipedia way...and have removed following recent link from article; --Leevanjackson (talk) 23:50, 15 March 2008 (UTC)

2008 Clinical Trials: Avicena's HD-02 to Proceed to NIH Sponsored Phase III Huntington's Disease Trial

[edit] global prevalence

trying to make a global map of prevalence but can't find a single source covering everything so have to build it up. some notes on different areas

[edit] GA review

This article generally does a good job covering an important topic on which there is a ton of material, so kudos to the writers. However, I think it does need a thorough copy edit and needs many citations; there are a bunch of sections that are unreferenced. Here are my suggestions. This looks like an awful lot but it's really mostly quick, easy fixes.

  1. The following sections have no citation: "Symptoms", "Cognitive", "Mechanism", "Pathophysiology", "Diagnosis", "Management", "Medication", "Social impact", and "Others".
  2. The following paragraphs have no citations: The first paragraph under "Genetics", the second and third under "Inheritance".
  3. I would leave the complicated epidemiology data out of the very first sentence, maybe put it in the second or third. Rather, I'd have the first sentence be about what the disease is like: "Huntington's is characterized by..." That way you could introduce the idea of the varied epidemiology at the beginning of a new sentence: "the number of people varies with ethnicity: 1 in 100,000..." ✓ Done LeeVJ (talk) 23:04, 23 May 2008 (UTC)
  4. "The disorder has been heavily researched in the last few decades" might be a problem per WP:DATED ✓ Done LeeVJ (talk) 22:14, 23 May 2008 (UTC)
  5. "late forties/early fifties" - I would write this out rather than using the slash, and make the spelled out number/numeral thing consistent. ✓ Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
  6. "usually at around 40-50 years" Use en dashes (–) rather than hyphens (-) for number ranges per WP:DASH. This is a repetition of the 2nd paragraph, too. ✓ Done LeeVJ (talk) 15:54, 22 May 2008 (UTC)
  7. " psychiatric changes, which pre-empt the physical ones, are overlooked" what does this mean? What does it mean to pre-epmt a symptom? Is that how you spell pre-empt? (I really don't know) ✓ Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
  8. "Physical symptoms are almost always evident" Does this mean "almost everyone with Huntington's gets physical symptoms?" Or something about how obvious the symptoms are? Maybe reword for clarity. ✓ Done LeeVJ (talk) 17:24, 22 May 2008 (UTC)
  9. "cognitive symptoms which can lead to psychopathological problems exhibit differently from person to person." would have a different meaning from "cognitive symptoms, which can lead to psychopathological problems, ..." The former is a more specific type of cognitive problem. Which is it? ✓ Done LeeVJ (talk) 21:16, 22 May 2008 (UTC)
  10. "some uncontrollable movement of the lips, chewing and swallowing (Dysphagia) which commonly causes weight loss" Some can usually be dropped without changing the meaning (see User:Tony1/How to satisfy Criterion 1a: redundancy exercises). Also, "uncontrollable movement of the lips, chewing and swallowing..." doesn't really make sense. Maybe "uncontrollable movement of the lips, problems with chewing and swallowing"? ✓ Done LeeVJ (talk) 22:49, 23 May 2008 (UTC)
  11. "Continence, eating and mobility are extremely difficult if not impossible." Impossible is a strong word. This would require a citation. ✓ Done LeeVJ (talk) 17:36, 22 May 2008 (UTC)
  12. "to date neither of this have been supported". Per WP:DATED, avoid "to date", replacing it with "As of [whenever]". ✓ Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
  13. I believe citation style calls for a capital letter after a colon in refs. ✓ Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
  14. "The latter can cause or worsen addictions such as alcoholism and gambling, or hypersexuality." is hypersexuality an addiction? If not, you could have "The latter can cause or worsen hypersexuality or addictions such as alcoholism and gambling." a cite would be good here too ..5 ✓ Done cite is left tagged LeeVJ (talk) 01:34, 27 May 2008 (UTC)
  15. Making that table float to the right would reduce whitespace (e.g. in rotavirus). ✓ Done LeeVJ (talk) 15:01, 22 May 2008 (UTC)
  16. Explain or at least wikilink "penetrance". {✓ Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
  17. "to have an increased mortality, progressively interfering with their functioning." Yeah, I guess dying would interfere with their functioning. :P Also, is there a simpler way to reword this for laypeople? ✓ Done LeeVJ (talk) 17:54, 23 May 2008 (UTC)
  18. You can do et al. for >3 or 6 names in a ref per WP:MEDMOS ✓ Done LeeVJ (talk) 15:51, 22 May 2008 (UTC)
  19. "Generally, but not always, the greater the number of CAG repeats..." doesn't really fit at the end of that paragraph, maybe you can fit it in the previous one. ✓ Done LeeVJ (talk) 18:24, 23 May 2008 (UTC)
  20. Image:Autosomal Dominant Pedigree Chart.svg could stand to be smaller. I'd recommend cropping the image and increasing the size of the text so it's still legible if you make it smaller (it's an svg so this won't be hard. I can do it if you need me to, I like doing junk like that).
    ✓ Done What do you think? Actually, I think I may have made the key box too big, I can shrink it and make the elements closer together if you think it's a good idea. delldot talk 07:05, 24 May 2008 (UTC)
    Much better! Still not sure about it's understanability to anyone who doesn't know what it means ! e.g. (I,II,III?) but at least it can be read now ..LeeVJ (talk) 11:34, 25 May 2008 (UTC)
  21. "and are finally cleared up in a process called degradation" cleared up? ✓ Done LeeVJ (talk) 17:45, 23 May 2008 (UTC)
  22. "The exact mechanism in which mHtt causes or affects the biological processes of DNA replication and programmed cell death (apoptosis) remains unclear, so research is divided into identifying the functioning of Htt, how mHtt differs or interferes with it, and the proteopathic effects of remnants of the protein (known as aggregates) left after degradation." - long and hard to follow. Is there a simpler way to say proteopathic? ✓ Done LeeVJ (talk) 23:59, 23 May 2008 (UTC)
  23. " This loss of BDNF may contribute to striatal cell death, which does not follow apoptotic pathways as the neurons appear to die of starvation." Can you reword into simpler terms for the layperson? This section could be fleshed out more anyway. Is this really all there is to say about their function?
  24. With mHtt, how are we supposed to deal with starting a sentence with a lower case letter? My instinct would be to reword so it doesn't come first (e.g. "The protein mHtt..." or "The erroneous protein mHtt" if there's an official thing known as an erroneous protein). You may want to look at featured protein articles if there are any to see how they handle the problem. ✓ Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
  25. "polyQ dependent transcription" should probably be "polyQ-dependent transcription". Can you check? ✓ Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
  26. "The aggregates also interact with SP1, thereby preventing it from binding to DNA,the normal functioning of these proteins" Unclear. Maybe "the way proteins normally do" or something. ✓ Done LeeVJ (talk) 20:24, 21 May 2008 (UTC)
  27. "Huntington mice models exposed to better husbandry techniques, especially better access to food and water, lived much longer than mice that were not well cared for." Citation needed here. The sentence should say "in a 1998 study..." or some such, since these are findings from a particular study, not something general. A review article that discusses the study should be used, not the study itself.
  28. "This is a significant find for Huntington's." What is a "significant find"? This sounds like opinion, though it's good that there's a ref. Don't know if this sentence adds anything though, without further explanation. ✓ Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
  29. I don't think the paragraph on Juvenile HD belongs in the prognosis section, it's more about symptoms or classification. Could merge with the mention under epidemiology as a last resort; at least this would cut down on repetition. ✓ Done LeeVJ (talk) 23:26, 23 May 2008 (UTC)
  30. Is there really only one sentence to be written about medication, in the treatment section? If so, this section should maybe be merged into another one. I would think, though, that more needs to be written here to adequately cover the subject.
  31. There are a number of very short paragraphs and sections. These are discouraged and should probably be merged or expanded.
  32. " An intracellularly expressed single-chain Fv against the amino-terminal end of mutant huntingtin (mHtt) has been shown to reduce mHtt aggregate formation and increase turnover of the mHtt fragments in tissue culture models of HD." Can the wording be simplified for the lay reader? ✓ Done LeeVJ (talk) 01:00, 27 May 2008 (UTC)
  33. "Intensive therapy: A pilot study on July, 2007, of inpatient rehabilitation for the Italian Welfare system, of speech, mind and body showed no motor decline in the two-year study." This needs rewording. ✓ Done LeeVJ (talk) 17:41, 23 May 2008 (UTC)
  34. The sentence under "Others" under "Research directions" needs a citation or citations.
  35. Any time you have a statistic, it requires a citation. For example, "The prevalence is, on average, between 5 and 8 per 100,000", and "...screening now make it possible (with 99 percent certainty) to have an HD-free child"
  36. It looks like there are an awful lot of primary sources, not the best per WP:MEDRS. Be careful when citing trials to be clear that it's a specific study and not general results, and use review articles or other secondary or tertiary sources whenever possible instead.
  • find references for all 'citations needed'. currently about 22
I have incorporated all the above points regarding missing references here, having tagged sections with 'fact' where required. LeeVJ (talk) 01:34, 27 May 2008 (UTC)

I'm failing this for now because I think finding all the needed citations will take more than the week usually allotted for a hold. Please feel free to nominate it again once that has been dealt with, though. I'm glad to give it another look when you want me to to let you know if I think it's ready to go up again. Sorry to be so picky, it really is a very nice article, so I decided to use a very fine toothed comb with the prose. Most of my points are very minor, however the citation needed issues need to get dealt with first and foremost. I'd also recommend having a copy editor look over the article, because there were a bunch of minor wording things that made me think the whole article could use a copy edit. It also looks like some of the areas I pointed out need a little expanding. Please don't hesitate to drop me a note if you need any help or explanation. delldot on a public computer talk 07:18, 21 May 2008 (UTC)

Get down with your bad self Leevanjackson! You're making great progress! delldot talk 07:05, 24 May 2008 (UTC)