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.

中文翻译：

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多学科康复对先兆亨廷顿病患者神经影像学、生物学、认知和运动结果的影响

背景亨廷顿病(HD)是一种慢性、进行性神经退行性疾病，目前尚无经证实的疾病缓解疗法。生活方式因素已被证明会影响疾病发作的年龄和疾病特征的进展。因此，我们研究了为期 9 个月的多学科康复干预对先兆 HD 个体的神经影像学、生物学和临床疾病结果的影响。方法 31 名患有先兆 HD 的人参与了这项研究。18 名参与者接受了为期 9 个月的多学科康复干预，包括有氧运动和阻力运动、计算机化认知训练、双任务训练以及睡眠卫生和营养指导。其余 13 名参与者被分配到标准护理对照组。神经影像学，收集了生物、认知、运动和心肺健康数据。结果 参与者对干预表现出良好的依从性 (87%) 和依从性 (85%)。与对照组相比，干预组观察到右侧壳核形状的保持。与对照组相比，干预组在干预后在语言学习和记忆、注意力、认知灵活性和处理速度方面表现出显着改善。干预组的微型社会认知和情绪评估 (mini-SEA) 的表现保持不变，但对照组的表现有所下降。在血清神经丝轻蛋白水平、姿势稳定性结果或心肺健康方面没有观察到变化。结论 本研究增加了大量文献，表明多学科康复对 HD 患者具有临床益处。需要大型随机对照试验来确定整个疾病范围内的获益程度。