The effects of multidisciplinary rehabilitation on neuroimaging, biological, cognitive and motor outcomes in individuals with premanifest Huntington's disease

Danielle M Bartlett; Andrew Govus; Timothy Rankin; Amit Lampit; Kirk Feindel; Govinda Poudel; Wei-Peng Teo; Johnny Lo; Nellie Georgiou-Karistianis; Mel R Ziman; Travis M Cruickshank

doi:10.1016/j.jns.2020.117022

The effects of multidisciplinary rehabilitation on neuroimaging, biological, cognitive and motor outcomes in individuals with premanifest Huntington's disease

J Neurol Sci. 2020 Sep 15:416:117022. doi: 10.1016/j.jns.2020.117022. Epub 2020 Jul 12.

Authors

Affiliations

¹ School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
² School of Allied Health, Human Services & Sport, Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Victoria, Australia.
³ School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia.
⁴ Department of Psychiatry, University of Melbourne, Victoria, Australia; Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
⁵ Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Australia.
⁶ Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
⁷ National Institute of Education, Nanyang Technological University, Singapore.
⁸ School of Science, Edith Cowan University, Joondalup, Western Australia, Australia.
⁹ School of Psychological Sciences, The Turner Institute of Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
¹⁰ School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; School of Biomedical Science, University of Western Australia, Crawley, Western Australia, Australia.
¹¹ School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia. Electronic address: t.cruickshank@ecu.edu.au.

PMID: 32688143
DOI: 10.1016/j.jns.2020.117022

Abstract

Background: Huntington's disease (HD) is a chronic, progressive neurodegenerative condition for which there are currently no proven disease-modifying therapies. Lifestyle factors have been shown to impact on the age of disease onset and progression of disease features. We therefore investigated the effects of a nine-month multidisciplinary rehabilitation intervention on neuroimaging, biological and clinical disease outcomes in individuals with premanifest HD.

Methods: 31 individuals with premanifest HD participated in the study. Eighteen participants underwent a nine-month multidisciplinary rehabilitation intervention comprising aerobic and resistance exercise, computerised cognitive training, dual-task training and sleep hygiene and nutritional guidance. The remaining 13 participants were allocated to a standard care control group. Neuroimaging, biological, cognitive, motor and cardiorespiratory fitness data was collected.

Results: Participants displayed good adherence (87%) and compliance (85%) to the intervention. Maintenance of the shape of the right putamen was observed in the intervention group when compared to the control group. The intervention group displayed significant improvements in verbal learning and memory, attention, cognitive flexibility and processing speed following the intervention when compared to the control group. Performance on the mini-social cognition and emotional assessment (mini-SEA) was maintained in the intervention group, but decreased in the control group. No changes were observed in serum neurofilament light protein levels, postural stability outcomes or cardiorespiratory fitness.

Conclusion: This study adds to the accumulating body of literature to suggest that multidisciplinary rehabilitation is of clinical benefit for individuals with HD. Large randomised controlled trials are necessary to determine the extent to which benefits occur across the spectrum of the disease.

Keywords: Cardiorespiratory fitness; MRI; Neurofilament light protein; Postural stability; Striatal shape.

MeSH terms

Cognition
Cognition Disorders*
Humans
Huntington Disease* / complications
Huntington Disease* / diagnostic imaging
Huntington Disease* / therapy
Neuroimaging