scholarly journals Optimizing Cognitive Training for the Treatment of Cognitive Dysfunction in Parkinson’s Disease: Current Limitations and Future Directions

2021 ◽  
Vol 13 ◽  
Author(s):  
Bianca Guglietti ◽  
David Hobbs ◽  
Lyndsey E. Collins-Praino
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Dysfunction ◽  
Cognitive Training ◽  
Assistive Technologies ◽  
Motor Impairments ◽  
Future Directions ◽  
Cognitive Domains ◽  
Current State ◽  
Non Motor Symptoms

Cognitive dysfunction, primarily involving impairments in executive function, visuospatial function and memory, is one of the most common non-motor symptoms of Parkinson’s disease (PD). Currently, the only pharmacological treatments available for the treatment of cognitive dysfunction in PD provide variable benefit, making the search for potential non-pharmacological therapies to improve cognitive function of significant interest. One such therapeutic strategy may be cognitive training (CT), which involves the repetition of standardized tasks with the aim of improving specific aspects of cognition. Several studies have examined the effects of CT in individuals with PD and have shown benefits in a variety of cognitive domains, but the widespread use of CT in these individuals may be limited by motor impairments and other concerns in study design. Here, we discuss the current state of the literature on the use of CT for PD and propose recommendations for future implementation. We also explore the potential use of more recent integrative, adaptive and assistive technologies, such as virtual reality, which may optimize the delivery of CT in PD.

scholarly journals Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease - A cochrane review summary with commentary

2021 ◽  
pp. 1-3
Author(s):  
Tobias Loetscher
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Training ◽  
Verbal Memory ◽  
Cognitive Impairments ◽  
Cochrane Review ◽  
Cognitive Domains ◽  
Training Interventions

BACKGROUND: The majority of people living with Parkinson’s disease will develop impairments in cognition. These impairments are associated with a reduced quality of life. OBJECTIVE: The Cochrane Review aimed to investigate whether cognitive training improves cognition in people with Parkinson’s disease and mild cognitive impairments or dementia. METHODS: A Cochrane Review by Orgeta et al. was summarized with comments. RESULTS: The review included seven studies with a total of 225 participants. There was no evidence for improvements in global cognition when cognitive training was compared to control conditions. Observed improvements in attention and verbal memory measures after cognitive training could not be confirmed in a subsequent sensitivity analysis. There was no evidence for benefits in other cognitive domains or quality of life measures. The certainty of the evidence was low for all comparisons. CONCLUSIONS: The effectiveness of cognitive training for people with Parkinson’s disease and cognitive impairments remains inconclusive. There is a pressing need for adequately powered trials with higher methodological quality.

Association between White Matter Lesions and Non-Motor Symptoms in Parkinson Disease

2018 ◽  
Vol 18 (2-3) ◽  
pp. 127-132 ◽  
Author(s):  
Jeong-Yoon Lee ◽  
Ji Sun Kim ◽  
Wooyoung Jang ◽  
Jinse Park ◽  
Eungseok Oh ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
White Matter ◽  
Parkinson Disease ◽  
Cognitive Dysfunction ◽  
Rating Scale ◽  
White Matter Lesions ◽  
Motor Dysfunction ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Background: There are only few studies exploring the relationship between white matter lesions (WMLs) and non-motor symptoms in Parkinson disease (PD). This study aimed to investigate the association between WMLs and the severity of non-motor symptoms in PD. Methods: The severity of motor dysfunction, cognitive impairment, and non-motor symptoms was assessed by various scales in 105 PD patients. We used a visual semiquantitative rating scale and divided the subjects into four groups: no, mild, moderate, and severe WMLs. We compared the means of all scores between the four groups and analyzed the association between the severity of WMLs and the specific domain of non-motor symptoms. Results: The non-motor symptoms as assessed by the Non-Motor Symptoms Scale, Parkinson’s Disease Questionnaire (PDQ-39), Parkinson’s Disease Sleep Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neuropsychiatric Inventory (NPI), and Parkinson Fatigue Scale (PFS) were significantly worse in the patients with moderate and severe WMLs than in those without WMLs. Compared with the no WML group, the scores for motor dysfunction were significantly higher in the mild, moderate, and severe WML groups. The scores for cognitive dysfunction were significantly higher in the patients with severe WMLs than in those without WMLs. The severity of WMLs showed linear associations with PFS, BDI, BAI, NPI, and PDQ-39 scores. The severity of WMLs also correlated linearly with scores for motor and cognitive dysfunction. Conclusions: Among the non-motor symptoms, fatigue, depression, anxiety, and quality of life were significantly affected by WMLs in PD. Confirmation of the possible role of WMLs in non-motor symptoms associated with PD in a prospective manner may be crucial not only for understanding non-motor symptoms but also for the development of treatment strategies.

scholarly journals The Beneficial Effects of Computer-Based Cognitive Training in Parkinson’s Disease: A Systematic Review

2020 ◽  
Vol 35 (4) ◽  
pp. 434-447 ◽  
Author(s):  
Anastasia Nousia ◽  
Maria Martzoukou ◽  
Zisis Tsouris ◽  
Vasileios Siokas ◽  
Athina-Maria Aloizou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Training ◽  
Cognitive Rehabilitation ◽  
Present Review ◽  
Cognitive Domains ◽  
Cognitive Improvement ◽  
Randomized Controlled Studies ◽  
Pubmed Database ◽  
Computer Based

Abstract Background Cognitive dysfunction is one of the most prevalent non-motor aspects of Parkinson’s disease (PD). The present review focuses on published studies investigating the effect of computer-based cognitive training (CT) on neuropsychological performance in PD. Methods A systematic search of the PubMed database and Google Scholar was carried out. Randomized controlled studies published before September 2019, investigating the effect of computer-based CT (regardless of the comparator, active or placebo) on PD patients were included. Literature search, data extraction, and Risk of Bias (RoB) evaluation (based on the RoB Cochrane tool for Randomized Trials) were performed by two authors (A.N. and M.M), independently. Results Among 30 full-texts assessed for eligibility, seven articles fulfilled the inclusion criteria and were involved in the qualitative analysis. The main outcomes of the retrieved studies (all studies used similar cognitive rehabilitation methodologies) were indicative of cognitive improvement in most cognitive domains, particularly memory, executive function, processing speed, and attention, that is, the domains primarily impaired in the disease. Conclusion Multidomain CT, which is exclusively based on computer software, leads to measurable improvements in most cognitive domains affected in patients with PD. The present review is the first to include studies assessing the effect of computer-based CT techniques without deploying CT with paper-pencil techniques. Limitations originate mainly due to the heterogeneity among included studies (differences in CT softwares, PD stages, number, and duration of training sessions.

scholarly journals Cognitive Training in Parkinson’s Disease: A Review of Studies from 2000 to 2014

2016 ◽  
Vol 2016 ◽  
pp. 1-19 ◽  
Author(s):  
Daniel Glizer ◽  
Penny A. MacDonald
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Training ◽  
Critical Examination ◽  
Future Directions ◽  
Training Interventions ◽  
Alternative Approach ◽  
Late Stages ◽  
Larger Sample

Cognitive deficits are prevalent among patients with Parkinson’s disease (PD), in both early and late stages of the disease. These deficits are associated with lower quality of life, loss of independence, and institutionalization. To date, there is no effective pharmacological treatment for the range of cognitive impairments presented in PD. Cognitive training (CT) has been explored as an alternative approach to remediating cognition in PD. In this review we present a detailed summary of 13 studies of CT that have been conducted between 2000 and 2014 and a critical examination of the evidence for the effectiveness and applicability of CT in PD. Although the evidence shows that CT leads to short-term, moderate improvements in some cognitive functions, methodological inconsistencies weaken these results. We discuss several key limitations of the literature to date, propose methods of addressing these questions, and outline the future directions that studies of CT in PD should pursue. Studies need to provide more detail about the cognitive profile of participants, include larger sample sizes, be hypothesis driven, and be clearer about the training interventions and the outcome measures.

scholarly journals The role of trophic factors and inflammatory processes in physical activity-induced neuroprotection in Parkinson’s disease

2017 ◽  
Vol 71 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Ewelina Pałasz ◽  
Agnieszka Bąk ◽  
Anna Gąsiorowska ◽  
Grażyna Niewiadomska
Keyword(s):  
Physical Activity ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Supportive Therapy ◽  
Trophic Factors ◽  
Moderate Physical Activity ◽  
Motor Impairments ◽  
Current State ◽  
Inflammatory Processes

Glial cells and neurotrophins play an important role in maintaining homeostasis of the CNS. Disturbances of their function can lead to a number of nervous system diseases, including Parkinson’s disease (PD). Current clinical studies provide evidence that moderate physical activity adapted to the health status of PD patients can support pharmacological treatment, slow down the onset of motor impairments, and extend the patients period of independence. Physical activity, by stimulating the production and release of endogenous trophic factors, prevents the neurodegeneration of dopaminergic neurons via inhibition of inflammatory processes and the reduction of oxidative stress. The aim of this study is to present the current state of knowledge for the anti-inflammatory and neuroprotective properties of physical activity as a supportive therapy in Parkinson’s disease.

scholarly journals Advancing Personalized Medicine in Common Forms of Parkinson’s Disease through Genetics: Current Therapeutics and the Future of Individualized Management

2021 ◽  
Vol 11 (3) ◽  
pp. 169
Author(s):  
Xylena Reed ◽  
Artur Schumacher-Schuh ◽  
Jing Hu ◽  
Sara Bandres-Ciga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Personalized Medicine ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Clinical Trial Design ◽  
Variable Response ◽  
Current State ◽  
Individualized Management ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is a condition with heterogeneous clinical manifestations that vary in age at onset, rate of progression, disease course, severity, motor and non-motor symptoms, and a variable response to antiparkinsonian drugs. It is considered that there are multiple PD etiological subtypes, some of which could be predicted by genetics. The characterization and prediction of these distinct molecular entities provides a growing opportunity to use individualized management and personalized therapies. Dissecting the genetic architecture of PD is a critical step in identifying therapeutic targets, and genetics represents a step forward to sub-categorize and predict PD risk and progression. A better understanding and separation of genetic subtypes has immediate implications in clinical trial design by unraveling the different flavors of clinical presentation and development. Personalized medicine is a nascent area of research and represents a paramount challenge in the treatment and cure of PD. This manuscript summarizes the current state of precision medicine in the PD field and discusses how genetics has become the engine to gain insights into disease during our constant effort to develop potential etiological based interventions.

Mood Disorders and Anxiety in Parkinson’s Disease: Current Concepts

2021 ◽  
Vol 34 (4) ◽  
pp. 280-288
Author(s):  
Hendrik Lintel ◽  
Timothy Corpuz ◽  
Saif-ur-Rahman Paracha ◽  
George T. Grossberg
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mood Disorders ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Anxiety And Depression ◽  
Current State ◽  
Non Motor Symptoms ◽  
Impaired Quality

Mood disorders and anxiety significantly impact the prognosis and disease course of Parkinson’s disease. Non-motor symptoms of Parkinson’s disease such as apathy, anhedonia, and fatigue overlap with diagnostic criteria for anxiety and depression, thus making accurate diagnosis of mood disorders in Parkinson’s disease patients difficult. Furthermore, treatment options for mood disorders can produce motor complications leading to poor adherence and impaired quality of life in Parkinson’s disease patients. This review aims to clarify the current state of diagnostic and treatment options pertaining to anxiety and mood disorders in Parkinson’s disease. It explores both the pharmacologic and non-pharmacologic treatment modalities for various mood disorders in comorbid Parkinson’s disease with a brief discussion of the future outlook of the field given the current state of the literature.

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