{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:16:24Z","timestamp":1788347784460,"version":"build-2803163510"},"reference-count":173,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Huntington\u2019s disease (HD) disrupts cortico-striato-thalamocortical circuits decades before clinical onset. Electroencephalography (EEG) offers millisecond temporal resolution, low cost, and broad accessibility, yet its mechanistic and biomarker potential in HD remains underexplored. We conducted a mechanistic review to synthesize half a century of EEG findings, identify reproducible electrophysiological signatures, and outline translational next steps. Methods: Two independent reviewers searched PubMed, Scopus, Google Scholar, ResearchGate, and the Cochrane Library (January 1970\u2013April 2025) using the terms \u201cEEG\u201d OR \u201celectroencephalography\u201d AND \u201cHuntington\u2019s disease\u201d. Clinical trials published in English that reported raw EEG (not ERP-only) in human HD gene carriers were eligible. Abstract\/title screening, full-text appraisal, and cross-reference mining yielded 22 studies (~700 HD recordings, ~600 controls). We extracted sample characteristics, acquisition protocols, spectral\/connectivity metrics, and neuroclinical correlations. Results: Across diverse platforms, a consistent spectral trajectory emerged: (i) presymptomatic carriers show a focal 7\u20139 Hz (low-alpha) power loss that scales with CAG repeat length; (ii) early-manifest patients exhibit widespread alpha attenuation, delta\u2013theta excess, and a flattened anterior-posterior gradient; (iii) advanced disease is characterized by global slow-wave dominance and low-voltage tracings. Source-resolved studies reveal early alpha hypocoherence and progressive delta\/high-beta hypersynchrony, microstate shifts (A\/B \u2191, C\/D \u2193), and rising omega complexity. These electrophysiological changes correlate with motor burden, cognitive slowing, sleep fragmentation, and neurovascular uncoupling, and achieve 80\u201390% diagnostic accuracy in shallow machine-learning pipelines. Conclusions: EEG offers a coherent, stage-sensitive window on HD pathophysiology\u2014from early thalamocortical disinhibition to late network fragmentation\u2014and fulfills key biomarker criteria. Translation now depends on large, longitudinal, multi-center cohorts with harmonized high-density protocols, rigorous artifact control, and linkage to clinical milestones. Such infrastructure will enable the qualification of alpha-band restoration, delta-band hypersynchrony, and neurovascular coupling as pharmacodynamic readouts, fostering precision monitoring and network-targeted therapy in Huntington\u2019s disease.<\/jats:p>","DOI":"10.3390\/jcm14145010","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T15:01:05Z","timestamp":1752591665000},"page":"5010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Neural Correlates of Huntington\u2019s Disease Based on Electroencephalography (EEG): A Mechanistic Review and Discussion of Excitation and Inhibition (E\/I) Imbalance"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5320-3658","authenticated-orcid":false,"given":"James","family":"Chmiel","sequence":"first","affiliation":[{"name":"Faculty of Physical Culture and Health, Institute of Physical Culture Sciences, University of Szczecin, Al. Piast\u00f3w 40B blok 6, 71-065 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5477-5405","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Nadobnik","sequence":"additional","affiliation":[{"name":"Faculty of Physical Culture and Health, Institute of Physical Culture Sciences, University of Szczecin, Al. Piast\u00f3w 40B blok 6, 71-065 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szymon","family":"Smerdel","sequence":"additional","affiliation":[{"name":"School of Sports Championships FASE\u2014Football Academy School of Excellence, Kelvin Grove, QLD 4059, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7806-0837","authenticated-orcid":false,"given":"Mirela","family":"Niedzielska","sequence":"additional","affiliation":[{"name":"Department of the History of Medicine and Medical Ethics, Pomeranian Medical University, 70-204 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"ref_1","unstructured":"Ajitkumar, A., Lui, F., and De Jesus, O. (2025). Huntington Disease. 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