Choudhury Tabina K, Harris Celeste, Crist Kathleen, Satterwhite Terry K, York Michele K
1 Texas A&M University, College Station, TX, USA.
2 Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
J Geriatr Psychiatry Neurol. 2017 Sep;30(5):253-260. doi: 10.1177/0891988717720299.
Available treatment options for Parkinson's disease (PD) are primarily aimed at pharmacological and/or neurosurgical management of motor symptoms. However, many patients also experience chronic non-motor symptoms (NMS), including significant cognitive and mood changes. Currently, there is a gap in the neuropsychological literature regarding the efficacy of nonpharmacological treatment options for cognitive and mood changes in PD.
We sought to evaluate the efficacy and patient satisfaction of a pilot nonpharmacological intervention for alleviating NMS in patients with PD.
Twenty-three independently functioning nondemented patients with PD participated in a 5-week Parkinson's Disease Enrichment Program. Each 4-hour weekly session included content which addressed the following components: education, exercise, recreation, and socialization/support. Participants received a pre-assessment, including cognitive tests and questionnaires for depression and quality of life. After the completion of the program, participants completed post-assessment batteries to measure changes in neurocognitive and psychiatric status, as well as patient satisfaction regarding the program.
Neuropsychological data from pre- and post-assessments revealed significant improvements in measures of executive functioning, memory, and depressive symptoms. No significant changes were observed on the remaining mood or cognitive measures. One hundred percent of participants reported enjoyment from socialization with other participants with PD and satisfaction with the program overall.
Positive preliminary results suggest that further expansion of this nonpharmacological pilot program for treatment of NMS may be beneficial for patients with PD. Future studies will investigate a larger cohort of participants with PD and cross-validate findings in demographically diverse samples.
帕金森病(PD)现有的治疗方案主要针对运动症状的药物和/或神经外科管理。然而,许多患者还会经历慢性非运动症状(NMS),包括显著的认知和情绪变化。目前,神经心理学文献中关于PD认知和情绪变化的非药物治疗方案的疗效存在空白。
我们试图评估一项缓解PD患者NMS的非药物干预试点项目的疗效和患者满意度。
23名独立生活的非痴呆PD患者参加了为期5周的帕金森病强化项目。每周一次的4小时课程包括以下内容:教育、锻炼、娱乐以及社交/支持。参与者接受了包括认知测试以及抑郁和生活质量问卷在内的预评估。项目结束后,参与者完成了后评估量表,以测量神经认知和精神状态的变化以及患者对该项目的满意度。
预评估和后评估的神经心理学数据显示,执行功能、记忆和抑郁症状的测量指标有显著改善。其余情绪或认知测量指标未观察到显著变化。100%的参与者表示与其他PD患者社交愉快,总体上对该项目满意。
积极的初步结果表明,进一步扩大这个治疗NMS的非药物试点项目可能对PD患者有益。未来的研究将调查更多的PD患者队列,并在人口统计学上多样化的样本中交叉验证研究结果。