F19 Cognitive reserve: the leisure time concurs to the cognition performance and to the independence of early huntington disease patients

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 92; no. Suppl 1; p. A26
• Main Authors: Migliore, Simone, D’Aurizio, Giulia, Maffi, Sabrina, Scaricamazza, Eugenia, Ceccarelli, Consuelo, Ristori, Giovanni, Romano, Silvia, Fichera, Mario, Castaldo, Anna, Curcio, Giuseppe, Squitieri, Ferdinando
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.09.2021
• Subjects: Cognition & reasoning; Huntingtons disease; Leisure
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp-2021-EHDN.62

BackgroundOur study aims to test the Cognitive Reserve (CR) in patients manifesting early Huntington Disease (HD), by investigating whether clinical performances may be influenced by lifetime intellectual enrichment.MethodsAll patients recruited in the study were enrolled in ENROLL-HD and carried an expanded mutation in the HTT gene. We evaluated a) the CR by the CR Index questionnaire (CRIq) and b) the clinical variables by the Unified Huntington’s Disease Rating Scale (UHDRS), at three different time-points (baseline-T0, 1 year follow up-T1 and 2 year follow up-T2). CRIq is an international validated scale which includes three sections and related subscales: education, working activity and leisure time. UHDRS includes motor, cognitive and functional assays.ResultsOur sample consisted of 75 early manifest patients (46M/29F; age: 47,2 ± 12,5 y; education: 11 ± 4.43 y, CAG repeat: 43,7 ± 2,3) in the first two HD stages, according to the Total Functional Capacity – TFC scale. A correlational analysis showed a significant association between the decrease of the CRIq leisure time (CRIq LT) and 1) the longitudinal loss of TFC units (i.e. the difference between the TFC scale score at T2 minus the score at T0 or TFC) (p < .05); 2) the multidimensional progression of HD measured by the composite UHDRS (cUHDRS, p < .01). The decrease of CRIq TL was significantly associated with the UHDRS-cognitive impairment (p < .05) at all timepoints.ConclusionOur findings highlight an influence of the leisure time on HD progression. Higher is the CRIq LT, lower is the HD progression and more preserved is the cognitive status overtime. The association between CR items and HD independence and cognition need to be further explored to take in account additional bias potentially occurring in clinical trials. Moreover, our data may pave the way to new therapeutic approaches to modify the HD course overtime, based to approaches of cognitive rehabilitation.