Clinical Benefits of Multidisciplinary Rehabilitation in Premanifest HD

Neurodegenerative disease concept illustration. Alzheimer’s, Parkinson’s disease concept 3d illustration.
Participants in the multidisciplinary intervention group had significant improvements in verbal learning and memory, attention, cognitive flexibility, and processing speed.

For patients with Huntington’s disease (HD), outpatient multidisciplinary rehabilitation may have clinical benefit; findings indicated an association with significant improvements in verbal learning and memory learning, attention, and cognition, according to study results published in the Journal of the Neurological Sciences.

Study researchers sought to determine the effects of multidisciplinary rehabilitation intervention on neuroimaging, biological, and clinical outcomes in those with premanifest HD. 31 patients from Australia with premanifest HD enrolled in this 9-month proof-of-concept study. A total of 18 patients were assigned to a 9-month outpatient multidisciplinary rehabilitation intervention, which consisted of aerobic and resistance exercise, computerized cognitive training, dual-task training, sleep hygiene, and nutritional counseling. The other 13 patients were assigned to a standard care control group. The study researchers collected neuroimaging, biological, cardiorespiratory, and cognitive motor data, assessing patients at baseline and 36 weeks.

During the study, participants in the multidisciplinary intervention group displayed high adherence (87%) and compliance (85%) to the intervention. No adverse events were observed in the intervention group. Participants in the intervention group maintained the shape of right putamen, whereas the control group reduced the shape over time (P <.05).

Additionally, participants in the multidisciplinary intervention had significantly greater improvements in verbal learning and memory (P <.001), attention (P <.001), cognitive flexibility (P <.001), and processing speed (P <.001) by 36 weeks. Study researchers observed deterioration in social cognitive performance in the control group (P <.001) but not in the intervention group (P =.409) following intervention.

Limitations of the study were the lack of a randomized design, potential selection bias, the inclusion of a small sample of patients with HD, and the lack of information on activities of daily living and healthcare utilization in the comparison group.

In addition to their findings, the researchers added that the study “provides a basis for larger case-controlled and randomised controlled trials to explore the benefits of multidisciplinary rehabilitation on the clinical and neuropathological trajectory of HD over longer periods of time and to ascertain the duration of benefits without therapy.”


Bartlett DM, Govus A, Rankin T, et al. The effects of multidisciplinary rehabilitation on neuroimaging, biological, cognitive and motor outcomes in individuals with premanifest Huntington’s disease. J Neurol Sci. Published online July 12, 2020. doi: 10.1016/j.jns.2020.117022