Huntingtons and EPA

Treatment of Huntingtons disease with eicosapentaenoic acid (epa): a randomised, placebo-controlled trial

Huntingtons disease is a devastating illness caused by over-expression of the protein huntingtin. The mechanism of the damage is unknown. There is evidence of increased membrane breakdown and oxidative damage to neurons. This may be associated with excess activity of phospholipase (PL) A2. The disease causes psychotic behaviour, movement disorders, memory loss and dementia. There are no known treatments.

Eicosapenaenoic acid (EPA) is an inhibitor of PLA2, A randomised, placebo-controlled double-blind trial of 2g/day of the 97% pure ethyl ester of EPA was performed over a six month period in patients with end-stage Huntington's disease.

The overall condition of each patient was assessed on the Unified Huntingtons Disease Rating Scale (UHDRS) and the brain of each patient at the beginning and end of the study was assessed by magnetic resonance imaging (MRI). Eight patients entered the study but one died prior to randomisation.

At the end of the study, four patients were rated as deteriorated and three as improved. The four patients who deteriorated were on placebo while the three who improved were on ethyl EPA(p<0.04, Fisher's exact test).

All patients had MRI scans at the beginning and end of the study but, because of the movement disorders, the before and after pairs were evaluable in only four patients. In the two patients on placebo, ventricular size had increased, indicating disease progression. In contrast, in the two patients on ethyl-EPA ventricular size decreased consistent with some recovery of brain mass.

Ethyl-EPA is the first treatment shown to be beneficial in Huntingtons disease in a placebo-controlled study.

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