# Investigating Autonomic Dysfunction as an Early Pathologic Feature of Huntington’s Disease

> **NIH NIH K23** · UNIVERSITY OF IOWA · 2024 · $179,369

## Abstract

Project Summary/Abstract
The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to support my short-term
career objective of determining if dysfunction of the autonomic nervous system (ANS) is an early pathological
feature of HD by quantitatively characterizing functional connections between brain regions that regulate the
ANS in children with the gene expansion that causes HD using magnetic resonance imaging (MRI). I will also
investigate unique physiologic measures of ANS function and early effects on the vascular system in these
participants. ANS dysfunction has been described in adult patients with HD, but it has been thought that this is
a secondary complication of neurodegeneration. However, I recently discovered that children carrying the HD
gene expansion that causes HD (GE children) exhibit symptoms consistent with enhanced sympathetic tone
decades prior to their predicted motor onset. These findings indicate that ANS dysfunction may be one of the
earliest manifestations of neurodegeneration in HD. As a result, the ANS may be a therapeutic target for disease
modification of HD, but more information is required. The ANS is highly regulated by cortical brain regions that
comprise the Central Autonomic Network (CAN), and cortical thinning and atrophy have been well-described in
HD. However, there are no published reports that have objectively characterized the integrity of the functional
connections in the CAN in HD. I will perform resting-state and tasked functional MRI on GE children to
characterize the function of the CAN at different stages of the disease. This experiment will test the specific
hypothesis that quantitative changes in functional integrity of the CAN are apparent decades prior to the predicted
motor onset of HD. Additionally, I will explore physiologic measure of ANS dysfunction including baroreflex
sensitivity (BRS) and how this relates to the function of the vascular system early in the disease course of HD.
Specifically, I will measure aortic stiffness and carotid artery compliance while also measuring cerebral blood
flow using arterial spin labeling to test the hypotheses that relative to healthy control children, GE children will
demonstrate increased aortic stiffness, decreased BRS, and decreased cerebral blood flow. These experiments
will provide vital information regarding when ANS dysfunction occurs in HD, the underlying mechanisms
causing the dysfunction, and if these changes have negative effects on the cardiovascular system early
in the disease course. I have a unique background that positions me well to be a successful translational
scientist. Further training is required in sophisticated neuroimaging methods, neurodevelopment and
neurobiology, as well as biostatistics. The proposed integrated research, world-class mentorship team, and
didactic training programs will ensure my short-term and long-term success. Additionally, the proposed research
and training plans support my long-term...

## Key facts

- **NIH application ID:** 10819139
- **Project number:** 5K23NS117736-04
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Jordan Schultz
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $179,369
- **Award type:** 5
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10819139

## Citation

> US National Institutes of Health, RePORTER application 10819139, Investigating Autonomic Dysfunction as an Early Pathologic Feature of Huntington’s Disease (5K23NS117736-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10819139. Licensed CC0.

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