Huntington’s disease (HD) is characterized by motor and cognitive impairments including
memory, executive, and attentional functions. However, because earlier studies relied on
multidetermined attentional tasks, uncertainty still abounds regarding the differential deficit across
attentional subcomponents. Likewise, the evolution of these deficits during the successive stages of
HD remains unclear. The present study simultaneously explored 3 distinct networks of attention
(alerting, orienting, executive conflict) in preclinical and clinical HD. Method: Thirty-eight HD
patients (18 preclinical) and 38 matched healthy controls completed the attention network test, an
integrated and theoretically grounded task assessing the integrity of 3 attentional networks. Results:
Preclinical HD was not characterized by any attentional deficit compared to controls. Conversely,
clinical HD was associated with a differential deficit across the 3 attentional networks under
investigation, showing preserved performance for alerting and orienting networks but massive and
specific impairment for the executive conflict network. This indexes an impaired use of executive
control to resolve the conflict between task-relevant stimuli and interfering task-irrelevant ones.
Conclusion: Clinical HD does not lead to a global attentional deficit but rather to a specific
impairment for the executive control of attention. Moreover, the absence of attentional deficits in
preclinical HD suggests that these deficits are absent at the initial stages of the disease. In view of
their impact on everyday life, attentional deficits should be considered in clinical contexts.
Therapeutic programs improving the executive control of attention by neuropsychology and neuromodulation
should be promoted