Category: Parkinson’s Disease: Clinical Trials
Objective: To determine cognitive training (CT) effects in Parkinson’s disease (PD) patients with mild cognitive impairment (PD-MCI) on cognitive and non-cognitive outcomes compared to an active control group (CG) and to analyze CT responsiveness predictors.
Background: Meta-analyses have demonstrated CT benefits on cognitive outcomes in PD patients. However, the patients’ cognitive status has only rarely been based on established criteria. Also, there are only few studies examining CT effects on non-cognitive outcomes (e.g. quality of life, neuropsychiatric symptoms), and prediction analyses of CT responsiveness have only sparsely been conducted.
Method: Sixty-four PD-MCI patients (age: 67.61 ± 7.70; UPDRS-III: 26.58 ± 13.54; MoCA: 24.47 ± 2.78) were randomized to either a CT-group or a low-intensity physical activity CG for six weeks (twice weekly, 90 minutes). Cognitive and non-cognitive outcomes were assessed pre- and post-training. MANOVAs with follow-up ANOVAs and multiple regression analyses were computed.
Results: Both interventions were highly feasible (participation, motivation, evaluation); the overall dropout rate was 4.7%. Time x Group interaction effects favoring the CT were observed for phonemic fluency as a specific executive test (p = .018, ηp² = .092) and a statistical trend for overall executive functions (p = .095, ηp² = .132). A statistical trend for a Time x Group interaction effect favoring the CG was shown for the digit span backward as a working memory test (p = .098, ηp² = .043). Regression analyses revealed cognitive baseline levels, education, Levodopa equivalent daily dose, motor scores, and ApoE status as significant predictors for CT responsiveness.
Conclusion: CT is a safe and feasible therapy option in PD-MCI, yielding improvement in certain executive functions. Data indicate that vulnerable individuals may show the largest cognitive responsiveness. Longitudinal studies are required to determine whether CT may also attenuate cognitive decline in the long term.
To cite this abstract in AMA style:
E. Kalbe, A.K Folkerts, A. Ophey, C. Eggers, S. Elben, K. Dimenshteyn, P. Sulzer, C. Schulte, N. Schmidt, C. Schlenstedt, D. Berg, K. Witt, L. Wojtecki, I. Liepelt-Scarfone. Enhancement of executive functions but not memory by multidomain cognitive group training in Parkinson patients with mild cognitive impairment: A multicenter randomized controlled trial [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/enhancement-of-executive-functions-but-not-memory-by-multidomain-cognitive-group-training-in-parkinson-patients-with-mild-cognitive-impairment-a-multicenter-randomized-controlled-trial/. Accessed November 22, 2024.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/enhancement-of-executive-functions-but-not-memory-by-multidomain-cognitive-group-training-in-parkinson-patients-with-mild-cognitive-impairment-a-multicenter-randomized-controlled-trial/