Objective: To assess the comparability of performance by people with Huntington’s disease (HD) on two tower tasks.

Background: Cognitive decline is a hallmark feature of HD. The Huntington’s Disease Cognitive Assessment Battery (HD-CAB) was developed as a brief, yet comprehensive fit-for-purpose cognitive assessment battery for HD clinical trials. The HD-CAB consists of six cognitive assessments: the Symbol Digit Modalities Test, Trail Making Test B, Emotion Recognition, Paced Tapping, Hopkins Verbal Learning Test – Revised, and One Touch Stockings of Cambridge (OTS). In 2021, Cambridge Cognition discontinued support for the version of the OTS used in the HD-CAB. To maintain the integrity of the HD-CAB as a comprehensive assessment of cognition in HD and ensure continuity across versions in the face of task replacement, identifying a psychometrically sound, alternative tower test was necessary.

Method: The OTS and TZ were administered to participants in Triplet Therapeutic’s longitudinal observational natural history study, SHIELD-HD. We assessed the (a) relationship between the two tests using the test-retest reliability of the OTS as the context for the interpretation of those estimates, (b) patterns of relationships the OTS and TZ shared with other tests in the HD-CAB, and (c) the comparability of HD-CAB overall composite scores when either the OTS or TZ was used in the calculation of the composite.

Results: The relationship between the OTS and TZ tests at first administration of each test (r = .67), the first instance of their simultaneous administration (r = .73), and the administrations of each test averaged independently (r = .73) were all comparable to the test-test correlation for the OTS observed across 16 weeks in SHIELD-HD (r = .72) and seven weeks (r = .79) as reported in the original HD-CAB manuscript. The correlation matrices show the relationships between the TZ and OTS and other tests in the HD-CAB were similar (range of r .16 – .69) and the correlation between the HD-CAB composite scores calculated using the OTS or TZ were highly correlated (r = .98).

Conclusion: Taken together, our results suggest that the OTS and TZ are comparable and therefore, that the TZ is likely a suitable replacement for the OTS in the HD-CAB.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-executive-function-in-hd-comparing-the-one-touch-stockings-of-cambridge-and-zindametrixs-tower-z-as-components-of-the-hd-cab/