Objective: To verify whether: 1. Art Therapy (AT) improves motor and non-motor performance in a large cohort of patients with Parkinson’s disease (PD); 2. specific clinical traits predict optimal responsiveness.

Background: AT has been used in different diseases for its potential benefits on psychosocial wellbeing and mental health. We previously found that visual AT with different media improved motor and oculomotor function in a small group of PD patients.

Method: In a prospective open label trial, 39 PD subjects (H&Y 2-3, age range: 54-84,  disease duration: 1-20 yrs) underwent 20 proctored visual AT sessions (2/week, 90 min each) tailored to each patient’s needs. Assessments before and after AT included: MDS-UPDRS (all components), Beck Depression Inventory (BDI)-II, Modified Fatigue Impact Scale, Parkinson’s Disease Questionnaire (PDQ)39, Pegboard Test, PROMIS-Self-Efficacy, Timed Up & Go (TUG-1; TUG-2; TUG-3). Visuospatial function was assessed by computerized Navon, Visual Search, and Simple Reaction Time tests. Effects of AT were analyzed with non-parametric permutation tests with Euclidean distance as test statistics and permutations obtained by symmetric reflection with respect to the mean. Responsiveness profiling, based on UPDRSIII changes, was assessed with Random Forest Importance analysis and Lasso regression followed by one-way MANOVA and Gaussian Naïve Bayes classification.

Results: Significant post-AT improvements (p<1e-5) emerged in: UPDRS-total (mean change, [95% CI]: -8.60, [-12.07; -5.55]), UPDRS-I (-2.15, [-3.67; -0.65]), UPDRS-III (-5.44, [-7.75; -3.49]), TUG-2 (-2.50, [-3.40; -0.77]), Pegboard non-dominant (-17.31, [-48.49; -10.87]), Navon-local (-70.76, [-210.49; -64.33]), Navon-none (-39.27, [-183.32; -58.68]). Benefits were also seen in: BDI (-2.86, p=0.01, [-4.63; -0.52]), TUG-1 (-1.26, p=0.03, [-1.48; -0.01]), PDQ39-emotions (-1.23, p=0.03, [-1.88; -0.06]). Patients displaying greater UPDRS-III score improvement (≥7) had worse pre-AT performance in visuospatial tests.

Conclusion: These results confirm that AT improves motor function and visuospatial processing as well as depressive symptoms, daily living and emotional wellbeing. They further suggest that enhancement of visuospatial abilities may drive the motor improvement. The patient group benefiting the most from AT is that displaying mild visuospatial deficits at baseline testing.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/enhancement-of-visuospatial-function-underlies-motor-improvement-following-art-therapy-in-pd/