Our Research

Markers of Sensori-Motor Impairments

CHANGE-HD-Child to Adult Neurodevelopment in Gene Expanded Huntington Disease

HD has long been considered an adult-onset disease. However, research has shown that brain changes are evident before motor impairments are observed. The gene responsible for HD plays a role in brain development and is present throughout the lifespan. With gene knockdown therapy showing promise for the treatment of HD, it is essential to understand how removing or disabling the gene could impact brain development. ChANGE HD is an NIH-funded, multi-site observational study aims to understand how the gene responsible for HD affects brain development. In addition to the prime site University of Iowa, the study is being conducted at Columbia University Medical Center, Children's Hospital of Philadelphia (U Penn), University of California-Davis, Vanderbilt University and University of Texas- Houston. People between the ages of 6 and 30 and are at risk for HD are eligible to participate in this study. "At risk" means someone who has a parent or grandparent with HD. We plan to study brain structure and function. To examine brain structure, we use Magnetic Resonance Imaging (MRI) to measure the volume of different parts of the brain. To examine brain function, we administer assessments to measure attention, reasoning, memory, movement control, coordination and balance. We also use questionnaires that ask about mood, relationships. hobbies and talents. Collaborators at CUIMC include Dr. Marder (Neurology- Aging and Dementia).

AGING IN PLACE

Aging populations have a greater need for health and disability support that places increased pressure on aged care and health services. This study examines an integrated robot and wearable sensor system to assess if gait and postural control impairments are early markers of mild cognitive impairment and functional limitations in community-dwelling older individuals. We examined gait using a novel mobile robot and wearable sensor system (APDM), instrumented insoles, assessed postural control (APDM system), cognitive function (Montreal Cognitive Assessment), and clinical assessment of balance and mobility, quality of life, and perception of technology. Collaborators on this NSF funded project include Dr. Yi Guo (Electrical Engineering, Stevens Institute of Technology), Dr. Damiano Zanotto (Mechanical Engineering, Stevens Institute of Technology) and Dr. Ashley Lytle (Social Psychology, Stevens Institute of Technology). Community collaborator involved Sunnyside Community Center in Queens, NY.

Auditory, Olfactory, and Motor Correlates of In-Vivo AD Neuropathology and Cognitive Decline in Late-Middle Age

The objective of the study is to examine the association of Amyloid, Tau, and Neurodegeneration (ATN) Alzheimer’s disease (AD) biomarkers with olfaction, hearing and motor performance using a cross-sectional design. We plan to achieve our goals by leveraging an ongoing Longitudinal study in multi-ethnic older individuals. We examine postural control using the modified Clinical Test of Sensory Integration in Balance (APDM system), examined gait (APDM) and are analyzing the relationship of motor markers with Amyloid, Tau and Neurodegeneration markers and other clinical tests (Olfaction, hearing, cognition). Collaborators on this NIH funded study include Dr. Jose Luchsinger (Medicine), Dr. Davanagere Devanand (Psychiatry) and Dr. Justin Golub (Otolaryngology).

Mechanisms Underlying Sensorimotor Impairments

ENERGY-HD: Mechanisms Underlying Exercise Capacity and Energy Expenditure in Huntington Disease

This study examines mechanisms underlying exercise capacity in people diagnosed with Huntington’s disease (HD) and those at risk for developing HD, as compared with matched healthy controls. We test exercise capacity using cardiopulmonary exercise testing (CPET), and examine several predictors such as disease burden (clinical neurological examination), caloric intake (NCI Food Frequency Questionnaire), physical activity over 7 days (Actigraph), body composition (BioElectrical Impedance), muscle oxidative capacity (Near Infrared Spectroscopy). Collaborators on this study, funded by NCATS, include Dr. Karen Marder (Neurology- Aging and Dementia) and Dr. Jacqueline Montes (Rehab-PT).

Targeted Exercise Interventions

SPARX 3- Study in Parkinson’s Disease of Exercise

Most clinicians treating people with Parkinson disease (PD) are unclear about how best to prescribe exercise despite the fact that it is now axiomatic that exercise is beneficial for PD. In contrast, drugs for PD are prescribed with care and specificity due to large scientific investigations showing efficacy and side effects. Exercise has great clinical potential given the ease of implementation, safety, and physiological benefits. However, exercise regimens in PD have not undergone the pipeline of testing in Phase II and phase III trials, unlike their pharmacologic counterparts, leaving many unanswered questions about dosing and efficacy. One exercise option that has the potential to slow the rate of the progression of the signs of PD is endurance (aerobic) exercise that increases heart rate and improves overall fitness. Our goal is to establish if high-intensity endurance exercise is efficacious as first-line therapy for recently diagnosed (≤3 years) people with PD. Our hypothesis is that high-intensity endurance exercise attenuates the progression of the signs of PD. This NIH funded Phase III trial is being conducted at 26 sites across the U.S. and Canada Dr. Daniel Corcos (PI-Northwestern University). Collaborators on this trial include Dr. Kimberly Kwei and Dr. Julian Agin-Leibes (Neurology- Movement Disorders.

DANCE-HD Movement Intervention in Neurodegenerative Disorders

Dance is a complex activity involving the integration of rhythm, spatial patterns, synchronization to external stimuli and whole-body coordination. While regular exercise is often recommended for people with Huntington's Disease (HD), there are few studies examining the use of dance to improve balance and mobility and positively affect the quality of life for individuals with HD. This study uniquely bridges the gap between science and the performing arts. In this pilot study, participants will attend 2 hours of group dance instruction per week at the Dance Department at Hunter College, CUNY. Our aims are: 1) To assess the safety and tolerability of structured dance class as a nontraditional intervention for people living with HD. 2) To improve motor function in people living with HD and 3) Improve cognitive function thereby enhancing executive functioning, which involves aspects (e.g., attention, organization) that have an impact on daily functioning and quality of life. Collaborators on this study, funded by the Huntington’s Disease Society of America, include Prof. Paul Dennis at the Hunter College Dance Department.