Effects of Rhythmic Interventions on Cognitive Abilities in Parkinson’s Disease

Objective: The objective of this study is to compare 2 different rhythmic, high-intensive interventions, that is, rhythmic speech-language therapy (rSLT) versus rhythmic balance-mobility training (rBMT), against a no-therapy (NT) condition in patients with Parkinson’s disease and against healthy controls (HCs) with regard to the change in or enhancement of cognitive abilities. Methods: The 4 groups (rSLT: N = 16; rBMT: N = 10; NT: N = 18; and HC: N = 17) were matched for age, sex, and educational level and were tested in 6 cognitive domains: working memory, executive function, visuo-construction, episodic memory, attention, and word retrieval. Assessments took place at baseline, at 4 weeks (T1), and at 6 months (T2). Rhythmic interventions were provided 3 times per week for 4 weeks in total. To analyze true intervention effects between groups and across time, statistical analyses included reliable change index. Intergroup differences were assessed with multivariate assessment of variance, while differences within groups were assessed with 95% confidence intervals of mean difference. Results: The rSLT improved working memory and word retrieval (p < 0.05), possibly a beneficial transfer effect of the training method per se. In contrast, the NT group worsened in phonemic and semantic shifting (p < 0.01). Observed improvements in flexibility and in episodic memory in the HC may be linked to training effects of retesting. Conclusions: Rhythmic cues are resistant to neurodegeneration and have a strong motivating factor. As thus, these may facilitate high-intensive and demanding training. Although both trainings were superior to NT, the improvement of cognitive abilities depends on the specific training method. Further, therapy may be more effective when delivered by a therapist rather than by an impersonal computer program.

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Extradural Motor Cortex Stimulation might improve episodic and working memory in patients with Parkinson’s disease

npj Parkinson s Disease ◽

10.1038/s41531-020-00129-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Carla Piano ◽

Marco Ciavarro ◽

Francesco Bove ◽

Daniela Di Giuda ◽

Fabrizio Cocciolillo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Motor Cortex ◽

Episodic Memory ◽

Memory Task ◽

Motor Symptoms ◽

Motor Cortex Stimulation ◽

Short Term ◽

Verbal Episodic Memory

Abstract Electric Extradural Motor Cortex Stimulation (EMCS) is a neurosurgical procedure suggested for treatment of patients with advanced Parkinson’s disease (PD). We report two PD patients treated by EMCS, who experienced worsening of motor symptoms and cognition 5 years after surgery, when EMCS batteries became discharged. One month after EMCS restoration, they experienced a subjective improvement of motor symptoms and cognition. Neuropsychological assessments were carried out before replacement of batteries (off-EMCS condition) and 6 months afterward (on-EMCS condition). As compared to off-EMCS condition, in on-EMCS condition both patients showed an improvement on tasks of verbal episodic memory and backward spatial short-term/working memory task, and a decline on tasks of selective visual attention and forward spatial short-term memory. These findings suggest that in PD patients EMCS may induce slight beneficial effects on motor symptoms and cognitive processes involved in verbal episodic memory and in active manipulation of information stored in working memory.

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Effects of Antiparkinson Medication on Cognition in Parkinson’s Disease: A Systematic Review

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.21 ◽

2018 ◽

Vol 45 (4) ◽

pp. 375-404 ◽

Cited By ~ 4

Author(s):

Marc-André Roy ◽

Maxime Doiron ◽

Jessica Talon-Croteau ◽

Nicolas Dupré ◽

Martine Simard

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Episodic Memory ◽

Cochrane Collaboration ◽

Cognitive Outcome ◽

Assessment Instrument ◽

Average Score ◽

Double Blind ◽

Language Studies

AbstractObjective: This study aimed to systematically review the effects of currently prescribed antiparkinson medication on cognition in patients with mild-to-moderate Parkinson’s disease (PD) who were either cognitively intact or mildly impaired. Methods: English- and French-language studies published between 1969 and 2017 were accessed via MedLine, PsychNET, EMBASE and EBSCO databases. Methodological quality (MQ) was evaluated with the quality assessment instrument of the Cochrane Collaboration Depression, Anxiety and Neurosis Review (scores from 0% to 44% indicate very low quality; scores from 45% to 64% indicate low quality; scores from 65% to 84% indicate medium quality; and scores from 85% to 100% indicate high quality). Hedges’ g and Student’s t-test were performed on all cognitive outcome measures reported. Results: In total, 14 studies assessed the cognitive effects of levodopa (L-D), pramipexole (PRX), selegiline (SEL) and rasagiline (RAS) in mild-to-moderate non-demented PD patients. The MQ was overall low, with an average score of 49.1%. Results for L-D showed deleterious effects on a test of cognitive inhibition, as well as benefits on tests of attention/processing speed/working memory, executive functions and episodic memory. Pramipexole was associated with a worsening of episodic memory and impulse control. Results on SEL indicated a deterioration of global cognition over time and of concept formation. Rasagiline had some benefits on working memory and verbal fluency. Conclusion: Antiparkinson medications can have deleterious (L-D; PRX; SEL) and beneficial (L-D; RAS) effects on cognition. However, randomized double-blind placebo-controlled trials with larger sample sizes are required to better elucidate this issue.

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Is Depression or Apathy Playing a Key Role in Predicting Financial Capacity in Parkinson’s Disease with Dementia and Frontotemporal Dementia?

Brain Sciences ◽

10.3390/brainsci11060785 ◽

2021 ◽

Vol 11 (6) ◽

pp. 785

Author(s):

Vaitsa Giannouli ◽

Magda Tsolaki

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Frontotemporal Dementia ◽

Cognitive Abilities ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Decisive Role ◽

Financial Capacity ◽

Capacity Performance

(1) Background: Depression and apathy both affect cognitive abilities, such as thinking, concentration and making decisions in young and old individuals. Although apathy is claimed to be a “core” feature of Parkinson’s disease (PD) and frontotemporal dementia (FTD), it may occur in the absence of depression and vice versa. Thus, the aim of this study is to explore whether depression or apathy better predict financial capacity performance in PD and FTD as well as in nondemented participants. (2) Methods: Eighty-eight participants divided into three groups (PD, FTD and non-demented participants) were examined with the Mini-Mental State Examination (MMSE) and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS)—Full and short form. The Geriatric Depression Scale informant version (GDS-15) and the Irritability-Apathy Scale (IAS) we completed by caregivers. (3) Results: The results indicated that both PD and FTD patients’ general cognitive functioning and financial capacity performance is negatively influenced by apathy and not by depression. (4) Conclusions: Differences in financial capacity performance indicate that apathy should not be disregarded in clinical assessments. Further studies on larger PD and FTD populations are necessary in order to investigate the decisive role of mood factors on financial capacity impairment.

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Delayed recall memory impairment in patients with Parkinson's disease

Dementia & Neuropsychologia ◽

10.1590/s1980-5764-2016dn1003006 ◽

2016 ◽

Vol 10 (3) ◽

pp. 204-209 ◽

Cited By ~ 1

Author(s):

Arthur Oscar Schelp ◽

Cristiane Lara Mendes-Chiloff ◽

Vanessa Cristina Paduan ◽

José Eduardo Corrente ◽

Fabrício Diniz de Lima ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Episodic Memory ◽

Memory Impairment ◽

Rating Scale ◽

Demographic Variables ◽

Delayed Recall ◽

Recall Memory ◽

Significant Difference ◽

With Memory

ABSTRACT Age is one of the risk factors for dementia in patients with Parkinson's disease (PDD). Distinct cognitive syndromes of Parkinson's disease (PD) have been identified in previous studies. Questions about the role of such cognitive disorders in PD outcomes, especially memory dysfunction, in patients with PD remain unanswered. Objective: To establish possible correlations between delayed recall memory (episodic memory), age, and other demographic variables in patients with PD. Methods: A two-stage protocol was applied. Patients with delayed recall memory compromise, selected based on a brief battery of tests (BBRC-Edu), were classified as dementia cases and submitted to the Mattis Dementia Rating Scale (MDRS). Data from patients with memory disturbances were compared against individuals without episodic memory impairment, and correlated with age and demographic variables. Results: Except for identification and naming, all subtests in the screening battery showed a significant difference (p≤0.0001) between the memory-compromised group (case) and the group without memory impairment (no case). The results also correlated negatively with age (p≤0.0001) and positively with level of education (p=0.0874) in patients with PD. Conclusion: The analysis showed a significant relationship between age and dementia characterized by impaired episodic memory. The findings support reports of a wide spectrum of neuropsychological performance impairment in PD with age, particularly dementia associated with memory deterioration. No correlations between disease duration and cognitive dysfunction were evident.

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The Neural Correlates of Spatial and Object Working Memory in Elderly and Parkinson’s Disease Subjects

Behavioural Neurology ◽

10.1155/2015/123636 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Silvia P. Caminiti ◽

Chiara Siri ◽

Lucia Guidi ◽

Angelo Antonini ◽

Daniela Perani

Keyword(s):

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Neural Correlates ◽

Elderly Subjects ◽

Task Execution ◽

Compensatory Mechanisms ◽

Frontoparietal Network ◽

Fmri Study ◽

Comparable Performance

This fMRI study deals with the neural correlates of spatial and objects working memory (SWM and OWM) in elderly subjects (ESs) and idiopathic Parkinson’s disease (IPD). Normal aging and IPD can be associated with a WM decline. In IPD population, some studies reported similar SWM and OWM deficits; others reported a greater SWM than OWM impairment. In the present fMRI research, we investigated whether compensated IPD patients and elderly subjects with comparable performance during the execution of SWM and OWM tasks would present differences in WM-related brain activations. We found that the two groups recruited a prevalent left frontoparietal network when performing the SWM task and a bilateral network during OWM task execution. More specifically, the ESs showed bilateral frontal and subcortical activations in SWM, at difference with the IPD patients who showed a strict left lateralized network, consistent with frontostriatal degeneration in IPD. The overall brain activation in the IPD group was more extended as number of voxels with respect to ESs, suggesting underlying compensatory mechanisms. In conclusion, notwithstanding comparable WM performance, the two groups showed consistencies and differences in the WM activated networks. The latter underline the compensatory processes of normal typical and pathological aging.

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Lee Silverman Voice Treatment versus standard speech and language therapy versus control in Parkinson’s disease: preliminary cost-consequence analysis of the PD COMM pilot randomised controlled trial

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00888-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sarah Scobie ◽

Sue Jowett ◽

Tosin Lambe ◽

Smitaa Patel ◽

Rebecca Woolley ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Language Therapy ◽

Voice Treatment ◽

Cost Consequence ◽

Randomised Controlled

Abstract Background The PD COMM pilot randomised controlled trial compared Lee Silverman Voice Treatment (LSVT® LOUD) with standard NHS speech and language therapy (SLT) and a control arm in people with Parkinson’s disease (PwPD) with self-reported problems with voice or speech. This analysis compares costs and quality of life outcomes between the trial arms, and considers the validity of the alternative outcome measures for economic evaluations. Methods A comparison of costs and outcomes was undertaken alongside the PD COMM pilot trial involving three arms: LSVT® LOUD treatment (n = 30); standard NHS SLT (n = 30); and a control arm (n = 29) excluded from receiving therapy for at least 6 months after randomisation unless deemed medically necessary. For all trial arms, resource use and NHS, social care and patient costs and quality of life were collected prospectively at baseline, 3, 6, and 12 months. Total economic costs and outcomes (EQ-5D-3L, ICECAP-O) were considered over the 12-month follow-up period from an NHS payer perspective. Quality of life measures for economic evaluation of SLT for people with Parkinson’s disease were compared. Results Whilst there was no difference between arms in voice or quality of life outcomes at 12 months, there were indications of differences at 3 months in favour of SLT, which need to be confirmed in the main trial. The estimated mean cost of NHS care was £3288 per patient per year for the LSVT® LOUD arm, £2033 for NHS SLT, and £1788 for the control arm. EQ-5D-3L was more strongly correlated to voice impairment than ICECAP-O, and was sensitive to differences in voice impairment between arms. Conclusions The pilot did not identify an effect of SLT on disease-specific or economic outcomes for PwPD at 12 months; however, there appeared to be improvements at 3 months. In addition to the sample size not powered to detect difference in cost-consequence analysis, many patients in the control arm started SLT during the 12-month period used for economic analysis, in line with the study protocol. The LSVT® LOUD intervention was more intense and therefore more costly. Early indications suggest that the preferred economic outcome measure for the full trial is EQ-5D-3L; however, the ICECAP-O should still be included to capture a broader measure of wellbeing. Trial registration International Standard Randomised Controlled Trial Number Register: ISRCTN75223808. Registered 22 March 2012.

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