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Movement sequencing in Huntington disease
Nellie Georgiou-Karistianis1, Jeffrey D Long, Spencer G Lourens
1School of Psychological Sciences, Monash University , Wellington Road, Clayton, Victoria , Australia.
Insights
Movement sequencing declines in prodromal Huntington's disease (HD). Individuals closer to diagnosis showed slower movement execution, suggesting compensatory strategies may impact motor control.
Area of Science:
- Neuroscience
- Movement Disorders
- Neurodegenerative Diseases
Background:
- Huntington's disease (HD) is a progressive neurodegenerative disorder.
- Prodromal HD is characterized by subtle motor and cognitive changes before clinical diagnosis.
- Understanding early motor deficits is crucial for timely intervention.
Purpose of the Study:
- To investigate longitudinal changes in movement sequencing in individuals with prodromal Huntington's disease (HD).
- To assess how proximity to HD diagnosis, indicated by the CAG-Age Product (CAP) score, influences motor sequencing.
- To analyze the impact of advance cueing on response initiation and execution in prodromal HD.
Main Methods:
- Longitudinal study of 795 prodromal HD participants and 225 controls over seven annual visits.
- Participants stratified into low, medium, and high CAP score groups.
- Cued movement sequence task with varying levels of advance information to assess initiation and execution.
Main Results:
- Prodromal HD participants exhibited longer initiation and movement times compared to controls at baseline.
- A disease gradient was observed, with higher CAP scores correlating with more pronounced motor deficits.
- The high CAP group showed increased movement time and faster, yet ultimately slower, initiation over time.
Conclusions:
- Prodromal HD progression is associated with altered movement sequencing.
- Individuals nearing diagnosis may employ compensatory strategies, leading to faster initiation but slower execution.
- This suggests a decline in the ability to translate planned movements into efficient motor actions in advancing prodromal HD.
Objectives:
To examine longitudinal changes in movement sequencing in prodromal Huntington's disease (HD) participants (795 prodromal HD; 225 controls) from the PREDICT-HD study.
Methods:
Prodromal HD participants were tested over seven annual visits and were stratified into three groups (low, medium, high) based on their CAG-Age Product (CAP) score, which indicates likely increasing proximity to diagnosis. A cued movement sequence task assessed the impact of advance cueing on response initiation and execution via three levels of advance information.
Results:
Compared to controls, all CAP groups showed longer initiation and movement times across all conditions at baseline, demonstrating a disease gradient for the majority of outcomes. Across all conditions, the high CAP group had the highest mean for baseline testing, but also demonstrated an increase in movement time across the study. For initiation time, the high CAP group showed the highest mean baseline time across all conditions, but also faster decreasing rates of change over time.
Conclusions:
With progress to diagnosis, participants may increasingly use compensatory strategies, as evidenced by faster initiation. However, this occurred in conjunction with slowed execution times, suggesting a decline in effectively accessing control processes required to translate movement into effective execution.
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