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J03 The Effect Of Multidisciplinary Rehabilitation On Brain Structure And Cognition In Huntington’s Disease: An Exploratory Study
  1. T Cruickshank1,
  2. J Thompson1,
  3. J Domínguez2,
  4. A Reyes1,
  5. M Bynevelt3,
  6. N Georgiou-Karistianis2,
  7. R Barker1,4,
  8. M Ziman1,5
  1. 1School of Medical Sciences, Edith Cowan University, Perth, Australia
  2. 2School of Psychological Sciences, Monash University, Melbourne, Australia
  3. 3Department of Surgery, UWA and Neurological Intervention and Imaging Service of Western Australia
  4. 4John Van Geest Centre for Brain Repair, Cambridge, UK
  5. 5School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia

Abstract

Background There is a wealth of evidence for grey matter degeneration and loss of cognitive function over time in individuals with Huntington’s disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD.

Aims This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD.

Methods Fifteen participants with manifest HD undertook a multidisciplinary rehabilitation intervention spanning nine months. The intervention consisted of once-weekly supervised clinical exercise, thrice weekly self-directed home based exercise and fortnightly occupational therapy. Participants were assessed using MR imaging and validated cognitive measures at baseline and after nine months.

Results Participants displayed significantly increased grey matter volume in the right caudate and bilaterally in the dorsolateral prefrontal cortex after nine months of multidisciplinary rehabilitation. Volumetric increases in grey matter were accompanied by significant improvements in verbal learning and memory (Hopkins Verbal Learning-Test). A significant association was found between grey matter volume increases in the dorsolateral prefrontal cortex and performance on verbal learning and memory.

Conclusions This study provides preliminary evidence that multidisciplinary rehabilitation positively impacts on grey matter changes and cognitive functions relating to verbal learning and memory in individuals with manifest HD. Larger controlled trials are required to confirm these preliminary findings.

KeyWords
  • Cognition
  • executive function
  • Huntington’s disease
  • neuropathology
  • rehabilitation

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