Article Dans Une Revue Journal of Neurology Année : 2025

Specific contribution of cognitive and motor impairments with functional capacity and dependence in Huntington’s disease

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Abstract Background Huntington’s disease (HD) leads to increasing dependence. Unlike psychiatric disorders, motor and cognitive deficits evolve progressively over time. Understanding their specific impact on daily activities is crucial for preserving autonomy. However, because cognitive tasks in HD rely on motor functions, and motor tasks demand cognitive processing, disentangling their specific impact remains a challenge. Objective To identify the specific contribution of cognitive and motor impairments on global functional capacity, basic and instrumental activities of daily living (ADL/IADL), and work-related activities (WRA) in HD. Methods 158 HD mutation carriers, enrolled in the BioHD (NCT01412125) and RepairHD (NCT03119246) studies, were evaluated with the Unified Huntington’s Disease Rating Scale and the SelfCog. The SelfCog assesses motor processing separately from memory, language, executive functions and visuospatial processing. Linear regressions were fitted to assess how functional capacity declined with motor and cognition impairments. Odds of dependence in ADLs, IADLs and WRAs were estimated using logistic regressions. Results Cognitive and motor performance were independently associated with functional capacities, though motor performance showed a stronger association than cognitive performance. Decline of all SelfCog cognitive domains contributed to functional decline, with stronger association with global and executive scores compared to language, visuospatial, and memory domains. Higher global and executive deficits were associated with an increased risk of dependence in ADLs, IADLs, and WRAs. Conclusion The independent contributions of motor, followed by cognitive—mainly executive—functions to functional decline suggest targeted interventions to preserve autonomy and quality of life in HD.

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hal-04993112 , version 1 (16-03-2025)

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Andres Gil-Salcedo, Marine Lunven, Charlotte Jacquemot, Renaud Massart, Anne-Catherine Bachoud-Levi. Specific contribution of cognitive and motor impairments with functional capacity and dependence in Huntington’s disease. Journal of Neurology, 2025, 272 (3), pp.224. ⟨10.1007/s00415-025-12982-9⟩. ⟨hal-04993112⟩
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