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The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease : an exploratory study

Cruickshank, Travis M; Thompson, Jennifer A; Domínguez D, Juan F; Reyes, Alvaro P; Bynevelt, Mike; Georgiou-Karistianis, Nellie; Barker, Roger A LU and Ziman, Mel R (2015) In Brain and Behavior 5(2).
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... (More)

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.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Aged, Brain, Brain Mapping, Cognition, Disease Progression, Female, Follow-Up Studies, Humans, Huntington Disease, Life Style, Magnetic Resonance Imaging, Male, Middle Aged, Pilot Projects, Evaluation Studies, Journal Article, Research Support, Non-U.S. Gov't
in
Brain and Behavior
volume
5
issue
2
publisher
John Wiley & Sons
external identifiers
  • scopus:84923312422
ISSN
2162-3279
DOI
10.1002/brb3.312
language
English
LU publication?
no
id
d76b7fd4-374b-414b-9bf5-4b6cc0c92c18
date added to LUP
2016-11-24 14:55:59
date last changed
2017-08-06 05:13:59
@article{d76b7fd4-374b-414b-9bf5-4b6cc0c92c18,
  abstract     = {<p>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.</p><p>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.</p><p>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.</p><p>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.</p>},
  articleno    = {e00312},
  author       = {Cruickshank, Travis M and Thompson, Jennifer A and Domínguez D, Juan F and Reyes, Alvaro P and Bynevelt, Mike and Georgiou-Karistianis, Nellie and Barker, Roger A and Ziman, Mel R},
  issn         = {2162-3279},
  keyword      = {Aged,Brain,Brain Mapping,Cognition,Disease Progression,Female,Follow-Up Studies,Humans,Huntington Disease,Life Style,Magnetic Resonance Imaging,Male,Middle Aged,Pilot Projects,Evaluation Studies,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {2},
  publisher    = {John Wiley & Sons},
  series       = {Brain and Behavior},
  title        = {The effect of multidisciplinary rehabilitation on brain structure and cognition in Huntington's disease : an exploratory study},
  url          = {http://dx.doi.org/10.1002/brb3.312},
  volume       = {5},
  year         = {2015},
}