Objective: To determine which Huntington’s disease (HD) patient characteristics correlate with ancillary service utilization. To examine the longitudinal impact of ancillary therapies on clinical characteristics.

Background: Prior HD studies suggest that ancillary services may improve motor symptoms, cognition, mood, and quality of life. It is unclear how often they are provided. Data are needed to understand their role in treatment and which patients receive them.

Method: Retrospective cross-sectional analysis of the Enroll-HD database. Patients were grouped by therapy: physical and/or occupational (PT/OT), psychotherapy and/or counseling, speech and/or swallowing (ST). Bivariate comparisons were conducted for demographic and disease characteristics between those with/without each therapy and to analyze one-year mean change in assessment scores.

Results: 4751 patients were included. 1537 (32.35%) utilized therapies (11.82% PT/OT, 5.33% psychotherapy/counseling, 3.01% ST, 1.98% all three, 10.21% two therapies).The PT/OT group had worse motor and functional scores compared to the “no PT/OT” group: mean UHDRS motor score (41.17 vs. 38.05, OR= 1.006, p=0.002), median total functional capacity score (TFC) (8.00 vs. 9.00, OR= 0.958, p<0.001). The psychotherapy/counseling group had worse mood but better cognitive and functional scores compared to the “no psychotherapy” group: median depression score (7.00 vs. 2.00, OR= 1.069, p<0.001), median MMSE (28.00 vs. 26.00, OR= 1.183, p<0.001), median TFC (10.00 vs. 8.00, OR= 1.144, p<0.001). The ST group had more dysarthria, and worse cognitive and functional scores compared to the “no ST” group: dysarthria (32.2% vs 20.1%, OR= 1.883, p<0.001), mean correct Symbol Digit Modality Test (16.79 vs. 23.27, OR= 0.961, p<0.001), median TFC (6.00 vs. 9.00, OR= 0.884, p<0.001). Over one year, depression scores improved in psychotherapy/counseling patients compared to those untreated (-1.24 vs. -0.11, p= 0.040). ST patients experienced worsening depression scores (1.14 vs. -0.23, p=0.044). Mean change in TFC was not significant for any therapies.

Conclusion: Only 32% of patients at Enroll-HD sites received PT/OT, ST, or psychotherapy/counseling. Use correlated with expected clinical characteristics, although impact of use is unclear.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/ancillary-service-utilization-and-impact-in-huntingtons-disease/