Title: Using computer based cognitive training to provide a personalised therapeutic intervention for people with Huntington's disease
Funder: Health and Care Research Wales (Welsh Government)

Abstract: Background: Cognitive impairments are problematic for people living with Huntington’s disease (HD), they may cause social isolation, reduce quality of life and mean people require extra care (1-2). The nature and degree of cognitive impairments varies among people with HD (3-5), therefore personalised cognitive training programmes which focus on improving the cognitive impairments of the individual present an exciting potential for therapeutic intervention. Novel pre-clinical work conducted by the applicant demonstrates that cognitive training can improve symptoms in a mouse model of HD. In addition, cognitive training studies have been conducted in patients with other neurodegenerative diseases including; Parkinson’s disease (6-8), Alzheimer’s disease (9-12) and multiple sclerosis (13-16) and have shown improvements in quality of life, cognitive and motor function. However, the feasibility, acceptability and effectiveness of using computerised cognitive training programmes, which are personalised to the user to improve their specific cognitive impairments, must be established prior to the implementation in people with HD. Aims: The study aims to determine feasibility, acceptability and gather preliminary evidence of the efficacy of a using a personalised computer based cognitive training intervention programme for people with HD. Key Research Questions: Is a computerised cognitive training intervention that is personalised, feasible and acceptable for people with HD? Does the intervention affect HD disease symptoms? Methods: A cross-sectional observational study of people with HD using HAPPYneuron cognitive training software will be completed to inform a subsequent feasibility study. At the beginning of the feasibility study, people with HD will be tested on a battery of HAPPYneuron tasks of: executive function, memory and attention to determine any specific cognitive impairments to determine their baseline cognitive ability. A cognitive training programme of HAPPYneuron tasks will then be designed and personalised to each participant, with the aim of improving their specific cognitive impairments. Participants will conduct 12 weeks of cognitive training, in their own homes, supported by home visits, email or text reminders. After the intervention, outcome measures of motor and cognitive skills (to be refined during this fellowship) will be completed to determine any benefit of the cognitive training intervention. Semi-structured interviews will be conducted with participants, familymembers and carers to provide qualitative evidence, evaluate the intervention and inform future delivery.Intervention: The HAPPYneuron cognitive training software has been developed by neurologists to stimulate a range of cognitive functions, using easy, simple and fun games, which can be personalised to the user and provide feedback on performance.Summary of benefits: This study will provide initial evidence for the use of computerised cognitive training programmes which can be personalised to the individual. The proposed intervention is relatively cheap, non-invasive, can be completed at home and combined with other therapies . The benefits will be for those with HD, but are also more wide reaching, particularly for patient groups with other neurodegenerative diseases. As a result of this study it will be possible to make crucial inferences which will be required before a larger randomised controlled study can be conducted.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES);8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: NEUROLOGICAL