It is beginning to look like RNA therapy might become a reality for Huntington's disease. While there can still be unforeseen problems, a recent announcement from CHDI and ISIS Pharmaceuticals tells us that very important steps demonstrating efficacy and safety have been made. This is very good news because a potent RNA drug will stop Huntington's at its source, and we could let ourselves say the "cure" word.

On December 6, members of the Peripheral and Central Nervous System Drug Advisory Committee unanimously voted to recommend FDA approval for tetrabenazine. This is a huge step forward because the FDA almost always follows the recommendations from it's advisory committees.

Earlier this week the FDA Revitalization Act became law. Though the major thrust of this legislation addresses drug safety and conflict of interest in FDA scientific advisory committees, there are several changes that are of special interest for the HD community.

If you are near Boston on December 1st, it will be more than worth the trip to the Inaugural Huntington Disease Clinical Research Symposium, hosted by the Huntington Study Group. This meeting is the first of its kind, and means that research for Huntingon people is on center stage.

Drug safety has understandably been much in the press recently -- but speeding good new drugs to those who need them most is equally critical.

Serotonin reuptake inhibitor drugs (SSRIs) treat depression and many other symptoms in Huntington's. While these actions are very important, SSRI drugs do much more. Studies show that they are neuroprotective, or able to limit HD damage to the brain. Studies also show that they promote neurogenesis or the development of new brain cells in mouse models. With all of these benefits for symptoms and neuroprotection, Dr. Goodman wonders why these drugs are underused in HD.

Two recent reports in prominant medical journals tell us that high doses of antioxidant supplements including Beta-carotene, vitamin A, vitamin E, and selenium, used separately or in combination are not helpful for chronic medical problems, and indeed may cause harm.

Endurance exercise--like walking or jogging--is good for almost any medical condition. It reduces risks for obesity, heart disease, diabetes, and some cancers. For neurologic processes, this type of exercise improves blood supply to the brain, boosts mood, decreases anxiety and improves cognition. Though there are no studies for HD, others done in aging, Alzheimer's and Parkinson's disease show that exercise improves functional capacity. What about exercise in Huntington's? Is it beneficial? How much is enough? Can there be too much?

Resveratrol is a natural substance found in small quantities in the skin of grapes, blueberries, cranberries and most highly concentrated in red wine. This substance which is available as a dietary supplement has been shown to protect several types of cells and organisms from oxidative stress, and to prolong life in some organisms. In this article, Dr. Goodman reviews the preliminary evidence that may support its use in Huntington's.

Participating centers have been announced, and are recruiting. The Dimebon trials will need 90 participants and will last three months.