Department of Pharmacology, Toxicology, and Neuroscience, LSUHSC-Shreveport, Shreveport, LA, USA.
LSU Health Shreveport Center for Brain Health, Shreveport, LA, USA.
NeuroRehabilitation. 2020;46(3):311-320. doi: 10.3233/NRE-192940.
People with Parkinson disease (PD) have difficulty initiating internally generated movements. We have shown that computer-based cognitive training can improve movement initiation. However, little is known about the optimal duration of training.
To determine the optimal training duration for computer-based neurorehabilitation of internally represented movement initiation in people with PD.
Nineteen PD and twenty-one age-matched control participants, ages 50-85 years, were included in analysis of pre- and post-training evaluation and 30 training sessions. Computer training consisted of cued and un-cued movement trials. The presentation of a cue (a combination of numbers on either the right, left or both sides of the screen) indicated that participants should respond by typing the numbers. Successful cued trials were followed by un-cued trials consisting of a green filled circle. Participants re-enter the cued sequence, thus producing an internally represented (IR) movement. The training was adaptive. Outcome measures were reaction time and error rate, and cumulative sum (CUSUM) analysis was used to identify peak training improvement.
Participants with PD were divided into impaired (IPD) and unimpaired (UPD) groups, based on mean control group pre-training performance. All three groups showed improved RT and error rates for IR trials; however, the IPD group demonstrated significantly greater improvement in reaction time. Training was most effective in participants with greater disease severity and duration. Peak day of training improvement for the IPD group was 8 days.
Optimal training duration was relatively short and the IPD group demonstrated the most gain, indicating that cognitive training should be tailored to individual needs.
帕金森病（PD）患者在发起内部产生的运动时存在困难。我们已经表明，基于计算机的认知训练可以改善运动发起。然而，对于最佳训练时长知之甚少。
确定基于计算机的神经康复治疗对 PD 患者内部运动发起的最佳训练时长。
19 名 PD 患者和 21 名年龄匹配的对照组参与者，年龄在 50-85 岁之间，纳入了预训练和后训练评估以及 30 次训练的分析。计算机训练包括提示和非提示运动试验。提示（屏幕上右侧、左侧或两侧的数字组合）的出现表示参与者应通过输入数字来响应。成功的提示试验后，会出现非提示试验，其中包含一个绿色填充的圆圈。参与者重新输入提示序列，从而产生内部代表（IR）运动。训练是自适应的。结果测量指标是反应时间和错误率，累积和（CUSUM）分析用于确定最佳训练改进的峰值。
根据平均对照组的预训练表现，PD 患者被分为受损（IPD）和未受损（UPD）组。所有三组的 IR 试验的反应时间和错误率均有所改善；然而，IPD 组的反应时间改善更为显著。训练在疾病严重程度和持续时间较大的参与者中效果最佳。IPD 组的最佳训练改进日为第 8 天。
最佳训练时长相对较短，IPD 组的收益最大，表明认知训练应根据个体需求进行调整。
