Effects of Computer-Based Cognitive Rehabilitation on Attention, Executive Functions, and Quality of Life in Patients with Parkinson’s Disease: A Randomized, Controlled, Single-Blinded Pilot Study

Author(s):  
Katrine Svaerke ◽  
Andreas Kirknaes Faerk ◽  
Asta Riis ◽  
Susanne Ebba Maja Stiegnitz von Ehrenfels ◽  
Jesper Mogensen ◽  
...  

<b><i>Background:</i></b> Cognitive decline in Parkinson’s disease (PD) has become increasingly recognized in recent years, and there is a need to identify methods for cognitive rehabilitation in PD patients. <b><i>Objective:</i></b> The aim of this study was to explore the feasibility and effects of 2 different computer-based cognitive rehabilitation (CBCR) interventions on attention, executive functions, and quality of life (QoL) in PD patients. <b><i>Methods:</i></b> Thirty nondemented PD patients were randomly assigned to one of 3 groups: one passive control group and 2 intervention groups with 2 different CBCR programmes. The intervention period was 8 weeks with follow-up visits in clinic every second week. Before and after the intervention period, patients were tested with a neuropsychological battery of attention, executive functions, and QoL. <b><i>Results:</i></b> Twenty-four patients completed the study. Patients in one of the CBCR groups experienced a significant within-group increase on the primary measures of attention, executive functions, and QoL. However, this effect was not significant between groups. No significant differences were observed for the other CBCR group or the control group. <b><i>Conclusions:</i></b> CBCR is a feasible intervention for cognitive rehabilitation in nondemented PD patients. The effects of training were modest and should be further explored in larger clinical trials. Some CBCR programmes might be more effective than others for PD patients. The protocol for this study was published prospectively at ClinicalTrials.gov on September 18, 2017 with ID: NCT03285347.

2021 ◽  
Author(s):  
Julie Péron ◽  
Philippe Voruz ◽  
Jordan Pierce ◽  
Kévin Ahrweiller ◽  
Claire Haegelen ◽  
...  

Abstract Risk factors for long-term non-motor disorders and quality of life following subthalamic nucleus deep-brain stimulation (STN DBS) have not yet been fully identified. In the present study, we investigated the impact of motor symptom asymmetry in Parkinson’s disease.Data were extracted for 52 patients with Parkinson’s disease (half with left-sided motor symptoms and half with right-sided ones) who underwent bilateral STN and a matched healthy control group. Performances for cognitive tests and neuropsychiatric and quality-of-life questionnaires at 12 months post-DBS were compared with a pre-DBS baseline. Results indicated a deterioration in cognitive performance post-DBS in patients with left-sided motor symptoms. Performances of patients with right-sided motor symptoms were maintained, except for a verbal executive task. These differential effects had an impact on patients’ quality of life. The results highlight the existence of two distinct cognitive profiles of Parkinson’s disease, depending on motor symptom asymmetry. This asymmetry is a potential risk factor for non-motor adverse effects following STN DBS.


2020 ◽  
Vol 34 (4) ◽  
pp. 533-544
Author(s):  
Petra Pohl ◽  
Ewa Wressle ◽  
Fredrik Lundin ◽  
Paul Enthoven ◽  
Nil Dizdar

Objective: To evaluate a group-based music intervention in patients with Parkinson’s disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention group ( n = 26), which received training with the music-based intervention, and control group ( n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinson’s disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jessica Calleo ◽  
Cristina Burrows ◽  
Harvey Levin ◽  
Laura Marsh ◽  
Eugene Lai ◽  
...  

Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits.


2015 ◽  
Vol 9 (3) ◽  
pp. 295-300 ◽  
Author(s):  
Nathalie Ribeiro Artigas ◽  
Vera Lúcia Widniczck Striebel ◽  
Arlete Hilbig ◽  
Carlos Roberto de Mello Rieder

Parkinson's disease (PD) is a neurodegenerative disorder that can dramatically impair patient quality of life (QoL). Objective: To analyze the QoL, motor capacity, depression, anxiety and social phobia of individuals who attended a patient support group (PSG) compared to non-participants. Methods: A cross-sectional study was performed. The sample consisted of 20 individuals with PD who attended a PSG and another 20 PD patients who did not attend a support group for PD patients, serving as the control group (nPSG). All patients answered questionnaires on motor capacity (UPDRS), QoL (Parkinson's Disease Questionnaire- PDQ-39), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory) and social phobia (Liebowitz Social Anxiety Scale). To determine data distribution, the Shapiro-Wilk test was performed. For comparison of means, Student's t-test was applied. In cases of asymmetry, the Mann-Whitney test was employed. To assess the association between the scales, Pearson's correlation coefficient (symmetric distribution) and Spearman's coefficient (asymmetric distribution) were applied. For the association between qualitative variables, Pearson's Chi-squared test was performed. A significance level of 5% (p≤0.05) was adopted. Results: Individuals in the PSG had a significantly better QoL (p=0.002), and lower depression (p=0.026), anxiety (p<0.001) and social phobia (p=0.01) scores compared to the nPSG. Conclusion: The participation of PD patients in social activities such as support groups is associated with better QoL and fewer symptoms of depression, anxiety and social phobia.


2020 ◽  
Vol 78 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Ana Cristina TILLMANN ◽  
Alessandra SWAROWSKY ◽  
Clynton Lourenço CORRÊA ◽  
Alexandro ANDRADE ◽  
Jéssica MORATELLI ◽  
...  

Abstract Background: New protocols applied in the rehabilitation of Parkinson's disease enable different action strategies for health professionals, as well as a new range of activities for these individuals. However, no valid samba protocol with activity prescription for this population was found in the literature. Objective: To investigate the feasibility of a Brazilian samba protocol in individuals with Parkinson's disease. Methods: Twenty participants, mean age of 66.4±10.7 years, diagnosed with idiopathic Parkinson 's disease, divided into: experimental group that received the intervention of Brazilian samba dance classes (10 individuals); and control group that maintained their routine activities (10 individuals). For data collection, a divided questionnaire was used: General Information; Disability stages scale; Balance and Quality of Life. Results: During class implementation, there were no falls, as all dance activities adhered to the details of the protocol steps without any changes. On average, patients completed 82.7% of activities. After 12 weeks, the experimental group had improvements in the UPDRS global score, in daily activities, and on motor examination. There was also improvement in balance scores and in the mobility domain of the quality of life in the experimental group. Conclusion: The samba protocol seems to be feasible and safe for patients with PD. Moreover, it has pleasant characteristics and offers sufficient physical benefits for combination with drug treatment. There were also benefits in social relationships and as a possible rehabilitation tool in individuals with Parkinson's disease.


Author(s):  
Jugal Shah ◽  
Pranav Joshi ◽  
Shikha V. Sood ◽  
Devang Rana ◽  
Supriya D. Malhotra

Background: Parkinson's disease (PD) is a highly debilitating disease characterized by tremors, bradykinesia and rigidity. It leads to lowered self-esteem and psychological consequences which affect quality of life. The aim of this study is to study the drug utilization pattern and assess the quality of life in patients of Parkinson’s Disease.Methods: 40 patients of PD at least 1 month duration and 20 age-based controls were analyzed for quality of life using Parkinson’s Disease Questionnaire-39 (PDQ-39). Drug prescriptions were analyzed.Results: Mean number of anti-Parkinson drugs prescribed is 2.65±1.21. Of 106 anti-Parkinson drugs prescribed, 45% were levodopa and carbidopa combinations, followed by dopamine agonists (18%), anticholinergic drugs (15%), amantadine (12%), MAO inhibitors (5%) and COMT inhibitors (5%). There were significant problems in speech, performance of daily chores and daytime somnolence (p<0.0001). Depression, isolation, cognitive decline and memory loss were noteworthy in the patients as compared to controls (p<0.05). 25% patients felt embarrassed due to their disease; 59% felt affected by others’ opinion, 60% felt difficulty in communicating with others (p<0.05). Almost 2/3rd patients needed help in personal care as compared to the control group (p<0.0001).Conclusions: Quality of life of parkinsonian patients is severely affected in spite of them receiving a large number of drugs. This may be both due to disease progression as well as medication. Levodopa-carbidopa combination is the most prescribed medication. Use of levodopa and carbidopa combination must be evaluated properly. Newer guidelines and interventions are the need of the hour which may provide a better outcome on the quality of life of parkinsonian patients.


2020 ◽  
Vol 48 (7) ◽  
pp. 030006052092244
Author(s):  
Jinzhong Huang ◽  
Wei Hong ◽  
Zhilong Yang ◽  
Jian Ding ◽  
Yi Ren

Purpose To investigate the efficacy of combining the dopamine receptor agonist pramipexole with levodopa for Parkinson’s disease (PD) treatment and to measure their effects on quality of life and tumor necrosis factor (TNF)-α levels in PD patients. Basic Procedure In total, 160 PD patients who were admitted to our hospital were equally randomized into a control treatment group (levodopa alone) and the study group (pramipexole combined with levodopa). Both groups were treated for 12 weeks. Findings After treatment, scores from the Unified Parkinson’s Disease Rating Scales (1–3), the Hamilton Depression Scale, and the Parkinson’s Disease Questionnaire (PDQ-39) were significantly decreased in both groups, whereas Mini-Mental State Examination scores were significantly increased. After treatment, the study group had significantly lower scores for all scales except the Mini-Mental State Examination, for which those who received combined treatment had significantly higher scores than the control group. The incidence of adverse reactions was significantly lower in the study group than in the control group. Furthermore, after treatment, serum TNF-α levels were significantly decreased in both groups compared with pre-treatment levels. Conclusion Pramipexole combined with levodopa relieved PD symptoms and improved the quality of life of PD patients, potentially by suppressing serum TNF-α levels.


Author(s):  
Francesca Morgante ◽  
Valentina Oppo ◽  
Margherita Fabbri ◽  
Enrica Olivola ◽  
Chiara Sorbera ◽  
...  

Abstract Objectives Levodopa–Carbidopa Intrajejunal gel (LCIG) infusion is an effective intervention for people with advanced Parkinson’s disease (PD). Although age may not be a limiting factor for LCIG implant, no data are available on late elderly PD (LE-PD) subjects. In this cross-sectional, we aimed to demonstrate if older age may impact on quality of life (QoL), motor and non-motor symptoms severity, and profile of side effects in PD treated with LCIG. Methods Out of 512 PD subjects treated with LCIG at 9 Italian PD centers, we selected 25 LE-PD defined as age ≥ 80 years at last follow-up who were available to attend the study visit. Twenty-five PD patients (Control-PD, defined as age < 75 years at last follow-up) matched to LE-PD by disease and LCIG duration served as control group. The following motor and non-motor variables were ascertained: quality of life (PDQ-8), time spent in ON, wearing-off Questionnaire, Unified PD Rating Scale, freezing of gait questionnaire, Parkinson’s disease sleep scale-2, Non Motor Symptoms Scale (NMSS), and MOCA. Results No statistically significant differences were found between LE-PD and Control-PD on PDQ-8 and several motor and non-motor variables. LE-PD had less frequent and milder impulsive–compulsive behaviors and milder dyskinesia. At multivariable regression, worse quality of life was associated with UPDRS-III and NMSS scores but not to age at study visit and age at LICG implant. Rate of adverse effects was similar in both groups. Drop-out rate calculated in the whole PD cohort was comparable between the two groups. Conclusion Our data provide evidence that valuable LCIG infusion might be achieved in late elderly PD.


2018 ◽  
Vol 35 (5) ◽  
pp. 6-11
Author(s):  
O. V. Khegai ◽  
N. V. Selyanina ◽  
Yu. V. Karakulova

Aim. To estimate the degree of influence of non-motor manifestations on the quality of life among patients with Parkinson’s disease. Materials and methods. In the study, the “case-control” design was used, processing of the data was conducted with nonparametric methods. Complex examination of 58 patients with Parkinson’s disease was performed. The control group included 15 healthy persons. Results. Manifestation of cognitive, anxiety-depressive, vegetative symptoms in the main group was significantly higher than in the control. There was revealed a negative correlation dependence between the general manifestation of vegetative disorders and the social functioning indices (R = – 0.5; p = 0.001), pain intensity (R = – 0.5; p = 0.001) and psychical health (R = – 0.5; p = 0.005) that proves aggravation of the data on health components as the severity of symptoms was growing. The analyzed vegetative disorders of separate subsystems demonstrated the analogous tendencies. Severity of depressive symptoms influences the pain indices (R = – 0.4; p = 0.01) and the social functions (R = – 0.3; p = 0.03). According to unified scale, non-motor symptoms negatively influence the general health status (R = – 0.3; p = 0.001), social functioning (R= – 0.23; p = 0.004), pain assessment (R = – 0.5; p = 0.001). Conclusions. Non-motor symptoms aggravate the quality of life, influencing both physical and psychological component of health. The absence of correlation between the duration of therapy and the severity of non-motor symptoms confirms the independence of this block of symptoms.


Motricidade ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 29
Author(s):  
Maira Peloggia Cursino ◽  
Doralice Fernanda Raquel ◽  
Camilla Zamfolini Hallal ◽  
Flávia Roberta Faganello Navega

The aim of this study was to analyse and compare the effects of gait training on a treadmill associated with partial body weight support (PBWS) or auditory stimulus (AS) and the kinematic variables of gait and quality of life (QOL) in patients with Parkinson's disease (PD). Twenty-one volunteers with PD participated and were divided into: group with PBWS (GPBWS) with AS (GAS), and control group (CG). Soil step length (SL), SL variability (SLV), step width (SW), SW variability (SWV), gait speed (GS), and QOL were evaluated by the Parkinson’s Disease Questionnaire-39 (PDQ-39). The training was performed for six weeks, with three weekly sessions of 30 minutes. The results showed homogeneity of groups (p> 0.05). There was an increase of SW in the GPBWS (p= 0.006) and GS in the GAS (p= 0.048) and decreased PDQ-39 in the CG (p= 0.005) and GAS (p= 0.006). For groups, regardless of evaluation, there were differences in SWV between the GPBWS and GAS (p= 0.030); for evaluations, independently of groups, there were differences in GS (p= 0.048) and PDQ-39 (p= 0.002). It was concluded that, among the studied conditions, there was a significant improvement for the groups: AS in GS and QOL, CG in QOL and GPBWS did not improve. Thus, considering the clinical effect, treadmill training, independently of the stimuli, is clinically advantageous for gait improvements and QOL. The aim of this study was to analyse and compare the effects of gait training on a treadmill associated with partial body weight support (PBWS) or auditory stimulus (AS) and the kinematic variables of gait and quality of life (QOL) in patients with Parkinson's disease (PD). Twenty-one volunteers with PD participated and were divided into: group with PBWS (GPBWS) with AS (GAS), and control group (CG). Soil step length (SL), SL variability (SLV), step width (SW), SW variability (SWV), gait speed (GS), and QOL were evaluated by the Parkinson’s Disease Questionnaire-39 (PDQ-39). The training was performed for six weeks, with three weekly sessions of 30 minutes. The results showed homogeneity of groups (p> 0.05). There was an increase of SW in the GPBWS (p= 0.006) and GS in the GAS (p= 0.048) and decreased PDQ-39 in the CG (p= 0.005) and GAS (p= 0.006). For groups, regardless of evaluation, there were differences in SWV between the GPBWS and GAS (p= 0.030); for evaluations, independently of groups, there were differences in GS (p= 0.048) and PDQ-39 (p= 0.002). It was concluded that, among the studied conditions, there was a significant improvement for the groups: AS in GS and QOL, CG in QOL and GPBWS did not improve. Thus, considering the clinical effect, treadmill training, independently of the stimuli, is clinically advantageous for gait improvements and QOL.


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