Multidisciplinary rehabilitation reduces hypothalamic grey matter volume loss in individuals with preclinical Huntington's disease : A nine-month pilot study

Journal article

Bartlett, Danielle M., Dominguez D, Juan F., Lazar, Alpar S., Kordsachia, Catarina C., Rankin, Tim J., Lo, Johnny, Govus, Andrew D., Power, Brian D., Lampit, Amit, Eastwood, Peter R., Ziman, Mel R. and Cruickshank, Travis M.. (2020). Multidisciplinary rehabilitation reduces hypothalamic grey matter volume loss in individuals with preclinical Huntington's disease : A nine-month pilot study. Journal of the Neurological Sciences. 408, p. Article 116522. https://doi.org/10.1016/j.jns.2019.116522
AuthorsBartlett, Danielle M., Dominguez D, Juan F., Lazar, Alpar S., Kordsachia, Catarina C., Rankin, Tim J., Lo, Johnny, Govus, Andrew D., Power, Brian D., Lampit, Amit, Eastwood, Peter R., Ziman, Mel R. and Cruickshank, Travis M.
Abstract

Background
Hypothalamic pathology is a well-documented feature of Huntington's disease (HD) and is believed to contribute to circadian rhythm and habitual sleep disturbances. Currently, no therapies exist to combat hypothalamic changes, nor circadian rhythm and habitual sleep disturbances in HD.

Objective
To evaluate the effects of multidisciplinary rehabilitation on hypothalamic volume, brain-derived neurotrophic factor (BDNF), circadian rhythm and habitual sleep in individuals with preclinical HD.

Methods
Eighteen individuals with HD (ten premanifest and eight prodromal) undertook a nine-month multidisciplinary rehabilitation intervention (intervention group), which included exercise, cognitive and dual task training and social events, and were compared to a community sample of eleven individuals with premanifest HD receiving no intervention (control group). Hypothalamic volume, serum BDNF, salivary cortisol and melatonin concentrations, subjective sleep quality, daytime somnolence, habitual sleep-wake patterns, stress and anxiety and depression symptomatology were evaluated.

Results
Hypothalamus grey matter volume loss was significantly attenuated in the intervention group compared to the control group after controlling for age, gender, Unified Huntington's Disease Rating Scale-Total Motor Score and number of cytosine-adenine-guanine repeats. Serum BDNF levels were maintained in the intervention group, but decreased in the control group following the study period. Both groups exhibited decreases in cortisol and melatonin concentrations. No changes were observed in sleep or mood outcomes.

Conclusions
This exploratory study provides evidence that multidisciplinary rehabilitation can reduce hypothalamic volume loss and maintain peripheral BDNF levels in individuals with preclinical HD but may not impact on circadian rhythm. Larger, randomised controlled trials are required to confirm these findings.

Keywordshypothalamus; brain-derived neurotrophic factor; cortisol; melatonin; circadian rhythm; sleep
Year2020
JournalJournal of the Neurological Sciences
Journal citation408, p. Article 116522
PublisherElsevier B.V.
ISSN0022-510X
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jns.2019.116522
Scopus EID2-s2.0-85073970614
Page range1-9
FunderNational Health and Medical Research Council (NHMRC)
Lotterywest
Wellcome Trust
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online13 Oct 2019
Publication process dates
Accepted04 Oct 2019
Deposited03 Jun 2021
Grant ID107/20090827
207799/Z/17/Z
NHMRC/1136548
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