{
  "abstract": "Background Chorea is a prevalent feature of Huntington’s Disease, which significantly impairs quality of life (Sokol, Troost, Kluger, et al. Ann Clin Transl Neurol. 2021;8(8):1668-1679) and psychological wellbeing (Pérez-Pérez, García-López, Valle, et al. Neurol Ther. 2025;14(1):99-115). Virtual Reality (VR) has been implemented in early-stage Huntington’s Disease, demonstrating improvements in cognitive and motor impairment (Cellini, Paladina, Mascaro, et al. Medicina. 2022;58(7):919). However, the application of VR in advanced Huntington’s Disease remains underexplored.Aim To assess the impact of VR on the motor function and psychological wellbeing of a 35-year old female patient with Advanced Huntington’s Disease, focusing on chorea severity, anxiety and depression, and quality of life.Methods The patient was offered six fortnightly sessions of a VR experience of her choice within the Living Well Centre at John Eastwood Hospice. Chorea severity was measured using the Unified Huntington’s Disease Rating Scale (UHDRS), collected before, during and after each session. Psychological wellbeing was assessed using the Patient Health Questionnaire-4 (PHQ-4) before and after each session. The FACIT-PAL14 was used to collect quality of life data, completed at baseline and post intervention.Results The patient engaged in six sessions of VR, with clips lasting between 9-15 minutes. She chose to experience ‘Swimming with Dolphins’ for four sessions and an ‘Ocean Body Scan’ for two sessions. The patient enjoyed using VR every session, reporting feeling ‘relaxed’ and that it ‘stopped the fidgeting’. The UHDRS-Chorea scores decreased during the treatment phase, with an average reduction from 9.7 (pre-VR) to 3.2 (during-VR). After VR, UHDRS-Chorea scores increased slightly to an average of 7.2, but remained improved compared to baseline. The average PHQ-4 pre-score of 9 reduced to an average post-score of 2.3, a reliable and clinical improvement in symptoms of low mood and anxiety. The FACIT-PAL-14 score increased from 18 to 28, suggesting potential improvement in overall quality of life.Conclusion The use of VR for advanced Huntington’s Disease may provide immediate benefits for managing severe chorea and psychological distress. These preliminary findings support further exploration of VR interventions and their mechanisms, particularly for palliative patients with advanced disease, where conventional options such as ‘talking therapy’ may be limited.",
  "authors": [
    {
      "affiliations": [
        "John Eastwood Hospice, Sutton-in-Ashfield, UK",
        "Nottinghamshire Healthcare NHS Foundation Trust, UK"
      ],
      "name": "Sanchia Biswas"
    },
    {
      "affiliations": [
        "John Eastwood Hospice, Sutton-in-Ashfield, UK",
        "Nottinghamshire Healthcare NHS Foundation Trust, UK"
      ],
      "name": "Alice Gains"
    },
    {
      "affiliations": [
        "John Eastwood Hospice, Sutton-in-Ashfield, UK",
        "Nottinghamshire Healthcare NHS Foundation Trust, UK"
      ],
      "name": "Amelia Marheineke"
    },
    {
      "affiliations": [
        "John Eastwood Hospice, Sutton-in-Ashfield, UK",
        "Nottinghamshire Healthcare NHS Foundation Trust, UK"
      ],
      "name": "Lisa Clibbery"
    },
    {
      "affiliations": [
        "John Eastwood Hospice, Sutton-in-Ashfield, UK",
        "Nottinghamshire Healthcare NHS Foundation Trust, UK"
      ],
      "name": "Michelle Stendall"
    }
  ],
  "title": "P-183 Virtual reality for managing chorea and psychological distress in advanced Huntington’s disease: a clinical case study",
  "uid": "8cd59df5-22d4-52b1-811e-f1e4663674cb"
}