Which medication is known to improve chorea and cognition in Huntington's disease?

• A. Tetrabenazine (decrease DA)
• B. Amantadine (improve chorea & cognition)
• C. Anti-psychotics (reduce depression/anxiety)
• D. Stem cell therapy (slow progression)

Answer: (B)

In Huntington’s disease, chorea and difficulty with movement come from disrupted signaling in the basal ganglia, where techniques that modulate dopamine can stabilize motor control and may also influence cognition. Amantadine stands out because it has a dual action: it enhances dopaminergic activity to smooth out involuntary movements, and it also blocks NMDA receptors, which can help reduce excitotoxic stress on neurons. That combination can lead to improvements in chorea and, in some cases, better cognitive performance or slower cognitive decline.

Other options either primarily reduce chorea by lowering dopamine (which can worsen mood or cognition), help mainly with psychiatric symptoms, or are experimental with no proven benefit for slowing disease progression. So amantadine is the best-known choice for addressing both movement and cognitive aspects in Huntington’s disease.