The prestigious Journal of Neurology has just published the results of a study carried out by researchers at the Sant Pau Research Institute (IR Sant Pau), demonstrating the benefits of cognitive rehabilitation and music therapy in patients with mild to moderate cognitive impairment associated with Huntington’s disease.
The study, conducted at the Clinical School of Neuropsychology and Language Pathology at Sant Pau Hospital, was led by Dr Andrea Moreu-Valls, Dr Arnau Puig-Davi, and Dr Saúl Martínez-Horta. The results confirm that these non-pharmacological interventions not only improve patients’ cognitive status but also promote structural and functional changes in the brain, delaying the progression of neurological deterioration.
According to Dr Jaime Kulisevsky, head of the Parkinson’s Disease and Movement Disorders Group at IR Sant Pau and director of the Parkinson’s and Movement Disorders Unit at Sant Pau Hospital, who coordinated the study, “this work demonstrates that cognitive intervention can not only improve patients’ functionality but also influence neuronal plasticity mechanisms, opening new therapeutic perspectives.”
The clinical trial, lasting twenty-four weeks, included 44 participants with early or intermediate-stage Huntington’s disease. The patients were divided into three groups: one received cognitive training through the NeuronUP platform, another underwent active music therapy sessions, and a control group received no intervention. Each session lasted 45 minutes and was conducted weekly. Researchers assessed patients’ progress through neuropsychological evaluations, functional impact questionnaires, and neuroimaging studies.
The results showed a significant improvement in cognitive functions and a reduction in apathy in patients who participated in either of the two therapies. Changes were also observed in brain functional connectivity and the preservation of certain brain areas, suggesting a neuroprotective effect.
Dr Saúl Martínez-Horta, also a researcher in the Parkinson’s Disease and Movement Disorders Group at IR Sant Pau and a participant in the study, highlights the significance of the findings: “Thanks to magnetic resonance imaging techniques, we have been able to demonstrate that these interventions not only impact cognitive performance but also modify brain function and help preserve areas particularly affected by Huntington’s disease, such as the caudate and putamen.”
This finding is particularly relevant, as until now, there was no objective evidence demonstrating the direct influence of these types of interventions on preserving brain structure in Huntington’s patients. The study indicates that cognitive stimulation techniques may help reduce the loss of grey matter in key brain regions, potentially slowing disease progression.
Dr Arnau Puig, another researcher involved in the study, also emphasises the importance of patient motivation: “Apathy is one of the main challenges in Huntington’s disease. Many patients stop engaging in activities due to a lack of motivation, which worsens their quality of life. We have observed that participation in these therapies not only improves cognition but also helps them feel more active and engaged, which is very valuable for both patients and their families.”
Dr Kulisevsky adds: “We must bear in mind that this is a neurodegenerative disease with relatively rapid progression. The fact that we can observe positive changes suggests that deterioration could be less severe if this type of treatment were applied continuously.” He further states: “Moreover, these results make us reflect on the need to invest more efforts in these types of interventions. Traditionally, medicine has prioritised pharmacological treatments, but studies like this demonstrate that there are valid alternatives that can significantly improve patients’ quality of life.”
Huntington’s disease is a hereditary neurodegenerative disorder caused by a mutation in the HTT gene, leading to progressive degeneration of neurons in certain brain areas, affecting motor control, cognition, and the emotional state of patients. The first symptoms usually appear between the ages of 30 and 50 and include involuntary movements, cognitive difficulties, and psychiatric disorders.
It is a rare disease, with an incidence of approximately 5 to 10 cases per 100,000 people. Currently, there is no cure, and its progressive course inevitably leads to a gradual loss of functional independence and quality of life.
The researchers also emphasise that these strategies could be useful for other neurodegenerative diseases. “This is a clear example of translational research,” states Dr Kulisevsky. “Our findings suggest that these types of interventions should be integrated into the care offering for patients with neurodegenerative diseases, just as is done with physiotherapy or speech therapy.”
Dr Saúl Martínez-Horta highlights that these interventions could also be applied to diseases such as Parkinson’s or Alzheimer’s: “We know that neurodegeneration affects various brain areas and that neuronal plasticity can help maintain certain functions for longer. Our study suggests that, although they are not a cure, these therapies can help preserve patients’ quality of life for a longer time, delaying the loss of autonomy.”
In this regard, the researchers advocate for integrating these types of interventions into standard treatment protocols, as Dr Saúl Martínez-Horta emphasises: “This study shows us that non-pharmacological therapies have real potential and could become a standard component in the treatment of these diseases.”
Moreu-Valls A, Puig-Davi A, Martinez-Horta S, Kulisevsky G, Sampedro F, Perez-Perez J, Horta-Barba A, Olmedo-Saura G, Pagonabarraga J, Kulisevsky J. A randomised clinical trial to evaluate the efficacy of cognitive rehabilitation and music therapy in mild cognitive impairment in Huntington’s disease. J Neurol 2025;272:202. https://doi.org/10.1007/s00415-025-12927-2
