Effects of multimodal therapy on psychological symptoms in Huntington’s disease

Introduction: Huntington's Disease is a hereditary neurological disorder that is currently incurable. Only the symptoms can be treated, often with multimodal therapy. Some studies suggest that such a multimodal therapy can improve psychological symptoms in Huntington’s Disease patients, but relatively little is known (Bartlett et al., 2020). This meta-analysis therefore aims to show whether there are indeed effects of multimodal therapy on psychological symptoms in Huntington's Disease.

Methods: PRISMA-guidelines (Page et al., 2021) are followed. Sources: PEDro, PubMed, Web of Science, Scopus. Search terms: Multimodal therapy OR physical therapy OR rehabilitation AND Huntington's Disease. Inclusion criteria: experimental studies, multimodal therapy, Huntington's Disease, publication between 1990 and 2024, human participants. Methodological quality: PEDro score (Verhagen et al., 1998). Studies with at least a medium quality (a score≥5) are included into meta-analysis. Standardized mean differences with 95 % confidence intervals (SMD<.30=low, >.50=medium, >.80=strong) are shown in forest plots (Verhagen, & Ferreira, 2014) using RevMan 5.4 software (The Cochrane Collaboration, 2020).

Results: Of a total of 4833 publications, eight studies met the inclusion criteria and were methodologically analyzed. Four studies achieved the required PEDro total score of ≥ 5. The effects range from no effect of SMD=.00 for Hospital Anxiety and Depression Scale (HADS) depression subscale to a strong effect of SMD=-1.96 for Beck Depression Inventory (BDI). All effects are in favor to the experimental group.

Conclusions:

• Only a few studies achieved at least average methodological quality.
• Various interventions with different durations and intensities show very different effect sizes.
• Programs with a high proportion of exercise seem to be the most effective.
• Further research with high-quality designs is needed.