Objective: To investigate whether a cognitive-motor dual task (DT) paradigm uncovers deficits in balance in Huntington’s disease (HD) and, more importantly, prodromal HD, compared to healthy adults (HA).

Background: HD is a progressive neurodegenerative disease characterized by motoric, behavioral, and cognitive disturbances. HD individuals have increased difficulty with balance as the disease progresses. Adding a simultaneous cognitive tax to a balance assessment (so called DT paradigm) may have a deleterious effect on the motor testing, which can be expressed in terms of a Dual Task Cost (DTC) and measured as a percent worsening. DTC is calculated as the relative ratio of single task (ST) to DT, controlling for ST performance: DTC= (ST − DT)/ST x100.

Method: Balance under ST and DT conditions was examined using the BTrackS Balance Plate and Balance software in 28 individuals with HD, 8 individuals with prodromal HD (Pro-HD), and 20 HA. Participants stood on the balance board for two twenty second intervals where the first interval measured the ST condition and the second interval measured the DT condition. During the DT condition, patients were simultaneously administered the Paced Auditory Serial Addition Test (PASAT). Eyes-open DTC was determined by calculating the percent change in Total Body Sway (TBS) from the no PASAT to the PASAT condition.

Results: Subject groups were well-matched with regards to age and education. Mean CAP score was 475.64 for the HD and 356.14 for the Pro-HD individuals. Mean TBS in the EO DT condition was 20.7 cm for HA; 35.00 cm for Pro-HD, and 58.50 cm for HD individuals. Eyes-open DTC was minimal (1.95%) for the HA individuals; whereas individuals with HD showed 63.78% (p<.001) worsening and, more importantly, Pro-HD individuals showed 43.81% (p=.004) worsening compared to HA when the concurrent cognitive task was administered.

Conclusion: The addition of a cognitive task to individuals’ balance assessment resulted in a significant DTC for the HD and pro-HD cohorts, not seen in NC. It is likely that this interference more accurately reflects real life performance and may have additional value for estimating transition to manifest disease, appraising fall risk, or serving as a valid outcome measure in both observational and interventional trials in HD.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-useful-cognitive-motor-dual-task-paradigm-in-prodromal-and-manifest-hd/