Huntington's Disease Clinical Trial
Official title:
Exercise Effects in Huntington's Disease
Huntington's disease (HD) is an incurable and fatal disorder characterised by progressive degeneration of the basal ganglia and the cerebral cortex. Contrary to earlier thinking, HD is associated with abnormalities in peripheral tissues which might even contribute to brain pathology including muscle wasting, mitochondrial abnormalities, and impaired muscle energy metabolism. Mitochondrial impairment and muscle atrophy in human HD patients and murine models of HD are associated with altered expression of PGC-1a, a transcriptional cofactor that seems to regulate many, if not all of the adaptations of muscle fibres to chronic endurance training, and induces improved exercise performance and increased peak oxygen uptake. We aim at investigating whether endurance exercise has the capability of stabilizing and / or reversing PGC-1a dependent alterations of muscle function and structure in HD patients, and whether muscle training ameliorates musculoskeletal and cardiovascular function, as well as motor and cognitive symptoms in HD patients.
Huntington disease (HD) is an incurable and fatal disorder that affects muscle function and
leads to cognitive decline and dementia. HD was long considered a brain disorder but
meanwhile it was shown that HD also affects other tissues such as muscle, leading to muscle
wasting. Previous studies suggested that the muscle disorder might be caused by an impaired
energy metabolism through mitochondrial dysfunction, which also might also contribute to
brain pathology.
In muscle tissue of healthy persons, a protein named PGC 1- α seems to regulate many, if not
all of the adaptations of muscle metabolism and mitochondrial biogenesis to chronic endurance
training. It was shown that PGC 1- α is reduced in muscle tissue of human HD patients and
animal models of HD.
We aim investigating whether endurance exercise has the capability of stabilizing and / or
reversing PGC-1α dependent decline of muscle function and structure in HD patients, and
whether muscle training ameliorates muscular and cardiovascular function, as well as
coordination and cognitive decline in HD. To this end, we will train 20 male HD patients
using a 6 months progressive endurance exercise program. In order to compare the size effect
of exercise between HD patients and healthy individuals, 20 age-matched healthy males will
perform the identical exercise regimen as HD patients. Within one week before the training
period starts and within one week after it has ended, we will assess metabolic and functional
data. In addition, we will analyze muscle tissue samples for muscle fiber structure,
metabolic phenotype and cellular pathology. Finally, gene and protein expression analyses
will be performed on muscle tissue extracts to gain insights into the molecular regulation of
training adaptations in HD.
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