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Dr. Paulsen's research program, in the Neurology Department, supports research in rare forms of very early cognitive decline and dementia (i.e., CADASIL, Huntington's disease). Our research studies help develop and refine the tools that can be used in clinical trials to measure the effectiveness of treatment before the disease impacts daily life. We seek to develop measures, methods and models of disease onset and progression that facilitate interventions and treatment programs throughout the life course of disease from being healthy and living at risk to managing early brain dysfunction and mild cognitive declines, to preparing for disease progression with loss of control over emotional, organizational, motor, and cognitive processes. Starting treatment sooner may help delay the start of symptoms or slow down the progression of the disease. Some scientists think that treatments may be more likely to work when the brain is still healthy, rather than later in the disease when many brain cells are gone. We want to plan for future clinical trials by finding and tracking subtle but measurable changes in behavior, cognition, and emotional responses that occur before the more visible symptoms appear.