{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:18:43Z","timestamp":1791231523913,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T00:00:00Z","timestamp":1410480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2014,9,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The clinical syndrome of Huntington's disease (HD) is notable for a triad of motor, cognitive, and emotional features. All HD patients eventually become occupationally disabled; however, the factors that render HD patients unable to maintain employment have not been extensively studied. This review begins by discussing the clinical triad of HD, highlighting the distinction in the motor disorder between involuntary movements, such as chorea, and voluntary movement impairment, with the latter contributing more to functional disability. Cognitive disorder clearly contributes to disability, though the relative contribution compared to motor is difficult to unravel, especially because many of the tests used to asses \u201ccognition\u201d have a strong motor component. The role of emotional changes in disability needs more study. The literature on contributions to functional disability, driving impairment, and nursing home placement is reviewed. Relevant experience is presented from the long\u2010standing JHU HD observational study on motor versus cognitive onset, as well as on cognitive and motor features at the time when individuals discontinued working. Finally, we briefly review government policies in several countries on disability determination. We interpret the data from our own studies and from the literature to indicate that there is usually a close relationship between cognitive and motor dysfunction, and that it is critical to take both into consideration in determining disability. \u00a9 2014 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.26012","type":"journal-article","created":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T07:10:44Z","timestamp":1410505844000},"page":"1351-1358","source":"Crossref","is-referenced-by-count":95,"title":["Determinants of functional disability in Huntington's disease: Role of cognitive and motor dysfunction"],"prefix":"10.1002","volume":"29","author":[{"given":"Christopher A.","family":"Ross","sequence":"first","affiliation":[{"name":"Division of Neurobiology, Department of Psychiatry, Departments of Neurology Neuroscience, and Pharmacology, and Program in Cellular and Molecular Medicine, Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Pantelyat","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Kogan","sequence":"additional","affiliation":[{"name":"Huntington's Disease Society of America New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Brandt","sequence":"additional","affiliation":[{"name":"Division of Medical Psychology, Department of Psychiatry, and Department of Neurology, Johns Hopkins University School of Medicine, Joint Appointment, Department of Mental Health Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60111-1"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70245-3"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.24"},{"key":"e_1_2_13_5_1","first-page":"181","article-title":"The psychopathology of Huntington's disease","volume":"69","author":"Folstein SE","year":"1991","journal-title":"Res Publ Assoc Res Nerv Ment Dis"},{"key":"e_1_2_13_6_1","volume-title":"Huntington's Disease: A Disorder of Families","author":"Folstein SE","year":"1989"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","unstructured":"Unified Huntington's Disease Rating Scale: reliability and consistency. 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