认知训练对帕金森病的长期影响:一项随机对照试验

IF 1.9 Q3 CLINICAL NEUROLOGY Clinical Parkinsonism Related Disorders Pub Date : 2023-01-01 DOI:10.1016/j.prdoa.2023.100204
Tim D. van Balkom , Odile A. van den Heuvel , Henk W. Berendse , Ysbrand D. van der Werf , Rob H. Hagen , Tanja Berk , Chris Vriend
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引用次数: 0

摘要

计算机化认知训练可能有望改善帕金森病的认知障碍,甚至被认为可以延缓认知衰退。然而,迄今为止的证据有限。这项研究的目的是在长达两年的随访中评估为期八周的认知训练效果的持久性。方法采用双盲随机对照试验,136例(1 36例)患有帕金森病,有主观认知障碍,但无严重认知障碍(蒙特利尔认知评估≥22)。参与者接受了为期8周的以家庭为基础的干预,使用BrainGymmer进行适应性、计算机化的认知训练(n = 68)或主动对照(n = 68)。他们在基线和干预后1年和2年接受了广泛的神经心理学评估、精神病学问卷和运动症状评估。我们使用混合模型分析来评估随访时认知功能的变化,并使用Fisher精确测试来评估认知状态的转换。结果在1年和2年的随访中,神经心理评估结果没有组间差异。各组在随访中表现出认知状态转换的可能性相同。相当数量的评估被遗漏(1y: n = 27;2y: n = 33),最主要的原因是COVID-19法规。结论8周认知训练对帕金森病患者的长期认知功能无影响。未来的研究可能会集中在一个认知亚群上,以提高研究结果的可靠性。需要改进干预措施,以实现有效、持久的治疗选择。
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Long-term effects of cognitive training in Parkinson’s disease: A randomized, controlled trial

Background

Computerized cognitive training may be promising to improve cognitive impairment in Parkinson’s disease and has even been suggested to delay cognitive decline. However, evidence to date is limited. The aim of this study was to assess the durability of eight-week cognitive training effects at up to two years follow-up.

Methods

One hundred and thirty-six (1 3 6) individuals with Parkinson’s disease, subjective cognitive complaints but without severe cognitive impairment (Montreal Cognitive Assessment ≥ 22) participated in this double-blind RCT. Participants underwent an eight-week home-based intervention of either adaptive, computerized cognitive training with BrainGymmer (n = 68) or an active control (n = 68). They underwent extensive neuropsychological assessment, psychiatric questionnaires and motor symptom assessment at baseline and one and two years after the intervention. We used mixed-model analyses to assess changes in cognitive function at follow-up and performed Fisher’s exact tests to assess conversion of cognitive status.

Results

There were no group differences on any neuropsychological assessment outcome at one- and two-year follow-up. Groups were equally likely to show conversion of cognitive status at follow-up. A considerable amount of assessments was missed (1y: n = 27; 2y: n = 33), most notably due to COVID-19 regulations.

Conclusions

Eight-week cognitive training did not affect long-term cognitive function in Parkinson’s disease. Future studies may focus on one cognitive subgroup to enhance reliability of study results. Intervention improvements are needed to work towards effective, lasting treatment options.

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来源期刊
Clinical Parkinsonism  Related Disorders
Clinical Parkinsonism Related Disorders Medicine-Neurology (clinical)
CiteScore
2.70
自引率
0.00%
发文量
50
审稿时长
98 days
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