scholarly journals Effects of Home-Based Working Memory Training on Visuo-Spatial Working Memory in Parkinson’s Disease: A Randomized Controlled Trial

2020 ◽  
Vol 12 ◽  
pp. 117957351989946 ◽  
Author(s):  
Kathrin Giehl ◽  
Anja Ophey ◽  
Paul Reker ◽  
Sarah Rehberg ◽  
Jochen Hammes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Working Memory ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Spatial Working Memory ◽  
Controlled Trial ◽  
Memory Training ◽  
Randomized Controlled ◽  
Home Based

Background: Cognitive impairment is a very frequent and severe nonmotor symptom of Parkinson’s disease (PD). Early intervention in this at-risk group for cognitive decline may be crucial for long-term preservation of cognitive functions. Computerized working memory training (WMT) has been proven beneficial in non-PD patient populations, but such evidence is still needed for patients with PD. Objective: This study aimed to evaluate the effect of WMT on visuo-spatial working memory (WM) in cognitively unimpaired patients with PD. Methods: A single-blind randomized controlled trial encompassing 76 patients with PD but no cognitive impairment according to level II diagnostic criteria was conducted. Thirty-seven patients engaged in home-based adaptive WMT 5 times per week for a period of 5 weeks, whereas the remaining patients were in the waiting list arm of the study (control group [CG]). Working memory performance was evaluated using a computerized task before and after intervention and at 14-week follow-up, allowing to quantify the precision of WM on a continuous scale, ie, to test not only if an item was remembered but also how well the location of this item was retained. Results: Coincidently, the WMT group showed slightly worse WM performance compared with the CG at baseline, which was ameliorated after WMT. This training-induced effect remained stable until follow-up. Conclusion: Patients showing relatively low WM performance, despite not formally diagnosable as Parkinson’s disease with mild cognitive impairment (PD-MCI), seem to benefit from home-based WMT. Thus, WMT could potentially be implemented in future trials as a time- and cost-efficient route to counteract subtle cognitive changes in early disease stages. Trial registration: German Clinical Trial Register (drks.de, DRKS00009379)

A process evaluation of a home-based occupational therapy intervention for Parkinson’s patients and their caregivers performed alongside a randomized controlled trial

2016 ◽  
Vol 30 (12) ◽  
pp. 1186-1199 ◽  
Author(s):  
Ingrid HWM Sturkenboom ◽  
Maria WG Nijhuis-van der Sanden ◽  
Maud JL Graff
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trial ◽  
Occupational Therapy ◽  
Contextual Factors ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Home Based ◽  
Occupational Therapy Intervention ◽  
Therapy Intervention

Objective: To evaluate fidelity, treatment enactment and the experiences of an occupational therapy intervention in Parkinson’s disease, to identify factors that affect intervention delivery and benefits. Design: Mixed methods alongside a randomized controlled trial. Subjects: These include 124 home-dwelling Parkinson’s disease patients and their primary caregivers (recipients), and 18 occupational therapists. Intervention: Ten-week home-based intervention according to the Dutch guidelines for occupational therapy in Parkinson’s disease. Main measures: Data were collected on intervention dose, protocol process, content of treatment (fidelity), offered and performed strategies (treatment enactment), and recipients’ experiences. Therapists’ experiences were collected through case note analyses and focus group interviews. Results: Mean intervention dose was 9.3 (SD 2.3) hours. Mean protocol process adherence was high (93%; SD 9%), however the intervention did not (fully) address the goal for 268 of 617 treatment goals. Frequencies of offered and performed strategies appeared similar, apart from ‘using other tools and materials’ which showed a drop from 279 advised to 149 used. The recipients were satisfied overall with the intervention (mean score 8 out of 10). The therapists noted positive or negative influencing factors on both process and benefits: the research context, the socio-political healthcare context, the recipients’ personal and contextual factors, and the therapists’ competence. Conclusion: We found some prerequisite factors in equipment provision and available dose important for treatment delivery. Other elicited factors related to, or affected, the required professional competencies and tools to tailor interventions to the complexity of interacting personal and contextual factors of patients and caregivers.

Component analysis of verbal versus spatial working memory training in adolescents with ADHD: A randomized, controlled trial

2011 ◽  
Vol 17 (6) ◽  
pp. 546-563 ◽  
Author(s):  
Bradley S. Gibson ◽  
Dawn M. Gondoli ◽  
Ann C. Johnson ◽  
Christine M. Steeger ◽  
Bradley A. Dobrzenski ◽  
...  
Keyword(s):  
Working Memory ◽  
Randomized Controlled Trial ◽  
Spatial Working Memory ◽  
Controlled Trial ◽  
Component Analysis ◽  
Working Memory Training ◽  
Memory Training ◽  
Randomized Controlled

Home based training for dexterity in Parkinson's disease: A randomized controlled trial

2017 ◽  
Vol 41 ◽  
pp. 92-98 ◽  
Author(s):  
Tim Vanbellingen ◽  
Thomas Nyffeler ◽  
Julia Nigg ◽  
Jorina Janssens ◽  
Johanna Hoppe ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Home Based

scholarly journals Evaluating a frontostriatal working-memory updating-training paradigm in Parkinson’s disease: the iPARK trial, a double-blinded randomized controlled trial

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Magdalena Eriksson Domellöf ◽  
Lois Walton ◽  
Carl-Johan Boraxbekk ◽  
David Bäckström ◽  
Maria Josefsson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Working Memory ◽  
Parkinson's Disease ◽  
Cognitive Training ◽  
Controlled Trial ◽  
Memory Updating ◽  
Randomized Controlled ◽  
Working Memory Updating ◽  
Double Blinded ◽  
Striatal System

Abstract Background Cognitive decline and dementia are common in Parkinson’s disease (PD). Cognitive deficits have been linked to the depletion of dopamine in the nigrostriatal pathway, but pharmacological treatments for PD have little evidence of improving or delaying cognitive decline. Therefore, exploring non-pharmacological treatment options is important. There have been some promising results of cognitive training interventions in PD, especially for improvements in working memory and executive functions. Yet, existing studies are often underpowered, lacking appropriate control condition, long term follow-up, a thorough description of the intervention and characteristics of the participants. Working memory updating training has previously shown to increase striatal activation in healthy young and old participants as well as dopaminergic neurotransmission in healthy young participants. In the light of dopamine dysfunction in PD, with negative effects on both motor and cognitive functions it is of interest to study if an impaired striatal system can be responsive to a non-invasive, non-pharmacological intervention. Methods and design The iPARK trial is a double-blinded, randomized controlled trial with a parallel-group design that aims to recruit 80 patients with PD (during the period 02/2017–02/2023). Included patients need to have PD, Hoehn and Yahr staging I-III, be between 45 to 75 years of age and not have a diagnosis of dementia. All patients will undergo 30 sessions (6–8 weeks) of web-based cognitive training performed from home. The target intervention is a process-based training program targeting working memory updating. The placebo program is a low dose short-term memory program. A battery of neuropsychological tests and questionnaires will be performed before training, directly after training, and 16 weeks after training. Discussion We expect that the iPARK trial will provide novel and clinically useful information on whether updating training is an effective cognitive training paradigm in PD. Further, it will hopefully contribute to a better understanding of cognitive function in PD and provide answers regarding cognitive plasticity as well as determining critical factors for a responsive striatal system. Trial registration Clinicaltrials.gov registry number: NCT03680170, registry name: “Cognitive Training in Parkinson’s Disease: the iPARK study”, retrospectively registered on the 21st of September 2018. The inclusion of the first participant was the 1st of February 2017.

scholarly journals Working memory training increases neural efficiency in Parkinson’s disease: a randomized controlled trial

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Kathrin Giehl ◽  
Anja Ophey ◽  
Jochen Hammes ◽  
Sarah Rehberg ◽  
Thorsten Lichtenstein ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Working Memory ◽  
Parkinson's Disease ◽  
Functional Connectivity ◽  
Controlled Trial ◽  
Memory Task ◽  
Neural Correlates ◽  
Working Memory Training ◽  
Memory Training ◽  
Memory Processes

Abstract Impairment of working memory and executive functions is already frequently observed in early stages of Parkinson’s disease. Improvements in working memory performance in this cohort could potentially be achieved via working memory training. However, the specific neural mechanisms underlying different working memory processes such as maintenance as opposed to manipulation are largely under-investigated in Parkinson’s disease. Moreover, the plasticity of these correlates as a function of working memory training is currently unknown in this population. Thus, the working memory subprocesses of maintenance and manipulation were assessed in 41 cognitively healthy patients with Parkinson’s disease using a newly developed working memory paradigm and functional MRI. Nineteen patients were randomized to a 5-week home-based digital working memory training intervention while the remaining patients entered a control, wait list condition. Working memory task-related activation patterns and context-dependent functional connectivity, as well as the change of these neural correlates as a function of training, were assessed. While both working memory processes activated an extended frontoparietal–cerebellar network, only the manipulation of items within working memory also recruited the anterior striatum. The intervention effect on the neural correlates was small, but decreased activation in areas relevant for working memory could be observed, with activation changes correlating with behavioural change. Moreover, training seemed to result in decreased functional connectivity when pure maintenance was required, and in a reorganization of functional connectivity when items had to be manipulated. In accordance with the neural efficacy hypothesis, training resulted in overall reduced activation and reorganized functional connectivity, with a differential effect on the different working memory processes under investigation. Now, larger trials including follow-up examinations are needed to further explore the long-term effects of such interventions on a neural level and to estimate the clinical relevance to potentially delay cognitive decline in cognitively healthy patients with Parkinson’s disease.

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