Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial
Background. Meta-analyses have demonstrated cognitive training (CT) benefits in Parkinson’s disease (PD) patients. However, the patients’ cognitive status has only rarely been based on established criteria. Also, prediction analyses of CT success have only sparsely been conducted. Objective. To dete...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2020/4068706 |
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| author | Elke Kalbe Ann-Kristin Folkerts Anja Ophey Carsten Eggers Saskia Elben Karina Dimenshteyn Patricia Sulzer Claudia Schulte Nele Schmidt Christian Schlenstedt Daniela Berg Karsten Witt Lars Wojtecki Inga Liepelt-Scarfone |
| author_facet | Elke Kalbe Ann-Kristin Folkerts Anja Ophey Carsten Eggers Saskia Elben Karina Dimenshteyn Patricia Sulzer Claudia Schulte Nele Schmidt Christian Schlenstedt Daniela Berg Karsten Witt Lars Wojtecki Inga Liepelt-Scarfone |
| author_sort | Elke Kalbe |
| collection | DOAJ |
| description | Background. Meta-analyses have demonstrated cognitive training (CT) benefits in Parkinson’s disease (PD) patients. However, the patients’ cognitive status has only rarely been based on established criteria. Also, prediction analyses of CT success have only sparsely been conducted. Objective. To determine CT effects in PD patients with mild cognitive impairment (PD-MCI) on cognitive and noncognitive outcomes compared to an active control group (CG) and to analyze CT success predictors. Methods. 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). Outcomes were assessed before and after training. MANOVAs with follow-up ANOVAs and multiple regression analyses were computed. Results. Both interventions were highly feasible (participation, motivation, and evaluation); the overall dropout rate was 4.7%. Time × group interaction effects favoring CT were observed for phonemic fluency as a specific executive test (p=0.018, ηp2=0.092) and a statistical trend for overall executive functions (p=0.095, ηp2=0.132). A statistical trend for a time × group interaction effect favoring CG was shown for the digit span backward as a working memory test (p=0.098, ηp2=0.043). Regression analyses revealed cognitive baseline levels, education, levodopa equivalent daily dose, motor scores, and ApoE status as significant predictors for CT success. Conclusions. CT is a safe and feasible therapy option in PD-MCI, yielding executive functions improvement. Data indicate that vulnerable individuals may show the largest cognitive gains. Longitudinal studies are required to determine whether CT may also attenuate cognitive decline in the long term. This trial is registered with DRKS00010186. |
| format | Article |
| id | doaj-art-7306ea9dadf14548934fc2081c922ddb |
| institution | Kabale University |
| issn | 2090-8083 2042-0080 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-7306ea9dadf14548934fc2081c922ddb2025-02-03T06:05:34ZengWileyParkinson's Disease2090-80832042-00802020-01-01202010.1155/2020/40687064068706Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled TrialElke Kalbe0Ann-Kristin Folkerts1Anja Ophey2Carsten Eggers3Saskia Elben4Karina Dimenshteyn5Patricia Sulzer6Claudia Schulte7Nele Schmidt8Christian Schlenstedt9Daniela Berg10Karsten Witt11Lars Wojtecki12Inga Liepelt-Scarfone13Medical Psychology∣Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, GermanyMedical Psychology∣Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, GermanyMedical Psychology∣Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Interventions (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, GermanyDepartment of Neurology, University Hospital of Marburg, Center for Mind,Brain and Behavior—CMBB, Universitäten Marburg und Gießen, Marburg, GermanyDepartment of Neurology, Center for Movement Disorders and Neuromodulation and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, GermanyDepartment of Neurology, Center for Movement Disorders and Neuromodulation and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, GermanyGerman Center for Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tuebingen, Tuebingen, GermanyGerman Center for Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tuebingen, Tuebingen, GermanyDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, GermanyDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, GermanyDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, GermanyDepartment of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, GermanyDepartment of Neurology, Center for Movement Disorders and Neuromodulation and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, GermanyGerman Center for Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tuebingen, Tuebingen, GermanyBackground. Meta-analyses have demonstrated cognitive training (CT) benefits in Parkinson’s disease (PD) patients. However, the patients’ cognitive status has only rarely been based on established criteria. Also, prediction analyses of CT success have only sparsely been conducted. Objective. To determine CT effects in PD patients with mild cognitive impairment (PD-MCI) on cognitive and noncognitive outcomes compared to an active control group (CG) and to analyze CT success predictors. Methods. 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). Outcomes were assessed before and after training. MANOVAs with follow-up ANOVAs and multiple regression analyses were computed. Results. Both interventions were highly feasible (participation, motivation, and evaluation); the overall dropout rate was 4.7%. Time × group interaction effects favoring CT were observed for phonemic fluency as a specific executive test (p=0.018, ηp2=0.092) and a statistical trend for overall executive functions (p=0.095, ηp2=0.132). A statistical trend for a time × group interaction effect favoring CG was shown for the digit span backward as a working memory test (p=0.098, ηp2=0.043). Regression analyses revealed cognitive baseline levels, education, levodopa equivalent daily dose, motor scores, and ApoE status as significant predictors for CT success. Conclusions. CT is a safe and feasible therapy option in PD-MCI, yielding executive functions improvement. Data indicate that vulnerable individuals may show the largest cognitive gains. Longitudinal studies are required to determine whether CT may also attenuate cognitive decline in the long term. This trial is registered with DRKS00010186.http://dx.doi.org/10.1155/2020/4068706 |
| spellingShingle | Elke Kalbe Ann-Kristin Folkerts Anja Ophey Carsten Eggers Saskia Elben Karina Dimenshteyn Patricia Sulzer Claudia Schulte Nele Schmidt Christian Schlenstedt Daniela Berg Karsten Witt Lars Wojtecki Inga Liepelt-Scarfone Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial Parkinson's Disease |
| title | Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial |
| title_full | Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial |
| title_fullStr | Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial |
| title_full_unstemmed | Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial |
| title_short | Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial |
| title_sort | enhancement of executive functions but not memory by multidomain group cognitive training in patients with parkinson s disease and mild cognitive impairment a multicenter randomized controlled trial |
| url | http://dx.doi.org/10.1155/2020/4068706 |
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