Huntington disease (HD) is a neurodegenerative condition with prominent motor (including oculomotor), cognitive, and psychiatric effects. While neuropsychological deficits are present in HD, motor impairments may impact performance on neuropsychological measures, especially those requiring a speeded response, as has been demonstrated in multiple sclerosis and schizophrenia. The current study is the first to explore associations between oculomotor functions and neuropsychological performance in HD. Participants with impaired oculomotor functioning performed worse than those with normal oculomotor functioning on cognitive tasks requiring oculomotor involvement, particularly on psychomotor speed tasks, controlling for covariates. Consideration of oculomotor dysfunction on neuropsychological performance is critical, particularly for populations with motor deficits.

Background: Huntington disease (HD) is a neurodegenerative disease caused by a CAG repeat expansion on chromosome 4. Pathology is associated with CAG repeat length. Prior studies examining people in the intermediate allele (IA) range found subtle differences in motor, cognitive, and behavioral domains compared to controls. Objective: The purpose of this study was to examine baseline and longitudinal differences in motor, cognitive, behavioral, functional and imaging outcomes between persons with CAG repeats in four ranges: normal (≤ 26), intermediate (27–35), reduced penetrance (36–39), and full penetrance (≥ 40). Methods: We examined longitudinal data from 1379 participants (280 normal [NA], 21 intermediate [IA], 88 reduced penetrance [RP], and 986 full penetrance [FP] allele ranges). We used linear mixed models to identify differences in baseline and longitudinal outcomes between groups. Three models were tested: 1) no baseline or longitudinal differences; 2) baseline differences but no longitudinal differences; and 3) baseline and longitudinal differences. Results: Model 3 was the best fitting model for most outcome variables. Differences between the NA and the FP group account for the majority of significant findings. Some differences between the RP and NA groups were significant. While there were baseline and longitudinal trends of declining performance across increasing CAG repeat length groups, we found no significant differences between the NA and IA groups. Conclusions: We did not find evidence to support differences in the IA group compared to the nongene-expanded controls. These findings are limited by a small IA sample size.

For complete reporting of pre-and post-survey responses please see Appendices 4 to 17. Analysis of pre-and post-student surveys do not indicate any intervention effects on students' perceptions and attitudes. Parent Survey Methods To assess changes in parents' perceptions and attitudes of the lunchroom surveys were administered pre-and post-intervention. An email with a link to the online survey was sent to parents in October 2016 by an onsite school administrator. Parents were asked to complete a 5-10-minute survey about their child's participation in the school meals, why their child eats school lunch, communication of school lunch, the purpose of school lunch, perceptions of school lunchrooms and staff, and factors for keeping their child healthy. The complete survey can be viewed in Appendix 18. The post-survey was administered in the spring of 2017.