None listed
Conditions
Brief summary
Huntington’s disease (HD) involves progressive decline in cognitive function, often beginning many years prior to clinical diagnosis, and drastically affects quality of life. Further, there are currently no effective treatments for cognitive decline in HD. Cognitive training has been found to be effective in improving cognitive function in other populations, but has not been thoroughly investigated in HD. This study aims to examine the effects of cognitive training on cognitive and clinical outcomes in people with HD, as well as its effects on brain function. This will be done by randomly allocating participants to either an intervention group or a control group. The intervention group will complete cognitive training over 3 months, whereas the control group will receive a monthly newsletter on lifestyle factors associated with cognitive function and will be provided access to the training program after the study period. It is hypothesised that compared to the control group, participants in the intervention group will have: (1) improved cognitive function; (2) improved neuropsychiatric symptoms; (3) improved subjective cognition; (4) improved health-related quality of life; (5) increased connectivity in brain networks involved in cognitive tasks; and (6) increased connectivity in brain networks during rest, after the study period.
Interventions
The intervention consists of computerised cognitive training, using the BrainHQ platform. BrainHQ involves a suite of online exercises targeting various cognitive functions, including processing speed, attention, working memory and executive functions. The training will be adaptive, i.e., the difficulty level will be adjusted according to participant performance and progress. Exercises will involve short games requiring a response using mouse or keyboard, such as reproducing a sequence of digits presented in moving circles. Training will be administered on the participants’ personal computer, within their own homes. Participants will access the training via the BrainHQ website. Participants will be required to complete two 1-hour sessions of training per week, over 12 weeks. One session each week will be completed individually, without supervision, while another session will be supervised using a video conference software, and in a group format if scheduling allows. Supervision will be conducted by a student researcher trained in administering the cognitive training. Participant adherence will be assessed according to the activity logs in BrainHQ, which automatically records the number of hours of training completed. Fidelity will be maintained through weekly phone calls by the student researcher to provide feedback on progress and increase motivation to complete the training. Barriers to adherence will be discussed and troubleshooted.
Sponsors
Study design
Eligibility
Inclusion criteria
Inclusion criteria include: (a) Genetically positive for Huntington’s disease (HD) (b) Premanifest disease or early-stage manifest disease (total functional capacity [TFC] = 7-13) (c) 18+ years of age (d) Access to computer with Internet connection
Exclusion criteria
Exclusion criteria include: (a) Absence of known genetic confirmation for HD (b) Late-stage disease (TFC < 7) (c) Under 18 years of age (d) Diagnosis of any major neurological or psychiatric condition other than HD (besides anxiety or depression), history of substance abuse or head injury (e) Severe depression and anxiety symptoms (score > 14 on either HADS subscale) (f) Unstable dose of medication for depression and anxiety in the last 6 months Additional exclusion criteria if undergoing MRI: (a) Left-handed (b) Currently pregnant (c) Other MRI contraindications