Previous literature suggests that state-of-the-art balance equipment can demonstrate early pathology in HD; however, more practical and cost-efficient assessments are necessary for widespread clinical use. Studies examining balance in HD are limited and, to our knowledge, none have systematically investigated balance in prodromal HD (ProHD).

A brief balance assessment using a WBB and laptop software that measures total body sway (TBS) was administered to 31 HD, 16 ProHD, 16 presymptomatic HD (PreHD), and 21 normal control (NC) subjects. The balance test consisted of four conditions: eyes open versus closed while standing on a stable versus unstable (i.e., foam) surface. Participants also completed tests of cognitive (MMSE, MoCA, Stroop Word, Symbol Digit), motor (UHDRS TMS), and functional ability (TFC and TUG). Non-parametric analyses were used for these data.

HD patients had significantly higher TBS, indicating greater balance difficulties, as compared to all of the other cohorts. Importantly, the ProHD group had significantly higher TBS than both the NC (ps < 0.05, ds > 0.30) and PreHD (ps < 0.05, ds > 0.30) groups, suggesting that balance deficits can be detected in the prodromal stage of HD.