Huntington disease Quiz: Ace Your Exams

A 36-year-old man comes to the clinic with his partner due to episodes of uncontrollable crying and laughing, as well as abnormal body movements. The partner states that the patient has not been himself for the past year. In the beginning, she thought that he was going through a tough time because he was fired from his job as an accountant. He was constantly making mistakes, and his boss eventually released him after multiple poor performance reviews. The patient’s partner started worrying when she noticed him making odd movements with his hands. Vitals are within normal limits. On physical examination, the patient appears restless and sad. There is a mild hand tremor present on the right and occasional brief, abrupt movement of the right upper extremity as well as occasional facial grimacing. The patient walks in slow small steps. Which of the following is most likely to be found on brain imaging of this patient?