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帕金森病的认知康复:系统评价。

Cognitive Rehabilitation in Parkinson's Disease: A Systematic Review.

机构信息

National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.

Department of Neuroscience, Faculty of Medicine, University of Sheffield, UK.

出版信息

J Parkinsons Dis. 2018;8(2):233-245. doi: 10.3233/JPD-171250.

Abstract

BACKGROUND

Cognitive impairments are the most common non-motor symptoms in Parkinson's disease (PD). These symptoms have a negative impact on patients' quality of life and daily living activities. This review will focus on published articles that investigated the efficacy of cognitive rehabilitation in PD.

OBJECTIVES

To review the existing literature on the efficacy of cognitive rehabilitation in PD and highlight the most effective form of intervention to prevent cognitive decline. This review will also point out any limitations and provide directions for future research.

METHODS

Published articles available in the Web of Science and PubMed databases up to November 2017 were reviewed for possible inclusion. We identified 15 articles that examined the effects of cognitive rehabilitation in PD and met inclusion criteria.

RESULTS

The main outcomes of this review indicated that, although previous studies used different cognitive rehabilitation methodologies, all studies reported cognitive improvements on at least one cognitive domain. Additionally, the most frequent cognitive domains showing improvements are executive functions and attention.

CONCLUSION

This review reports the outcomes of studies that examined the effectiveness of cognitive rehabilitation in PD. It also points out the limitations of the studies indicating the limited availability of follow up data on the long-term effects of cognitive interventions. The review also highlights the fact that some of the studies did not include a PD group who did not undergo training. There remains, therefore, a need for longitudinal studies to investigate the potential long term benefits of cognitive training. In addition, future investigations should examine whether any disease characteristics such as disease stage, degree of cognitive impairment and/or the dominant side (right/left) or specific motor symptoms (rigidity/tremor) influence treatment efficacy.

摘要

背景

认知障碍是帕金森病(PD)最常见的非运动症状。这些症状对患者的生活质量和日常生活活动有负面影响。本综述将重点关注已发表的关于认知康复对 PD 影响的文章。

目的

综述 PD 认知康复的现有文献,并强调预防认知能力下降最有效的干预形式。本综述还将指出任何局限性,并为未来的研究提供方向。

方法

检索 Web of Science 和 PubMed 数据库中截至 2017 年 11 月发表的可能纳入的文章。我们确定了 15 篇研究认知康复对 PD 影响的文章,这些文章符合纳入标准。

结果

本综述的主要结果表明,尽管以前的研究使用了不同的认知康复方法,但所有研究都报告了至少一个认知领域的认知改善。此外,改善最频繁的认知领域是执行功能和注意力。

结论

本综述报告了检查 PD 认知康复有效性的研究结果。它还指出了研究的局限性,表明认知干预的长期效果的随访数据有限。该综述还强调了这样一个事实,即一些研究没有纳入未接受训练的 PD 组。因此,需要进行纵向研究,以调查认知训练的潜在长期益处。此外,未来的研究应检查疾病特征(如疾病阶段、认知障碍程度和/或优势侧(右/左)或特定运动症状(僵硬/震颤)是否会影响治疗效果。

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