A randomized clinical trial to evaluate the efficacy of cognitive rehabilitation and music therapy in mild cognitive impairment in Huntington's disease

Journal

Journal of Neurology

Year

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).

Music and Health Institute Terms

Neurodegenerative Disorders; Huntington's Disease; Cognitive Abilities; Emotional Functioning; Wellness and Well-being; Music Therapy; Observational Measures

Indexed Terms

Clinical trial; Cognitive Behavioral Therapy; Cognitive Dysfunction; Cognitive rehabilitation; Cognitive Training; Huntington Disease; Huntington’s disease; Magnetic Resonance Imaging; Neuroimaging; Non-pharmacological treatment; Single-Blind Method

Study Type

Randomized Controlled Trial; Quantitative Methods

PubMed ID

PMID: 39934473

Document Type

Article

More Info

Share

COinS