A Review of the Clinical Evidence for Complementary and Alternative Medicine in Huntington’s Disease

Abstract

Background: There is a lack of published guidelines related to the use of complementary and alternative medicine (CAM) for Huntington's disease (HD). We conducted a review of the literature to summarize the available evidence for various mind-body practices and nutraceuticals. Methods: PubMed and Cochrane Library electronic databases were searched independently from inception to February 2019 by two independent raters. Studies were classified for the level of evidence (Class I, II, III, or IV) according to the American Academy of Neurology (AAN) classification scale. Results: Randomized controlled trials in HD were reviewed for mind-body interventions (dance therapy, music therapy, and exercise), alternative systems (traditional Chinese medicine [TCM]), and nutraceuticals/diet (aminooxyacetic acid [AOAA], coenzyme q10, creatine, cannabinoids, alpha-tocopherol, eicosapentaenoic acid, idebenone, levocarnitine, and triheptanoin). Few studies met AAN Class I or II level of evidence for benefits, and these are highlighted. Discussion: There is a relative paucity of clinical trials examining CAM modalities in HD when compared to other neurodegenerative disorders. Currently, there is no evidence supporting disease modification or symptom improvement with any specific dietary or nutraceutical supplement for HD. Supervised exercise and contemporary dance are safe for people with HD, but more robust studies are warranted to guide specific recommendations for these and other mind-body interventions.

Physical therapy management of middle and late stage of Huntington’s disease

“…PNF, dance, music, use of RCH, RAC and aids are effective methods to improve gait and balance and seem to have positive effects in treating the symptoms of the disease [7][8][9][10] . Exercise appears to be beneficial for patients with HD in improving cardiovascular and mitochondrial function and neuroplasticity [1,[11][12][13][14][15] . To make it more fun and effective it can be done through hydrotherapy or through dual-task activities [16][17] .…”

“…The results of the research also showed that there was a positive effect on their physical condition. Yu and Bega [12] also conducted a review on the application of alternative therapies in HD. The PubMed and Cochrane Library databases were searched and the results were sorted by level of evidence (Class I, II, III, IV) according to the American Academy of Neurology classification scale.…”

Perspective Chapter: Nutraceuticals as a Therapeutic Promise in Healthy Aging and Neurocognitive Disorders

“…In Huntington's disease (HD), there are very few nutraceutical compounds that are found to be helpful. These include amino-oxy acetic acid (AOAA), levocarnitine [57], curcumin, taurine, resveratrol, anthocyanins, and quercetin [58]. Souvenaid™, a medical food composed of uridine monophosphate, DHA, choline, EPA, selenium, folic acid, phospholipids, and B vitamins has been found to have a significant positive impact on the behavioral symptomatology and theory of mind (ToM) skills in patients with frontotemporal dementia (FTD) [59].…”

Cognition-oriented treatments and physical exercise on cognitive function in Huntington’s disease: Protocol for systematic review

“…Existing reviews of the effects of non-pharmacological interventions such as physical exercise [13], physical therapy [14] and art-based rehabilitation [15,16] on cognitive function in HD have been largely inconclusive. This is partly attributed to reviews including only randomized controlled trials, leading to only a few studies being eligible for synthesis [13,15]. Further, the effect of cognitive interventions has been largely unexplored in HD.…”