The Predict-HD study aimed to understand the early progression of Huntington's disease (HD) using genetic, neurobiological, and refined clinical markers in individuals with a known gene mutation but no clinical symptoms. The study involved 438 participants who were positive for the HD gene mutation but did not meet diagnostic criteria for HD. The researchers modeled the predictability of baseline cognitive, motor, psychiatric, and imaging measures using estimated time until diagnosis as the predictor. The results showed that the estimated time to diagnosis was related to most clinical and neuroimaging markers, with detectable changes occurring one to two decades before the predicted time of clinical diagnosis. These findings suggest a robust and consistent pattern of disease development, providing a time scale for measurable disease progression and potential markers for preventive HD trials.The Predict-HD study aimed to understand the early progression of Huntington's disease (HD) using genetic, neurobiological, and refined clinical markers in individuals with a known gene mutation but no clinical symptoms. The study involved 438 participants who were positive for the HD gene mutation but did not meet diagnostic criteria for HD. The researchers modeled the predictability of baseline cognitive, motor, psychiatric, and imaging measures using estimated time until diagnosis as the predictor. The results showed that the estimated time to diagnosis was related to most clinical and neuroimaging markers, with detectable changes occurring one to two decades before the predicted time of clinical diagnosis. These findings suggest a robust and consistent pattern of disease development, providing a time scale for measurable disease progression and potential markers for preventive HD trials.