Through the creation of their St. Louis Huntington's Disease Foundation, Sandy and Alan McDonald have found a unique way to advocate and promote care for Huntington's. In the article below Alan tells the story. "Hat's off" to this remarkable couple.

By now you've heard the disappointing news that TREND-HD, the phase III clinical trial testing ethyl-EPA for Huntington's has failed. The facts are pretty clear, EPA was no better than placebo, and in the following weeks, the HD community took a deep breath and accepted that this was the end of the omega-3 story. But should it be? In this article Dr. Goodman suggests a second look-- and wonders if the wrong omega-3 was tested.

We welcome Dr. Roger Carnes M.D., a retired obstetrician-gynecologist from Washington State as guest editor/writer for HDDW. Here he reviews the process of genetic testing on embryos for couples at risk for Huntington's, and reports on information obtained from an interview with Dr. Mark Hughes, whose laboratory performs all the testing performed in the U.S.

Researchers from the University of Cambridge in England report promising results for trehalose in models of both Huntington's and Parkinson's. Dr. LaVonne Veatch Goodman reviews this report that focuses on trehalose benefit shown in a cellular system called autophagy. This mode of action now joins a growing list of cellular benefits for this safe treatment; in fact, scientists have now described more neuroprotective mechanisms triggered by trehalose than any other agent studied in HD models.

Huntington's families frequently complain about inadequate treatment given by general physicians who have little experience with the disease. Dr. Goodman discusses possible reasons for this situation and suggests a solution that could improve treatment.

This week the news is our own as we launch a new focus and look to the HDDW web site. All subsequent articles will focus solely on treatments and clinical trials for Huntington's Disease. Articles will be separated into sections that include treatment and clinical trial news, research relevant to treatments, and feature/opinion articles.

The first goal is to supply information on old treatments: available drugs, supplements, lifestyle and alternative therapies that may give benefit to Huntington's people. These treatments are further separated into those that are used for chorea or psychiatric symptoms, and those that may provide neuroprotection or delay the progression of disease. Though the benefit of the majority of treatments, either those for symptoms or neuroprotection, have not been proved by clinical trials, the evidence that is available will be presented.

This week we review two related research studies that describe neuropsychiatric symptoms in Huntington's. The first is an old study (2001) of diagnosed Huntington's patients. The second is a more recent study (2007) of gene positive individuals before or during the onset of motor symptoms. It is no surprise to Huntington's families that high rates of neuropsychiatric symptoms occurred in both groups. However what Dr. Goodman finds surprising is how few were treated.

Impressive progress has been made by CHDI, a non-profit drug development organization devoted to HD. Dr. LaVonne Veatch Goodman presents highlights on drugs being developed for HD reported at this year's CHDI conference.

The Huntington's community has been without treatment for so long that we don't let ourselves even think about success. And true to that pattern, both Jim Tretheway and I recently gave cautious overviews on the status of CHDI and HD drug development. This week, I'll take different approach using a real world example that gives a best case scenario that could be possible for HD following the advances made in the past two years by scientists and CHDI. Why do this? We need to be prepared for best case too.

Congress will probably pass a law next year that aims to improve the safety of mass market drugs like Vioxx. In this perspective published in PharmaDD, Dr. Nathan Goodman pleads with Congress to also include reforms that will provide faster access to drugs for seriously ill patients.

See Goodman's article in PharmaDD.