Session Information
Date: Thursday, June 23, 2016
Session Title: Clinical trials and therapy in movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To investigate the potential of cognitive training to improve symptoms of freezing of gait in Parkinson’s disease.
Background: Freezing of gait (FOG) is a disabling symptom of Parkinson’s disease (PD), which has been linked to deficits in frontostriatal pathways. These pathways support executive functions, which are consistently shown to be impaired in patients with FOG. Recent meta-analytic evidence confirms cognitive training is an effective means of improving executive functions in PD. Therefore an intriguing possibility is that enhancement of executive functions in patients with FOG may lead to reductions in freezing symptomatology. We have undertaken a large scale study to investigate whether targeted CT can improve FOG in PD patients.
Methods: This was a randomized double blind active controlled trial, completed between 2013 and 2016. Participants were allocated to one of two groups if they had self-reported FOG, and intact cognition (MMSE ≥ 24). The intervention group completed computerized CT targeting executive functions, processing speed and attention. The control group completed various tasks of mild cognitive complexity (e.g., watching educational videos). Both groups completed their respective psychologist-facilitated training sessions twice per week for seven weeks. All participants underwent timed up and go test both on and off dopaminergic medication, a detailed neuropsychological assessment, and completed questionnaires relating to mood, sleep and daily functioning pre- and post-intervention. A subset of participants also completed functional neuroimaging pre- and post-intervention. The primary outcome measure was a reduction in FOG during timed up and go assessments. Secondary outcome measures were improved cognitive and psychosocial functioning.
Results: Fifty-seven patients completed the program (treatment: 32, control: 25). Analysis of the outcome measures is currently underway.
Conclusions: We have completed the largest CT trial to date in PD. Available evidence indicates the disabling symptom of FOG may be improved using this method, and here we will present findings to clarify the utility of this potential treatment strategy.
To cite this abstract in AMA style:
C.C. Walton, L. Mowszowski, J.M. Shine, M. Gilat, J.M. Hall, C. O'Callaghan, A.J. Muller, M. Georiades, J.Y.Y. Szeto, K.A. Ehgoetz Martens, S.L. Naismith, S.J.G. Lewis. A double-blind randomized controlled trial of cognitive training for freezing of gait in Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/a-double-blind-randomized-controlled-trial-of-cognitive-training-for-freezing-of-gait-in-parkinsons-disease/. Accessed November 24, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-double-blind-randomized-controlled-trial-of-cognitive-training-for-freezing-of-gait-in-parkinsons-disease/