Objectively characterizing Huntington's disease using a novel upper limb dexterity test.

Area of Science:

• Neuroscience
• Clinical Assessment
• Biomedical Engineering

Background:

• Huntington's disease (HD) is a progressive neurodegenerative disorder.
• Objective and reliable assessment tools are needed to track HD progression.
• The Clinch Token Transfer Test (C3t) is a novel bi-manual task designed to assess motor and cognitive function.

Purpose of the Study:

• To evaluate the concurrent and convergent validity of the C3t.
• To determine if the C3t can objectively reflect Huntington's disease severity.
• To assess the C3t's utility as a standalone measure without requiring clinical expertise.

Main Methods:

• 105 participants with pre-manifest or manifest HD completed the C3t and Unified Huntington's Disease Rating Scale (UHDRS).
• Regression analyses estimated clinical scores from C3t scores.
• Spearman correlations and scatterplots assessed C3t's association with disease severity.
• Longitudinal changes were analyzed over 12 months in 33 participants.

Main Results:

• Baseline C3t scores accurately predicted baseline clinical scores (9-13% accuracy).
• C3t scores demonstrated significant associations with individual and composite UHDRS scores.
• Changes in C3t scores over 12 months mirrored changes in clinical measures.

Conclusions:

• The C3t is a promising, simple, and objective outcome measure for Huntington's disease.
• It accurately reflects disease severity and supports remote clinical monitoring.
• The C3t may also serve as a screening tool for clinical trial recruitment.