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Why is a healthy life style important in HD? A big part of the answer include factors that promote the process of neuroplasticity. The "plasticity" part of neuroplasticity refers to capacity to change, similar to how plastic is malleable and can be made into many shapes. Similarly, neuroplasticity describes the ability of nerve cells to change -- based on various forces -- by making new, or stronger connections to other nerve cells in the brain. Healthy life style factors promote these forces. And vitally important in brain diseases, healthy life style factors can help preserve brain function while damage occurs.

Neuroplasticity in HD: The Battle: There is a constant battle regarding neuroplasticity factors in HD. On one side is mutant huntingtin protein that, in ways not yet known, that damages brain nerve cells. On the other side are protective forces that are active very early in HD. We know this because brain imaging studies show that while damage occurs, new brain connections are made that detour around damaged areas. And while the detour may not be as good as the original path, it works effectively for a long time. The very good news is that a healthy life style will make stronger detours around the areas of brain most damaged by HD.

What healthy life style factors? Healthy life style factors include exercise, sleep, diet, social and intellectual experiences, and stress reduction. There is increasing scientific evidence that each of these factors can have protective influence on body and brain; and that combining factors increases it more. The other good news is that working on one factor makes others easier. For instance, good sleep gives us more energy to exercise, and in turn exercise improves sleep and reduces stress.

But does a healthy life style work in HD? The evidence says yes. Studies show that higher degrees of exercise (physical and mental) are correlated with delay of onset of HD symptoms by as much as 4.6 years [Trembath MK 2010], and in other study that disease progression measures stabilized over a 2 year period with intensive intermittent combined therapy [Zinzi P 2007]. We can probably trust these results as true, because similar levels of benefit are seen in aging [Nemati Karimooy H 2012], and in other neurodegenerative diseases like Alzheimer's [Venturelli M 2011] and Parkinson's [Ahlskog JE 2011]. And as with the general population, substance abuse including overuse of alcohol is harmful with studies suggesting it causes an earlier onset of HD symptoms [Byars JA 2012].

Author's comments: Like a constant battle between good and evil, in HD there is a molecular level battle between protective neuroplasticity forces and destructive mutant protein toxicity. Healthy life style can tip the balance to protection, at least for a while. Think of it this way, if HD had a drug that gave more years of good life, we'd all be running to get it. Until then, let's get working every day on a healthy life style.

References

Trembath MK, Horton ZA, Tippett L, Hogg V, Collins VR, Churchyard A, Velakoulis D, Roxburgh R, Delatycki MB. A retrospective study of the impact of lifestyle on age at onset of Huntington disease. Mov Disord. 2010 Jul 30;25(10):1444-50. doi: 10.1002/mds.23108. PubMed abstract

Zinzi P, Salmaso D, De Grandis R, Graziani G, Maceroni S, Bentivoglio A, Zappata P, Frontali M, Jacopini G. Effects of an intensive rehabilitation programme on patients with Huntington's disease: a pilot study. Clin Rehabil. 2007 Jul;21(7):603-13. PubMed abstract

Nemati Karimooy H, Hosseini M, Nemati M, Esmaily HO. Lifelong physical activity affects mini mental state exam scores in individuals over 55 years of age. J Bodyw Mov Ther. 2012 Apr;16(2):230-5. doi: 10.1016/j.jbmt.2011.08.003. Epub 2011 Sep 16. PubMed abstract

Venturelli M, Scarsini R, Schena F. Six-month walking program changes cognitive and ADL performance in patients with Alzheimer. Am J Alzheimers Dis Other Demen. 2011 Aug;26(5):381-8. doi: 10.1177/1533317511418956. Epub 2011 Aug 17. PubMed abstract

Ahlskog JE. Does vigorous exercise have a neuroprotective effect in Parkinson disease?. Neurology. 2011 Jul 19;77(3):288-94. doi: 10.1212/WNL.0b013e318225ab66. PubMed abstract

Byars JA, Beglinger LJ, Moser DJ, Gonzalez-Alegre P, Nopoulos P. Substance abuse may be a risk factor for earlier onset of Huntington disease. J Neurol. 2012 Sep;259(9):1824-31. doi: 10.1007/s00415-012-6415-8. Epub 2012 Jan 25. PubMed abstract