A randomized clinical trial to evaluate the efficacy of cognitive rehabilitation and music therapy in mild cognitive impairment in Huntington's disease
Moreu Valls, Andrea (Universitat Autònoma de Barcelona. Departament d'Infermeria)
Puig-Davi, Arnau (Institut de Recerca Sant Pau)
Martínez-Horta, Saul (Institut de Recerca Sant Pau)
Kulisevsky, Gabriel (Institut de Recerca Sant Pau)
Sampedro, Frederic (Institut de Recerca Sant Pau)
Pérez-Pérez, Jesús (Institut de Recerca Sant Pau)
Horta, Andrea (Institut de Recerca Sant Pau)
Olmedo-Saura, Gonzalo (Institut de Recerca Sant Pau)
Pagonabarraga Mora, Javier (Institut de Recerca Sant Pau)
Kulisevsky, Jaime (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2025
Abstract:	Background: Cognitive impairment is a core feature of Huntington's disease (HD), yet no disease-modifying or symptomatic interventions have demonstrated efficacy in addressing these deficits. Non-pharmacological interventions, particularly cognitive training (CT), are promising options for maintaining neural plasticity, enhancing cognition, and improving emotional well-being. Methods: This 24-week, single-center, randomized, single-blind study evaluated the safety and efficacy of two cognitive rehabilitation strategies in early-to-middle-stage HD patients. Participants were randomized into a computerized cognitive training (CT; n = 13) intervention or a music therapy (MT; n = 16) intervention. A standard of care (SoC; n = 15) group with no active intervention was also involved. Weekly 45-min sessions were conducted. Baseline and endpoint assessments included measures of global cognition, functional, motor, and neuropsychiatric assessments, along with structural and functional neuroimaging. Results: Both CT and MT groups demonstrated significant improvements in primary and secondary cognitive endpoints, including global cognition an composite measures of disease severity. Regression analysis identified longitudinal cognitive score changes as independent predictors of the rate of atrophy in the caudate, putamen, and inferior frontal gyrus. Functional connectivity analysis showed distinct intervention-related effects: CT group exhibited increased connectivity between the central executive and sensorymotor networks, while MT group reduced aberrant connectivity between the central executive and the default-mode network. Conclusion: This is the first randomized-controlled trial to evaluate two cognitive rehabilitation strategies in HD using multimodal neuroimaging. Both interventions were effective in improving cognition and modulating structural and functional brain changes in regions critical to HD. Trial Registration ClinicalTrials. gov (ID: NCT05769972).
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Language:	Anglès
Document:	Article ; Versió acceptada per publicar
Subject:	Clinical trial ; Cognitive rehabilitation ; Huntington's disease ; Music therapy ; Neuroimaging ; Non-pharmacological treatment
Published in:	Journal of neurology, Vol. 272, Num. 3 (February 2025) , ISSN 1432-1459

DOI: 10.1007/s00415-025-12927-2

Available from: 2026-02-28 postprint 704.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Published articles