Psychiatry - Research Publications

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End date: 2013 × Start date: 2010 × Type: Abstract ×

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    Physical therapy as an environmental modulator of genetic determinism in HD: The FIT-HD study
    Goh, A ; Hannan, A ; Cox, K ; Lautenschlager, N ; Leavitt, BR ; Thompson, LM (IOS Press, 2013)
    HD has long been viewed as the quintessential example of genetic determinism. However, research has demonstrated that environmental factors play a signifi cant role in modulating the disease process, including the age of onset. In transgenic mouse models of HD, co-author Hannan’s laboratory has demonstrated that environmental enrichment (enhanced motor, cognitive and sensory stimulation) delays onset and progression of motor symptoms and neural degeneration. Introducing an exercise wheel to young HD mice delays onset and progression of motor symptoms, and reverses reduction of brain derived neurotrophic factor in the striatum and hippocampus. Such stimulation has also ameliorated defi cits in learning and memory, as well as depressive behaviours in HD mice. Physical activity (PA) has been found to have benefi cial neural effects in older adults, with increases in hippocampal volume and cognition, apparent even when exercise is limited to later life. We have found that PA improved cognitive function in those at risk of Alzheimer’s disease (AD), and are conducting randomized controlled trials (RCT) investigating this PA program in AD patients, older adults at risk of AD with vascular risk factors or sedentary lifestyle, and in older care recipients and carers. The role of exercise as a potential modifi er is receiving increasing attention in HD. Avoiding passivity was found to be a potential benefi cial modulator in HD, and a PA program improved in motor function in HD patients. However, evidence from RCTs is lacking. AIMS of this study are to: 1) examine the feasibility of our PA program in FIT-HD (by measuring adherence, acceptability, benefi ts, risks); 2) improve physical and mental health and quality of life in HD carriers. HYPOTHESES. Participants randomised to the PA program will: 1) increase PA and adhere to the protocol; have 2) improved quality of life and fi tness, 3) improved sleep, 4) less motor and cognitive decline, 5) improved resting brain state, and 6) have less depressive symptoms, as compared to participants randomised to usual care. Methods: RCT of a validated 24-week PA intervention in HD in Australia. Participants are randomly allocated to an education/usual care group or to a 24-week home-based PA program. Results: PA should be more promoted in the HD community due to multiple health benefi ts. Should our RCT be completed successfully and our hypotheses supported then this could change clinical care of HD.