Abstract
Background
The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases.
Aims
To evaluate the efficacy of CCT in patients with Parkinson’s disease and mild cognitive impairment (PD-MCI).
Methods
In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure.
Results
Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found.
Conclusion
CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia.
Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019).
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
Keshavan MS, Vinogradov S, Rumsey J et al (2014) Cognitive training in mental disorders: update and future directions. Am J Psychiatry 171:510–522. https://doi.org/10.1176/appi.ajp.2013.13081075
Nousia A, Martzoukou M, Tsouris Z (2020) The beneficial effects of computer-based cognitive training in parkinson’s disease: a systematic review. Arch Clin Neuropsychol 00:1–14. https://doi.org/10.1093/arclin/acz080
Jean L, Bergeron M-E, Thivierge S et al (2010) Cognitive intervention programs for individuals with mild cognitive impairment: systematic review of the literature. Am J Geriatr Psychiatry 18:281–296. https://doi.org/10.1097/JGP.0b013e3181c37ce9
Bernini S, Alloni A, Panzarasa S et al (2019) A computer-based cognitive training in Mild cognitive impairment in parkinson’s disease. NeuroRehabilitation 44:555–567. https://doi.org/10.3233/NRE-192714
Coyle H, Traynor V, Solowij N (2015) Computerized and virtual reality cognitive training for individuals at high risk of cognitive decline: systematic review of the literature. Am J Geriatr Psychiatry 23:335–359. https://doi.org/10.1016/j.jagp.2014.04.009
Hill NTM, Mowszowski L, Naismith SL et al (2017) Computerized cognitive training in older adults with mild cognitive impairment or dementia: a systematic review and meta-analysis. Am J Psychiatry 174:329–340. https://doi.org/10.1176/appi.ajp.2016.16030360
Alzahrani H, Venneri A (2018) Cognitive rehabilitation in parkinson’s disease: a systematic review. J Parkinsons Dis 8:233–245. https://doi.org/10.3233/JPD-171250
Calleo J, Burrows C, Levin H (2012) Cognitive rehabilitation for executive dysfunction in Parkinson’s disease: application and current directions. Parkinsons Dis. https://doi.org/10.1155/2012/512892
Hindle JV, Petrelli A, Clare L et al (2013) Nonpharmacological enhancement of cognitive function in Parkinson’s disease: a systematic review. Mov Disord 28:1034–1049. https://doi.org/10.1002/mds.25377
Leung IHK, Walton CC, Hallock H et al (2015) Cognitive training in Parkinson disease: a systematic review and meta-analysis. Neurology 85:1843–1851. https://doi.org/10.1212/WNL.0000000000002145
Van de Weijer SCF, Hommel ALAJ, Bloem BR et al (2018) Promising non-pharmacological therapies in PD: targeting late stage disease and the role of computer based cognitive training. Parkinsonism Relat Disord 46(Suppl 1):S42–S46. https://doi.org/10.1016/j.parkreldis.2017.09.002
Walton CC, Naismith SL, Lampit A et al (2017) Cognitive training in Parkinson’s disease: a theoretical perspective. Neurorehabil Neural Repair 33(9):695–706
Biundo R, Weis L, Fiorenzato E et al (2017) Cognitive rehabilitation in parkinson’s disease: is it feasible?. Arch Clin Neuropsychol
Robert PH, König A, Amieva H et al (2014) Recommendations for the use of serious games in people with Alzheimer’s disease, related disorders and frailty. Front Aging Neurosci. https://doi.org/10.3389/fnagi.2014.00054
Alloni A, Sinforiani E, Zucchella C et al (2017) Computer-based cognitive rehabilitation: the CoRe system. Disabil Rehabil. https://doi.org/10.3109/09638288.2015.1096969
Alloni A, Quaglini S, Panzarasa S et al (2018) Evaluation of an ontology-based system for computerized cognitive rehabilitation. Int J Med Inform. https://doi.org/10.1016/j.ijmedinf.2018.04.005
Mewborn CM, Lindbergh CA, Stephen Miller L (2017) Cognitive interventions for cognitively healthy, mildly impaired, and mixed samples of older adults: a systematic review and meta-analysis of randomized-controlled trials. Neuropsychol Rev 27(4):403–439
Postuma RB, Berg D, Stern M et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30:1591–1601. https://doi.org/10.1002/mds.26424
Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442
Litvan I, Goldman JG, Troster Schmand BA et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement Disorder Society Task Force guidelines. Mov Disord 27:349–356. https://doi.org/10.1002/mds.24893
Magni E, Binetti G, Bianchetti A et al (1996) Mini-mental state examination: a normative study in italian elderly population. Eur J Neurol 3:198–202. https://doi.org/10.1111/j.1468-1331.1996.tb00423.x
Conti S, Bonazzi S, Laiacona M et al (2015) Montreal cognitive assessment (MoCA)-Italian version: regression based norms and equivalent scores. Neurol Sci 36:209–214. https://doi.org/10.1007/s10072-014-1921-3
Spinnler H (1987) Italian standardization and classification of Neuropsychological tests. The Italian Group on the Neuropsychological Study of Aging. Ital J Neurol Sci Suppl 8:1–120
Novelli G, Papagno C, Capitani E et al (1986) Tre test clinici di memoria verbale a lungo termine. Taratura su soggetti normali. Arch di Psicol Neurol Psychiatry 47:278–296
Carlesimo GA, Caltagirone C, Gainotti G (1996) The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. Eur Neurol 36:378–384. https://doi.org/10.1159/000117297
Cafarra P, Vezzadini G, Dieci F et al (2002) Rey-Osterrieth complex figure: normative values in an Italian population sample. Neurol Sci 22:443–447. https://doi.org/10.1007/s100720200003
Appollonio I, Leone M, Isella V et al (2005) The frontal assessment battery (FAB): normative values in an Italian population sample. Neurol Sci 26:108–116. https://doi.org/10.1007/s10072-005-0443-4
Novelli G, Papagno C, Capitani E et al (1986) Tre test clinici di ricerca e produzione lessicale. Taratura su soggetti normali. Arch di Psicol Neurol Psychiatry 47:477–506
Giovagnoli AR, Del Pesce M, Mascheroni S et al (1996) Trail making test: normative values from 287 normal adult controls. Ital J Neurol Sci 17:305–309
Capitani E, Laiacona M (1997) Composite neuropsychological batteries and demographic correction: standardization based on equivalent scores, with a review of published data. The Italian Group for the Neuropsychological Study of Ageing. J Clin Exp Neuropsychol 19:795–809. https://doi.org/10.1080/01688639708403761
Beck AT, Steer RA, Brown G (2010) Beck Depression Inventory-IIUSA, NCS Person, Inc., 1996 (Italian translation: Ghisi, M., Flebus, G.B., Montano, A., Sanavio, E., Sica, C. Manuale. Adattamento italiano. Florence, Giunti O.S. Organizzazioni Speciali
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186
Nucci M, Mapelli D, Mondini S (2012) Cognitive Reserve Index questionnaire (CRIq): a new instrument for measuring cognitive reserve. Aging Clin Exp Res 24:218–226. https://doi.org/10.3275/7800
Dalrymple-Alford JC, MacAskill MR, Nakas CT et al (2010) The MoCA: well-suited screen for cognitive impairment in Parkinson disease. Neurology 75:1717–1725. https://doi.org/10.1212/WNL.0b013e3181fc29c9
Pena J, Ibarretxe-Bilbao N, Garcia-Gorostiaga I et al (2014) Improving functional disability and cognition in Parkinson disease: randomized controlled trial. Neurology 83:2167–2174. https://doi.org/10.1212/WNL.0000000000001043
Cerasa A, Gioia MC, Salsone M et al (2014) Neurofunctional correlates of attention rehabilitation in Parkinson’s disease: an explorative study. Neurol Sci 35:1173–1180. https://doi.org/10.1007/s10072-014-1666-z
De Luca R, Latella D, Maggio MG et al (2019) Computer assisted cognitive rehabilitation improves visuospatial and executive functions in Parkinson’s disease: preliminary results. NeuroRehabilitation 45:285–290. https://doi.org/10.3233/NRE-192789
París AP, Saleta HG, de la Cruz Crespo Maraver M et al (2011) Blind randomized controlled study of the efficacy of cognitive training in Parkinson’s disease. Mov Disord 26:1251–1258. https://doi.org/10.1002/mds.23688
Lövdén M, Brehmer Y, Li S-C et al (2012) Training-induced compensation versus magnification of individual differences in memory performance. Front Hum Neurosci 6:141. https://doi.org/10.3389/fnhum.2012.00141
Funding
This work was supported by a grant from the Italian Ministry of Health (Ricerca Corrente 2017-2019).
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SBe and SBo: Study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript. All authors: interpretation of data. SQ and SP: Analysis and interpretation of data. MB: acquisition of data. ES and CT: Critical revision of the manuscript for important intellectual content.
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The study was performed in accordance with the guidelines of the Declaration of Helsinki. The study was approved by local ethics committee (San Matteo Hospital, Pavia, Italy).
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Bernini, S., Panzarasa, S., Barbieri, M. et al. A double-blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods in mild cognitive impairment in Parkinson’s disease: preliminary report of benefits associated with the use of a computerized tool. Aging Clin Exp Res 33, 1567–1575 (2021). https://doi.org/10.1007/s40520-020-01665-2
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DOI: https://doi.org/10.1007/s40520-020-01665-2