scholarly journals Enriched Rehabilitation Improves Gait Disorder and Cognitive Function in Parkinson’s Disease: A Randomized Clinical Trial

2021 ◽  
Vol 15 ◽  
Author(s):  
Xin Wang ◽  
LanLan Chen ◽  
Hongyu Zhou ◽  
Yao Xu ◽  
Hongying Zhang ◽  
...  

Background: Studies on non-pharmacological strategies for improving gait performance and cognition in Parkinson’s disease (PD) are of great significance. We aimed to investigate the effect of and mechanism underlying enriched rehabilitation as a potentially effective strategy for improving gait performance and cognition in early-stage PD.Methods: Forty participants with early-stage PD were randomly assigned to receive 12 weeks (2 h/day, 6 days/week) of enriched rehabilitation (ER; n = 20; mean age, 66.14 ± 4.15 years; 45% men) or conventional rehabilitation (CR; n = 20; mean age 65.32 ± 4.23 years; 50% men). In addition, 20 age-matched healthy volunteers were enrolled as a control (HC) group. We assessed the general motor function using the Unified PD Rating Scale—Part III (UPDRS-III) and gait performance during single-task (ST) and dual-task (DT) conditions pre- and post-intervention. Cognitive function assessments included the Montreal Cognitive Assessment (MoCA), the Symbol Digit Modalities Test (SDMT), and the Trail Making Test (TMT), which were conducted pre- and post-intervention. We also investigated alteration in positive resting-state functional connectivity (RSFC) of the left dorsolateral prefrontal cortex (DLPFC) in participants with PD, mediated by ER, using functional magnetic resonance imaging (fMRI).Results: Compared with the HC group, PD participants in both ER and CR groups performed consistently poorer on cognitive and motor assessments. Significant improvements were observed in general motor function as assessed by the UPDRS-III in both ER and CR groups post-intervention. However, only the ER group showed improvements in gait parameters under ST and DT conditions post-intervention. Moreover, ER had a significant effect on cognition, which was reflected in increased MoCA, SDMT, and TMT scores post-intervention. MoCA, SDMT, and TMT scores were significantly different between ER and CR groups post-intervention. The RSFC analysis showed strengthened positive functional connectivity between the left DLPFC and other brain areas including the left insula and left inferior frontal gyrus (LIFG) post-ER.Conclusion: Our findings indicated that ER could serve as a potentially effective therapy for early-stage PD for improving gait performance and cognitive function. The underlying mechanism based on fMRI involved strengthened RSFC between the left DLPFC and other brain areas (e.g., the left insula and LIFG).

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S942-S943
Author(s):  
Ingelin Testad ◽  
Martine Kajander ◽  
Anne Torsvik Henriksen ◽  
Målfrid Meling ◽  
Vigdis Vagle ◽  
...  

Abstract With the limited advancements in medical treatment, there is a growing emphasis on supporting people with early-stage dementia adjusting to their diagnosis and improve their quality of life. This study aimed to evaluate the effects and experiences of people with early-stage dementia attending a 12-week Health Promotion, consisting of 2-hour sessions at weekly intervals focusing on understanding the progression of dementia, promoting physical activity, nutrition, coping, relationships, home- and travel safety, medication and communication with health care providers. Quantitative and qualitative assessments were conducted at baseline and follow-up 1-2 months post intervention, including cognition, self-rated health and depressive symptoms and individual short interviews. A total of 90 persons with dementia participated in this study. The results demonstrated a stable cognitive function, measured by Mini Mental State Examination, of people with dementia during the 4 month follow-up, and a significant improvement in self-rated health measured by EQ VAS (95% CI 0.2 to 7.6, p=0.037). Depressive symptoms measured by Cornell Scale for Depression in Dementia, demonstrated a decline by one point, which is an improvement in depressive symptoms, although not significant. 32 of the 90 qualitative interviews with participants and their carers were included and analyzed with systematic text condensation. The results demonstrated that the intervention was well received by the participants, learning about dementia, practical strategies and focusing on remaining resources was particularly highlighted as well as improved family communication. In conclusion, the intervention had beneficial effects on the cognitive function, self-rated health and depressive symptoms of people with dementia.


2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
A Kremer ◽  
T Buchwald ◽  
M Vetter ◽  
A Dörfler ◽  
C Forster

2017 ◽  
Author(s):  
Roel M. Willems ◽  
Franziska Hartung

Behavioral evidence suggests that engaging with fiction is positively correlated with social abilities. The rationale behind this link is that engaging with fictional narratives offers a ‘training modus’ for mentalizing and empathizing. We investigated the influence of the amount of reading that participants report doing in their daily lives, on connections between brain areas while they listened to literary narratives. Participants (N=57) listened to two literary narratives while brain activation was measured with fMRI. We computed time-course correlations between brain regions, and compared the correlation values from listening to narratives to listening to reversed speech. The between-region correlations were then related to the amount of fiction that participants read in their daily lives. Our results show that amount of fiction reading is related to functional connectivity in areas known to be involved in language and mentalizing. This suggests that reading fiction influences social cognition as well as language skills.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xiao-Lin Wei ◽  
Ru-Zhen Yuan ◽  
Yong-Mei Jin ◽  
Shu Li ◽  
Ming-Yue Wang ◽  
...  

Abstract Background More than 50% cognitive impairment was reported by cancer patients before and after medical treatment. However, there are no effective interventions to manage the cognitive problem in women with breast cancer. This pilot study was designed to evaluate the protective effect of Baduanjin exercise on cognitive function and cancer-related symptoms in women with early-stage breast cancer undergoing chemotherapy. Method A single-blinded, randomized control trial was designed. The trial will recruit 70 patients with early-stage breast cancer scheduled to receive chemotherapy from Shanghai in China. All participants will be randomly assigned to (1:1) the supervised Baduanjin group (5 times/week, 30 min each time) or the wait-list control group for 3 months. The effect of Baduanjin exercise intervention will be evaluated by outcome measures including subjective and objective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 8 weeks (T1), and 12 weeks (T2). The PCI score in the FACT-Cog as the primary cognitive outcome will be reported descriptively, while effect sizes and 95% confidence intervals (CIs) will be calculated. The collected data will be analyzed by using an intention-to-treat principle and linear mixed-effects modeling. Discussion This is the first randomized clinical trial to investigate whether Baduanjin exercise will have a positive role in improving cognitive function in women with breast cancer receiving chemotherapy. If possible, Baduanjin exercise will be a potential non-pharmacological intervention to manage cognitive dysfunction and promote survivorship care among breast cancer survivors. Trial registration Chinese Clinical Trial Registry (ChiCTR) ChiCTR2000033152. Registered on 22 May 2020


2011 ◽  
Vol 26 (S2) ◽  
pp. 937-937 ◽  
Author(s):  
D. Linden ◽  
T. Lancaster

We investigated whether depressed patients who received fMRI-based neurofeedback are able to upregulate the activity in brain areas devoted to positive emotion processing and thereby establish improvements in mood state. Eight medicated patients with major depression participated in four separate fMRI sessions, each of which consisted of an emotion localiser and three neurofeedback runs. Target areas were selected individually with a functional localiser that identified the region most responsive to positive affective images. The target areas were in uni- or bilateral prefrontal cortex, insula or amygdala. During neurofeedback runs, patients received real-time feedback about activation levels in the target area. Each patient learnt to increase target area activity over successive sessions. Depression scores on the 17-item Hamilton Depression Rating Scale improved significantly. No such improvement was seen in a non-neurofeedback control group (N = 8) that was matched for symptom severity, demographics and medication and used the same cognitive/affective strategies that were employed successfully by the neurofeedback group, but outside the scanner. This group difference in treatment effects was supported by a significant interaction between the factors time (pre/post-intervention) and group (neurofeedback/controls) on the repeated measures ANOVA (F(1,14) = 10.15, p = .007). The neurofeedback group showed increasing activity in the ventral striatum and regions involved in cognitive control as training progressed. Upregulation of brain areas responsive to positive affective cues through fMRI-neurofeedback is thus a promising tool in the treatment of depression. The novelty of the present approach consists in the combination of biological and cognitive factors in the same intervention.


2021 ◽  
Author(s):  
Yusi Chen ◽  
Qasim Bukhari ◽  
Tiger Wutu Lin ◽  
Terrence J Sejnowski

Recordings from resting state functional magnetic resonance imaging (rs-fMRI) reflect the influence of pathways between brain areas. A wide range of methods have been proposed to measure this functional connectivity (FC), but the lack of ''ground truth'' has made it difficult to systematically validate them. Most measures of FC produce connectivity estimates that are symmetrical between brain areas. Differential covariance (dCov) is an algorithm for analyzing FC with directed graph edges. Applied to synthetic datasets, dCov-FC was more effective than covariance and partial correlation in reducing false positive connections and more accurately matching the underlying structural connectivity. When we applied dCov-FC to resting state fMRI recordings from the human connectome project (HCP) and anesthetized mice, dCov-FC accurately identified strong cortical connections from diffusion Magnetic Resonance Imaging (dMRI) in individual humans and viral tract tracing in mice. In addition, those HCP subjects whose rs-fMRI were more integrated, as assessed by a graph-theoretic measure, tended to have shorter reaction times in several behavioral tests. Thus, dCov-FC was able to identify anatomically verified connectivity that yielded measures of brain integration causally related to behavior.


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