Psychiatry Commons^™

Prognostic Role And Implications Of Mutation Status Of Tumor Suppressor Gene Arid1a In Cancer: A Systematic Review And Meta-Analysis, C. Luchini, N. Veronese, M. Solmi, H. Cho, J. H. Kim, S. Kyo, S. Y. Lee, D. W. Kim, G. M. Yousef, C. U. Correll, +22 Additional Authors

Journal Articles

Loss of the tumor suppressor gene AT-rich interactive domain-containing protein 1A (ARID1A) has been demonstrated in several cancers, but its prognostic role is unknown. We aimed to investigate the risk associated with loss of ARID1A (ARID1A-) for all-cause mortality, cancer-specific mortality and recurrence of disease in subjects with cancer. PubMed and SCOPUS search from database inception until 01/31/2015 without language restriction was conducted, contacting authors for unpublished data. Eligible were prospective studies reporting data on prognostic parameters in subjects with cancer, comparing participants with presence of ARID1A (ARID1A+) vs. ARID1A-, assessed either via immunohistochemistry (loss of expression) or with genetic …

Neural Substrates Of Inhibitory Control Deficits In 22q11.2 Deletion Syndrome, C. A. Montojo, M. Jalbrzikowski, E. Congdon, S. Domicoli, C. Chow, C. Dawson, K. H. Karlsgodt, R. M. Bilder, C. E. Bearden

Journal Articles

22q11.2 deletion syndrome (22q11DS) is associated with elevated levels of impulsivity, inattention, and distractibility, which may be related to underlying neurobiological dysfunction due to haploin-sufficiency for genes involved in dopaminergic neurotransmission (i. e. catechol-O-methyltransferase). The Stop-signal task has been employed to probe the neural circuitry involved in response inhibition (RI); findings in healthy individuals indicate that a fronto-basal ganglia network underlies successful inhibition of a prepotent motor response. However, little is known about the neurobiological substrates of RI difficulties in 22q11DS. Here, we investigated this using functional magnetic resonance imaging while 45 adult participants (15 22q11DS patients, 30 matched controls) …

The Navigate Program For First-Episode Psychosis: Rationale, Overview, And Description Of Psychosocial Components, K. T. Mueser, D. L. Penn, P. Meyer-Kalos, S. R. Mcgurk, C. Cather, S. Saade, D. G. Robinson, N. R. Schooler, R. A. Rosenheck, J. M. Kane, +6 Additional Authors

Journal Articles

Comprehensive coordinated specialty care programs for first-episode psychosis have been widely implemented in other countries but not in the United States. The National Institute of Mental Health's Recovery After an Initial Schizophrenia Episode (RAISE) initiative focused on the development and evaluation of first-episode treatment programs designed for the U.S. health care system. This article describes the background, rationale, and nature of the intervention developed by the RAISE Early Treatment Program project-known as the NAVIGATE program-with a particular focus on its psychosocial components. NAVIGATE is a team-based, multicomponent treatment program designed to be implemented in routine mental health treatment settings and …

Psychiatric Genome-Wide Association Study Analyses Implicate Neuronal, Immune And Histone Pathways, C. O'Dushlaine, C. Betancur, S. Herms, R. Krasucki, M. Leboyer, D. H. Ledbetter, T. Lencz, A. K. Malhotra, J. W. Smoller, P. A. Holmans, +365 Additional Authors

Journal Articles

Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from over 60,000 participants from the Psychiatric Genomics Consortium. We developed an analysis framework to rank pathways that requires only summary statistics. We combined this score across disorders to find common pathways across three adult psychiatric disorders: schizophrenia, major depression and bipolar disorder. Histone methylation processes showed the strongest association, and we also found statistically significant evidence for associations with multiple …

Severity Of Thought Disorder Predicts Psychosis In Persons At Clinical High-Risk, D. O. Perkins, C. D. Jeffries, B. A. Cornblatt, S. W. Woods, J. Addington, D. H. Mathalon, L. J. Seidman, M. T. Tsuang, E. F. Walker, T. H. Mcglashan, +4 Additional Authors

Journal Articles

BACKGROUND: Improving predictive accuracy is of paramount importance for early detection and prevention of psychosis. We sought a symptom severity classifier that would improve psychosis risk prediction. METHODS: Subjects were from two cohorts of the North American Prodrome Longitudinal Study. All subjects met Criteria of Psychosis-Risk States. In Cohort-1 (n=296) we developed a classifier that included those items of the Scale of Psychosis-Risk Symptoms that best distinguished subjects who converted to psychosis from nonconverters, with performance initially validated by randomization tests in Cohort-1. Cohort-2 (n=592) served as an independent test set. RESULTS: We derived 2-Item and 4-Item subscales. Both included …

Prevalence Of Childhood Obsessive-Compulsive Personality Traits In Adults With Obsessive Compulsive Disorder Versus Obsessive Compulsive Personality Disorder, A. Pinto, A. L. Greene, E. A. Storch, H. B. Simpson

Journal Articles

Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on under-controlled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n=28) to adults with OCPD (without OCD) (n=27), adults with both OCD and OCPD (n=28), and healthy controls (HC) (n=28), using the childhood retrospective perfectionism questionnaire, a validated measure of perfectionism, inflexibility, and drive for order. Adults with OCPD (both with and without comorbid OCD) reported …

Antipsychotic Treatment And Functional Connectivity Of The Striatum In First-Episode Schizophrenia, D. K. Sarpal, D. G. Robinson, T. Lencz, M. Argyelan, T. Ikuta, K. Karlsgodt, J. Gallego, J. M. Kane, P. R. Szeszko, A. K. Malhotra

Journal Articles

IMPORTANCE Previous evidence has implicated corticostriatal abnormalities in the pathophysiology of psychosis. Although the striatum is the primary target of all efficacious antipsychotics, the relationship between its functional connectivity and symptomatic reduction remains unknown. OBJECTIVE To explore the longitudinal effect of treatment with second-generation antipsychotics on functional connectivity of the striatum during the resting state in patients experiencing a first episode of psychosis. DESIGN, SETTING, AND PARTICIPANTS This prospective controlled study took place at a clinical research center and included 24 patients with first-episode psychosis and 24 healthy participants matched for age, sex, education, and handedness. Medications were administered in …

Neural Systems Mediating Decision-Making And Response Inhibition For Social And Nonsocial Stimuli In Autism, K. M. Shafritz, J. D. Bregman, T. Ikuta, P. R. Szeszko

Journal Articles

Autism is marked by impairments in social reciprocity and communication, along with restricted, repetitive and stereotyped behaviors. Prior studies have separately investigated social processing and executive function in autism, but little is known about the brain mechanisms of cognitive control for both emotional and nonemotional stimuli. We used functional magnetic resonance imaging to identify differences in neurocircuitry between individuals with high functioning autism (HFA) and neurotypical controls during two versions of a go/no-go task: emotional (fear and happy faces) and nonemotional (English letters). During the letter task, HFA participants showed hypoactivation in the ventral prefrontal cortex. During the emotion task, …

Risk Of Metabolic Syndrome And Its Components In People With Schizophrenia And Related Psychotic Disorders, Bipolar Disorder And Major Depressive Disorder: A Systematic Review And Meta-Analysis, D. Vancampfort, B. Stubbs, A. J. Mitchell, M. De Hert, M. Wampers, P. B. Ward, S. Rosenbaum, C. U. Correll

Journal Articles

Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; …

Applying Cognitive Load Theory To Medical Education: Construct And Measurement Challenges, John Young, J. L. Sewell

Journal Articles

No abstract provided.

Progressive Reduction In Cortical Thickness As Psychosis Develops: A Multisite Longitudinal Neuroimaging Study Of Youth At Elevated Clinical Risk, T. D. Cannon, Y. Chung, G. He, D. Sun, K. Cadenhead, B. A. Cornblatt, M. Tsuang, E. Walker, S. W. Woods, R. Heinssen, +10 Additional Authors

Journal Articles

BACKGROUND: Individuals at clinical high risk (CHR) who progress to fully psychotic symptoms have been observed to show a steeper rate of cortical gray matter reduction compared with individuals without symptomatic progression and with healthy control subjects. Whether such changes reflect processes associated with the pathophysiology of schizophrenia or exposure to antipsychotic drugs is unknown. METHODS: In this multisite study, 274 CHR cases, including 35 individuals who converted to psychosis, and 135 healthy comparison subjects were scanned with magnetic resonance imaging at baseline, 12-month follow-up, or the point of conversion for the subjects who developed fully psychotic symptoms. RESULTS: In …

Prodromal Symptom Severity Predicts Accelerated Gray Matter Reduction And Third Ventricle Expansion Among Clinically High Risk Youth Developing Psychotic Disorders, Y. Chung, A. Jacobson, G. He, T. G. Van Erp, S. Mcewen, J. Addington, C. E. Bearden, K. Cadenhead, B. A. Cornblatt, T. D. Cannon, +8 Additional Authors

Journal Articles

A recent prospective longitudinal neuroimaging study of 274 prodromal risk syndrome subjects revealed that those who later developed full-blown psychotic symptoms exhibited accelerated gray matter loss and third ventricle expansion around the time of onset of psychosis. Previous studies also indicate that higher levels of unusual thought content during prodromal states are a significant predictor of psychosis in clinically high-risk youth (CHR). However, the relationship between clinical symptoms and changes in neuroanatomical structure has not been previously examined in the North American Prodrome Longitudinal Study (NAPLS) sample at the atlas level. In this report, we investigated whether symptom severity as …

Attitudes Of Psychiatric Nurses About The Request For Euthanasia On The Basis Of Unbearable Mental Suffering(Ums), M. De Hert, L. Van Bos, K. Sweers, M. Wampers, J. De Lepeleire, C. U. Correll

Journal Articles

INTRODUCTION: When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering. OBJECTIVES: The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS). METHOD: A questionnaire was sent to 11 psychiatric hospitals in the Flemish part …

Lithium In The Acute Treatment Of Bipolar I Disorder: A Double-Blind, Placebo-Controlled Study, R. L. Findling, A. Robb, N. K. Mcnamara, M. N. Pavuluri, V. Kafantaris, R. Scheffer, J. A. Frazier, M. Rynn, M. Delbello, R. A. Kowatch, B. M. Rowles, J. Lingler, K. Martz, R. Anand, T. E. Clemons, P. Taylor-Zapata

Journal Articles

No abstract provided.

Practice Effects Due To Serial Cognitive Assessment: Implications For Preclinical Alzheimer's Disease Randomized Controlled Trials, T. E. Goldberg, P. D. Harvey, K. A. Wesnes, P. J. Snyder, L. S. Schneider

Journal Articles

AbstractIntroduction Practice effects are characteristic of nearly all standard cognitive tasks when repeated during serial assessments and are frequently important confounders in clinical trials. Methods We summarize evidence that gains in neuropsychological test performance scores associated with practice effects occur as artifactual changes associated with serial testing within clinical trials. We identify and emphasize such gains in older, non–cognitively impaired individuals and estimate an effect size of 0.25 for composite cognitive measures in older populations assessed three times in a 6- to 12-month period. Results We identified three complementary approaches that can be used to attenuate practice effects: (1) massed …

Joint Analysis Of Psychiatric Disorders Increases Accuracy Of Risk Prediction For Schizophrenia, Bipolar Disorder, And Major Depressive Disorder, R. Maier, G. Moser, C. M. Hultman, M. Landen, D. F. Levinson, K. S. Kendler, J. W. Smoller, N. R. Wray, S. H. Lee, T. Lencz, +7 Additional Authors

Journal Articles

Genetic risk prediction has several potential applications in medical research and clinical practice and could be used, for example, to stratify a heterogeneous population of patients by their predicted genetic risk. However, for polygenic traits, such as psychiatric disorders, the accuracy of risk prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in …

Dissecting The Heterogeneity Of Treatment Response In First-Episode Schizophrenia, A. K. Malhotra

Journal Articles

The Mental Health Centers for Intervention Development and Applied Research (CIDAR) program prioritized research to provide an evidence base for biomarker development. At the Zucker Hillside Hospital (ZHH), our CIDAR grant supported research on a comprehensive investigation of treatment response and outcome in first episode schizophrenia. Results provide evidence that baseline neuroimaging, neurocognitive, and genetic measures are significantly associated with clinical response to treatment, and that our currently available interventions can effectively treat aspects of psychotic illness, as well as potentially reduce comorbidity associated with illness. Future research may include combining modalities to more robustly predict response and identify treatment …

Objective Identification And Analysis Of Physiological And Behavioral Signs Of Schizophrenia, M. Osipov, Y. Behzadi, J. M. Kane, G. Petrides, G. D. Clifford

Journal Articles

BACKGROUND: A patient's physical activity is often used by psychiatrists to contribute to the diagnostic process for mental disorders. Typically, it is based mostly on self-reports or observations, and hardly ever upon actigraphy. Other signals related to physiology are rarely used, despite the fact that the autonomic nervous system is often affected by mental disorders. AIM: This study attempted to fuse physiological and physical activity data and discover features that are predictive for schizophrenia. METHOD: Continuous simultaneous heart rate (HR) and physical activity recordings were made on 16 individuals with schizophrenia and 19 healthy controls. Statistical characteristics of the recorded …

Delayed Identification And Diagnosis Of Huntington's Disease Due To Psychiatric Symptoms, A. M. Pascu, P. Ifteni, A. Teodorescu, V. Burtea, C. U. Correll

Journal Articles

Huntington's disease (HD) is a progressive neurodegenerative illness that affects 2-9/100.000 of the general population. The usual onset is at around age 35-40 years, but there were cases with onset above 55 years. The disease manifests clinically with many neurological and psychiatric symptoms, leading in advanced phases to dementia, but cognitive symptoms are frequently present much earlier in the disease course. HD is caused by an expanded polyglutamine stretch in the N-terminal part of a 350 kDa protein called huntingtin (HTT). This stretch is encoded by a trinucleotide CAG repetition in exon 1 of HTT. An expansion of greater than …

Child And Adolescent Psychiatrists' Reported Monitoring Behaviors For Second-Generation Antipsychotics, A. M. Rodday, S. K. Parsons, C. Mankiw, C. U. Correll, A. S. Robb, B. T. Zima, T. S. Saunders, L. K. Leslie

Journal Articles

Objective: The number of children and adolescents (hereafter referred to as "children") who have been prescribed second-generation antipsychotics (SGAs) has increased over the last decade, but little is known about monitoring practices in pediatric patients who are vulnerable to adverse effects. We examined factors associated with psychiatrists' self-reported monitoring of children who were prescribed SGAs. Methods: A survey was mailed to a national, randomly selected sample of 1600 child and adolescent psychiatrists from the American Medical Association mailing list. Using logistic regression, we tested whether psychiatrist characteristics, attitudes, and practice characteristics were associated with monitoring (baseline and/or periodic) the following: …

Combination Of Agomelatine And Bupropion For Treatment-Resistant Depression: Results From A Chart Review Study Including A Matched Control Group, K. W. Suhs, C. U. Correll, C. K. Eberlein, R. Pul, H. Frieling, S. Bleich, K. G. Kahl

Journal Articles

Introduction: Although a growing selection of antidepressants is available, a significant number of patients do not reach clinical remission, despite multiple trials. Data concerning the efficacy and safety of combination therapies with newer antidepressants are limited. Methods: Fifteen inpatients with treatment-resistant depression (TRD), defined as Beck Depression Inventory-2 (BDI-2) scores >14 despite treatment with adequate doses of 1 antidepressant classes for 6weeks, were treated with agomelatine plus bupropion for 6weeks, and compared to 15 patients on antidepressant monotherapy with TRD matched on age, sex, and TRD stage based on retrospective chart review. The primary outcome was change in BDI-2 scores. …

Modeling Linkage Disequilibrium Increases Accuracy Of Polygenic Risk Scores, B. J. Vilhjalmsson, J. Yang, H. K. Finucane, A. Gusev, S. Lindstrom, S. Ripke, R. Tamimi, E. Stahl, A. L. Price, T. Lencz, +25 Additional Authors

Journal Articles

Polygenic risk scores have shown great promise in predicting complex disease risk and will become more accurate as training sample sizes increase. The standard approach for calculating risk scores involves linkage disequilibrium (LD)-based marker pruning and applying a p value threshold to association statistics, but this discards information and can reduce predictive accuracy. We introduce LDpred, a method that infers the posterior mean effect size of each marker by using a prior on effect sizes and LD information from an external reference panel. Theory and simulations show that LDpred outperforms the approach of pruning followed by thresholding, particularly at large …

Specificity Of Incident Diagnostic Outcomes In Patients At Clinical High Risk For Psychosis, J. R. Webb, J. Addington, D. O. Perkins, C. E. Bearden, K. S. Cadenhead, T. D. Cannon, B. A. Cornblatt, E. F. Walker, T. H. Mcglashan, S. W. Woods, +4 Additional Authors

Journal Articles

It is not well established whether the incident outcomes of the clinical high-risk (CHR) syndrome for psychosis are diagnostically specific for psychosis or whether CHR patients also are at elevated risk for a variety of nonpsychotic disorders. We collected 2 samples (NAPLS-1, PREDICT) that contained CHR patients and a control group who responded to CHR recruitment efforts but did not meet CHR criteria on interview (help-seeking comparison patients [HSC]). Incident diagnostic outcomes were defined as the occurrence of a SIPS-defined psychosis or a structured interview diagnosis from 1 of 3 nonpsychotic Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition …

Expert Consensus Document: Mind The Gaps—Advancing Research Into Short-Term And Long-Term Neuropsychological Outcomes Of Youth Sports-Related Concussions, Aaron J. Carman, Rennie Ferguson, Robert Cantu, R. Dawn Comstock, Penny A. Dacks, Gerard A. Gioia, +20 Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

Sports-related concussions and repetitive subconcussive exposure are increasingly recognized as potential dangers to paediatric populations, but much remains unknown about the short-term and long-term consequences of these events, including potential cognitive impairment and risk of later-life dementia. This Expert Consensus Document is the result of a 1-day meeting convened by Safe Kids Worldwide, the Alzheimer's Drug Discovery Foundation, and the Andrews Institute for Orthopaedics and Sports Medicine. The goal is to highlight knowledge gaps and areas of critically needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance, and information sharing. For …

Associations Of Military Divorce With Mental, Behavioral, And Physical Health Outcomes, Lawrence Wang, Amber Seelig, Shelley Macdermid Wadsworth, Hope Mcmaster, John E. Alcaraz, Nancy F. Crum-Cianflone

Department of Human Development and Family Sciences Faculty Publications

Background

Divorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members.

Methods

Millennium Cohort participants from the first enrollment panel, married at baseline (2001–2003), and married or divorced at follow-up (2004–2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models.

Results

Compared to those who …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Genome-Wide Methylome Analyses Reveal Novel Epigenetic Regulation Patterns In Schizophrenia And Bipolar Disorder, Yongsheng Li, Cynthia Camarillo, Juan Xu, Tania Bedard Arana, Yun Xiao, Zheng Zhao, Hong Chen, Mercedes Ramirez, Juan Zavala, Michael A. Escamilla, Chun Xu

Health & Biomedical Sciences Faculty Publications

Schizophrenia (SZ) and bipolar disorder (BP) are complex genetic disorders. Their appearance is also likely informed by as yet only partially described epigenetic contributions. Using a sequencing-based method for genome-wide analysis, we quantitatively compared the blood DNA methylation landscapes in SZ and BP subjects to control, both in an understudied population, Hispanics along the US-Mexico border. Remarkably, we identified thousands of differentially methylated regions for SZ and BP preferentially located in promoters 3'-UTRs and 5'-UTRs of genes. Distinct patterns of aberrant methylation of promoter sequences were located surrounding transcription start sites. In these instances, aberrant methylation occurred in CpG islands …

A Comparison Of Combined Overlap Block Fuzzy Cognitive Maps (Cobfcm) And Combined Overlap Block Neutrosophic Cognitive Map (Cobncm) In Finding The Hidden Patterns And Indeterminacies In Psychological Causal Models: Case Study Of Adhd, Hojjatollah Farahani, Florentin Smarandache, Lihshing Leigh Wang

Branch Mathematics and Statistics Faculty and Staff Publications

In spite of researchers’ concerns to find causalities, reviewing the literature of psychological studies one may argue that the classical statistical methods applied in order to find causalities are unable to find uncertainty and indeterminacies of the relationships between concepts.

In this paper, we introduce two methods to find effective solutions by identifying “hidden” patterns in the patients’ cognitive maps. Combined Overlap Block Fuzzy Cognitive Map (COBFCM) and Combined Overlap Block Neutrosophic Map (COBNCM) are effective when the number of concepts can be grouped and are large in numbers. In the first section, we introduce COBFCM, COBNCM, their applications, and …

The Effect Of Multidisciplinary Rehabilitation On Brain Structure And Cognition In Huntington's Disease: An Exploratory Study, Travis M. Cruickshank, Jennifer A. Thompson, Juan F. Dominguez D, Alvaro P. Reyes, Mike Bynevelt, Nellie Georgiou-Karistianis, Roger A. Barker, Mel R. Ziman

Research outputs 2014 to 2021

Background: There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD. Methods: Fifteen participants who …