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© 2015. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

There is a wealth of evidence detailing gray 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. 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 who manifest HD undertook a multidisciplinary rehabilitation intervention spanning 9 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 9 months.

Results

Participants displayed significantly increased gray matter volume in the right caudate and bilaterally in the dorsolateral prefrontal cortex after 9 months of multidisciplinary rehabilitation. Volumetric increases in gray matter were accompanied by significant improvements in verbal learning and memory (Hopkins Verbal Learning‐Test). A significant association was found between gray 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 gray 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.

Details

Title
The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease: an exploratory study
Author
Cruickshank, Travis M 1 ; Thompson, Jennifer A 1 ; Domínguez D, Juan F 2 ; Reyes, Alvaro P 1 ; Bynevelt, Mike 3 ; Nellie Georgiou‐Karistianis 2 ; Barker, Roger A 4 ; Ziman, Mel R 5 

 School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia 
 School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia 
 Department of Surgery, UWA and Neurological Intervention and Imaging Service of Western Australia, Perth, Western Australia, Australia 
 John van Geest Centre for Brain Repair, Cambridge, U.K 
 School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia 
Section
Original Research
Publication year
2015
Publication date
Feb 2015
Publisher
John Wiley & Sons, Inc.
e-ISSN
21623279
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2290229885
Copyright
© 2015. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.