Molecular Mechanisms and Biochemical Alterations in Huntington’s Disease: Current Perspectives and Emerging Insights

Huntington disease (HD) is a progressive, inherited neurodegenerative disorder with motor, cognitive, and psychiatric manifestations. This review aims to synthesize current knowledge on the epidemiology, pathogenesis, and management of HD, and critically evaluate advances in emerging therapeutic strategies. Key findings reveal that HD is frequently underdiagnosed in non-European populations due to limited data and awareness, and that significant disparities exist in access to care and genetic testing worldwide. Although current therapies are limited to symptomatic management, recent research has clarified the molecular mechanisms of neuronal degeneration, including excitotoxicity, mitochondrial dysfunction, and oxidative stress. The review highlights promising developments in RNA-targeted therapies, gene-editing technologies such as CRISPR-Cas9, stem cell approaches, and antioxidant interventions, though none have yet to demonstrate disease-modifying effects in clinical trials. Overall, continued research and improved global surveillance are essential for advancing early diagnosis, expanding access to care, and ultimately developing effective, disease-modifying treatments for HD.