Giehl Kathrin, Ophey Anja, Reker Paul, Rehberg Sarah, Hammes Jochen, Barbe Michael T, Zokaei Nahid, Eggers Carsten, Husain Masud, Kalbe Elke, van Eimeren Thilo
Multimodal Neuroimaging Group, Department of Nuclear Medicine, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany.
Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany.
J Cent Nerv Syst Dis. 2020 Jan 16;12:1179573519899469. doi: 10.1177/1179573519899469. eCollection 2020.
Cognitive impairment is a very frequent and severe nonmotor symptom of Parkinson's disease (PD). Early intervention in this at-risk group for cognitive decline may be crucial for long-term preservation of cognitive functions. Computerized working memory training (WMT) has been proven beneficial in non-PD patient populations, but such evidence is still needed for patients with PD.
This study aimed to evaluate the effect of WMT on visuo-spatial working memory (WM) in cognitively unimpaired patients with PD.
A single-blind randomized controlled trial encompassing 76 patients with PD but no cognitive impairment according to level II diagnostic criteria was conducted. Thirty-seven patients engaged in home-based adaptive WMT 5 times per week for a period of 5 weeks, whereas the remaining patients were in the waiting list arm of the study (control group [CG]). Working memory performance was evaluated using a computerized task before and after intervention and at 14-week follow-up, allowing to quantify the precision of WM on a continuous scale, ie, to test not only if an item was remembered but also how well the location of this item was retained.
Coincidently, the WMT group showed slightly worse WM performance compared with the CG at baseline, which was ameliorated after WMT. This training-induced effect remained stable until follow-up.
Patients showing relatively low WM performance, despite not formally diagnosable as Parkinson's disease with mild cognitive impairment (PD-MCI), seem to benefit from home-based WMT. Thus, WMT could potentially be implemented in future trials as a time- and cost-efficient route to counteract subtle cognitive changes in early disease stages.
German Clinical Trial Register (drks.de, DRKS00009379).
认知障碍是帕金森病（PD）非常常见且严重的非运动症状。对这个认知功能衰退风险人群进行早期干预对于长期维持认知功能可能至关重要。计算机化工作记忆训练（WMT）已被证明对非PD患者群体有益，但PD患者仍需要此类证据。
本研究旨在评估WMT对认知未受损的PD患者视觉空间工作记忆（WM）的影响。
进行了一项单盲随机对照试验，纳入76例根据II级诊断标准无认知障碍的PD患者。37例患者每周在家进行5次适应性WMT，持续5周，而其余患者作为研究的等待列表组（对照组[CG]）。在干预前后以及14周随访时使用计算机化任务评估工作记忆表现，从而在连续量表上量化WM的精确度，即不仅测试是否记住了某个项目，还测试该项目位置的保留程度。
巧合的是，WMT组在基线时的WM表现与CG相比略差，WMT后有所改善。这种训练诱导的效果在随访时保持稳定。
尽管未被正式诊断为轻度认知障碍帕金森病（PD-MCI），但WM表现相对较低的患者似乎从家庭WMT中受益。因此，WMT可能在未来试验中作为一种节省时间和成本的途径来应对疾病早期阶段的细微认知变化。
德国临床试验注册中心（drks.de，DRKS00009379）。
