Speech and swallowing rehabilitation in Huntington's disease: clinical outcomes and correlations with disease severity

Corticobulbar symptoms, including dysarthria and dysphagia, are frequent manifestations of Huntington's disease, yet evidence on speech and swallowing rehabilitation remains limited. This study explored the potential effects of a home-based corticobulbar rehabilitation program on selected speech and swallowing-related clinical outcomes in Huntington's disease.

This prospective, non-randomized, observational controlled study included 40 adults with genetically confirmed Huntington's disease. Twenty-five patients entered a 6-month home-based corticobulbar rehabilitation program, while 15 received standard care without structured speech or swallowing rehabilitation. Six patients in the rehabilitation group discontinued the program because of rapid progression of corticobulbar symptoms; therefore, complete-case outcome analyses included 34 patients: 19 rehabilitation completers and 15 controls. Speech and swallowing outcomes were assessed at baseline and month 6 by blinded speech-language pathologists using an exploratory clinical rating scale. Secondary outcomes included body mass index and Unified Huntington's Disease Rating Scale Total Motor Score.

No intervention-related adverse events were reported among completers. Breathy voice worsened in 6 control patients but in none of the rehabilitation completers (p = 0.004). Speech rate normalization was more frequent in the rehabilitation group than in controls (p = 0.003). Oral residue decreased more frequently in the rehabilitation group, whereas it increased more frequently in controls (p = 0.039). Body mass index was relatively preserved in the rehabilitation group overall (p = 0.025). UHDRS Total Motor Score changes favored rehabilitation but were considered exploratory because motor assessment was not blinded.

Home-based corticobulbar rehabilitation may be feasible and associated with favorable exploratory changes in selected speech and swallowing parameters in Huntington's disease.