Contemporary Dance Practice Improves Motor Function and Body Representation in Huntington's Disease: A Pilot Study

Background: Physical exercise improves neurological conditions, but adherence is hard to establish. Dance might be a promising alternative; however, since patients with Huntington's disease (HD) suffer from rhythmic movement execution deficits, any metric dance practice must be avoided. Objective: Here we asked, if contemporary dance, a lyrical dance form, practiced for two hours per week over five months, might improve motor function, neuropsychiatric variables, cognition and brain volume of HD patients. Methods: Nineteen patients aged between 43 and 78 years with mild to moderate HD (TFC range 7-13, UHDRS motor score range 3-58) participated in this randomized, controlled pilot study (NCT 01842919). The primary outcome measure was total motor score. Secondary outcome measures were differences in brain structure, cognitive function, neuropsychiatric variables, apathy and quality of life. A semi-structured interview assessed participants' experiences. Results: Adherence to dance classes was very good. All participants completed 5 months of dance practice. Motor impairment (median [IQR] decreased from 28[6-51] to 27[7-33] for the dance group compared to an increase of 19[13-35] - 25[14-42] for usual care, Z= -2.44, p = 0.015). No other behavioral measures showed any changes. Brain volume increased in the medial superior parietal and paracentral lobule, in line with compensatory structural brain changes in areas supporting spatial and somatosensory processing. These changes were also reflected in patients' reports that contemporary dance altered the way they "felt and lived in their bodies". Conclusions: Contemporary dance practice, through work on spatial and bodily representations, helps improve motor function in HD patients.