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A retrospective analysis of hand tapping as a longitudinal marker of disease progression in Huntington's disease

Collins, Lucy M; Lazic, Stanley E and Barker, Roger A LU (2014) In BMC Neurology 14.
Abstract

BACKGROUND: Current clinical assessments of motor function in Huntington's Disease (HD) rely on subjective ratings such as the Unified Huntington's Disease Rating scale (UHDRS). The ability to track disease progression using simple, objective, inexpensive, and robust measures would be beneficial.

METHODS: One objective measure of motor performance is hand-tapping. Over the last 14 years we have routinely collected, using a simple device, the number of taps made by the right and left hand over 30 seconds in HD patients attending our NHS clinics.

RESULTS: Here we report on a longitudinal cohort of 237 patients, which includes patients at all stages of the disease on a wide range of drug therapies. Hand tapping in these... (More)

BACKGROUND: Current clinical assessments of motor function in Huntington's Disease (HD) rely on subjective ratings such as the Unified Huntington's Disease Rating scale (UHDRS). The ability to track disease progression using simple, objective, inexpensive, and robust measures would be beneficial.

METHODS: One objective measure of motor performance is hand-tapping. Over the last 14 years we have routinely collected, using a simple device, the number of taps made by the right and left hand over 30 seconds in HD patients attending our NHS clinics.

RESULTS: Here we report on a longitudinal cohort of 237 patients, which includes patients at all stages of the disease on a wide range of drug therapies. Hand tapping in these patients declines linearly at a rate of 5.1 taps per year (p < 0.0001; 95% CI = 3.8 to 6.3 taps), and for each additional year of age patients could perform 0.9 fewer taps (main effect of age: p = 0.0007; 95% CI = 0.4 to 1.4). Individual trajectories can vary widely around this average rate of decline, and much of this variation could be attributed to CAG repeat length. Genotype information was available for a subset of 151 patients, and for each additional repeat, patients could perform 5.6 fewer taps (p < 0.0001; 95% CI = 3.3 to 8.0 taps), and progressed at a faster rate of 0.45 fewer taps per year (CAG by time interaction: p = 0.008; 95% CI = 0.12 to 0.78 taps). In addition, for each unit decrease in Total Functional Capacity (TFC) within individuals, the number of taps decreased by 6.3 (95% CI = 5.4 to 7.1, p < 0.0001).

CONCLUSIONS: Hand tapping is a simple, robust, and reliable marker of disease progression. As such, this simple motor task could be a useful tool by which to assess disease progression as well therapies designed to slow it down.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Adolescent, Adult, Aged, Cohort Studies, Disease Progression, Female, Hand, Humans, Huntington Disease, Longitudinal Studies, Male, Middle Aged, Motor Skills, Movement, Retrospective Studies, Young Adult, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
in
BMC Neurology
volume
14
publisher
BioMed Central
external identifiers
  • scopus:84896727446
ISSN
1471-2377
DOI
10.1186/1471-2377-14-35
language
English
LU publication?
no
id
b7c1fd5e-0e74-4f25-8eb4-e8628ba9e5ab
date added to LUP
2016-11-24 15:15:13
date last changed
2017-01-01 08:40:44
@article{b7c1fd5e-0e74-4f25-8eb4-e8628ba9e5ab,
  abstract     = {<p>BACKGROUND: Current clinical assessments of motor function in Huntington's Disease (HD) rely on subjective ratings such as the Unified Huntington's Disease Rating scale (UHDRS). The ability to track disease progression using simple, objective, inexpensive, and robust measures would be beneficial.</p><p>METHODS: One objective measure of motor performance is hand-tapping. Over the last 14 years we have routinely collected, using a simple device, the number of taps made by the right and left hand over 30 seconds in HD patients attending our NHS clinics.</p><p>RESULTS: Here we report on a longitudinal cohort of 237 patients, which includes patients at all stages of the disease on a wide range of drug therapies. Hand tapping in these patients declines linearly at a rate of 5.1 taps per year (p &lt; 0.0001; 95% CI = 3.8 to 6.3 taps), and for each additional year of age patients could perform 0.9 fewer taps (main effect of age: p = 0.0007; 95% CI = 0.4 to 1.4). Individual trajectories can vary widely around this average rate of decline, and much of this variation could be attributed to CAG repeat length. Genotype information was available for a subset of 151 patients, and for each additional repeat, patients could perform 5.6 fewer taps (p &lt; 0.0001; 95% CI = 3.3 to 8.0 taps), and progressed at a faster rate of 0.45 fewer taps per year (CAG by time interaction: p = 0.008; 95% CI = 0.12 to 0.78 taps). In addition, for each unit decrease in Total Functional Capacity (TFC) within individuals, the number of taps decreased by 6.3 (95% CI = 5.4 to 7.1, p &lt; 0.0001).</p><p>CONCLUSIONS: Hand tapping is a simple, robust, and reliable marker of disease progression. As such, this simple motor task could be a useful tool by which to assess disease progression as well therapies designed to slow it down.</p>},
  articleno    = {35},
  author       = {Collins, Lucy M and Lazic, Stanley E and Barker, Roger A},
  issn         = {1471-2377},
  keyword      = {Adolescent,Adult,Aged,Cohort Studies,Disease Progression,Female,Hand,Humans,Huntington Disease,Longitudinal Studies,Male,Middle Aged,Motor Skills,Movement,Retrospective Studies,Young Adult,Journal Article,Randomized Controlled Trial,Research Support, Non-U.S. Gov't},
  language     = {eng},
  month        = {02},
  publisher    = {BioMed Central},
  series       = {BMC Neurology},
  title        = {A retrospective analysis of hand tapping as a longitudinal marker of disease progression in Huntington's disease},
  url          = {http://dx.doi.org/10.1186/1471-2377-14-35},
  volume       = {14},
  year         = {2014},
}