Background. Impairments in postural control in Huntington disease (HD) have important consequences for daily functioning. This observational study systematically examined baseline postural control and the effect of sensory attenuation and sensory enhancement on postural control across the spectrum of HD. Methods. Participants (n = 39) included healthy controls and individuals in premanifest (pHD) and manifest stages (mHD) of HD. Using wearable sensors, postural control was assessed according to (1) postural set (sit vs stand), (2) sensory attenuation using clinical test of sensory integration, and (3) sensory enhancement with gaze fixation. Outcomes included sway smoothness, amplitude, and frequency. Results. Based on postural set, pHD reduced postural sway in sitting relative to standing, whereas mHD had pronounced sway in standing and sitting, highlighting a baseline postural deficit. During sensory attenuation, postural control in pHD deteriorated relative to controls when proprioceptive demands were high (eyes closed on foam), whereas mHD had significant deterioration of postural control when proprioception was attenuated (eyes open and closed on foam). Finally, gaze fixation improved sway smoothness, amplitude, and frequency in pHD; however, no benefit was observed in mHD. Conclusions. Systematic examination of postural control revealed a fundamental postural deficit in mHD, which further deteriorates when proprioception is challenged. Meanwhile, postural deficits in pHD are detectable when proprioceptive challenge is high. Sensory enhancing strategies using gaze fixation to benefit posture may be useful when introduced well before motor diagnosis. These findings encourage further examination of wearable sensors as part of routine clinical assessments in HD.

中文翻译：

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使用可穿戴传感器量化先兆和明显亨廷顿病的姿势控制

背景。亨廷顿病 (HD) 的姿势控制受损对日常功能有重要影响。这项观察性研究系统地检查了基线姿势控制以及感觉衰减和感觉增强对整个 HD 范围内姿势控制的影响。方法。参与者 (n = 39) 包括健康对照和处于 HD 前期 (pHD) 和明显阶段 (mHD) 的个体。使用可穿戴传感器，根据（1）姿势设置（坐与站），（2）使用感觉统合的临床测试的感觉衰减，和（3）注视注视的感觉增强来评估姿势控制。结果包括摇摆平滑度、幅度和频率。结果。基于姿势设置，相对于站立，pHD 减少了坐着时的姿势摇摆，而 mHD 在站立和坐着时有明显的摇摆，突出基线姿势缺陷。在感觉衰减期间，当本体感觉需求高时（眼睛闭上泡沫），pHD 的姿势控制相对于对照组恶化，而当本体感觉减弱（眼睛睁开和闭上泡沫）时，mHD 的姿势控制显着恶化。最后，注视改善了 pHD 的摇摆平滑度、幅度和频率；然而，在 mHD 中没有观察到任何益处。结论。对姿势控制的系统检查揭示了 mHD 的基本姿势缺陷，当本体感觉受到挑战时，这种缺陷会进一步恶化。同时，当本体感受挑战高时，可以检测到 pHD 的姿势缺陷。在运动诊断之前引入使用注视来改善姿势的感觉增强策略可能很有用。