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认知干预对特发性帕金森病认知症状及生活质量的影响:一项随机对照研究

Impact of cognitive intervention on cognitive symptoms and quality of life in idiopathic Parkinson's disease: a randomized and controlled study.

作者信息

Sousa Nariana Mattos Figueiredo, Neri Ana Cristina da Mata, Brandi Ivar Viana, Brucki Sonia Maria Dozzi

机构信息

Neurorehabilitation Program, Rede SARAH de Hospitais de Reabilitação - Reabilitação Neurológica, Unidade de Salvador - Salvador, BA, Brazil.

Department of Neurology, Faculdade de Medicina, Universidade de São Paulo - São Paulo, SP, Brazil.

出版信息

Dement Neuropsychol. 2021 Jan-Mar;15(1):51-59. doi: 10.1590/1980-57642021dn15-010005.

Abstract

UNLABELLED

Pharmacological treatments for mild cognitive impairment (MCI), are lacking, and alternative approaches have been implemented, including cognitive training (CT).

OBJECTIVE

To determine the impact of CT on cognitive and quality of life measures in patients with Parkinson's disease (PD) who were seen a hospital neurorehabilitation program.

METHODS

Thirty-nine individuals with MCI-PD, according to the Movement Disorder Society, were randomly distributed into two groups: experimental and control group, matched for demographic and clinical characteristics. Both groups were assessed for cognition and quality of life at the beginning of the study and at the end of the intervention protocol. The following instruments were used to assess cognition and quality of life: Addenbrooke's Cognitive Examination III, Digit Span, Trail Making Test (TMT, A and B) and Parkinson disease quality of life questionnaire. The experimental group (EG) engaged in CT, whereas the control group (CG) underwent activities of the general rehabilitation program.

RESULTS

No baseline evaluation differences were found. Intergroup analysis showed differences in measures, such as total score (1.977, p=0.0480) and visuospatial domain (-2.636, p=0.0084) of the ACE-III, with the EG performing better, in addition to better performance in TMT-B mistakes (-1.928, p=0.0439). Intragroup analysis revealed that the EG showed significant improvement in almost all the cognitive variables, well as in self-reported quality of life (total score and mobility, activities of daily living, body discomfort dimensions).

CONCLUSIONS

Engagement in cognitive activities was associated with better cognitive abilities in PD-MCI. Future studies should consider the long-term effect of this type of intervention and impact on functional activities.

摘要

未标注

针对轻度认知障碍(MCI)缺乏药物治疗方法,因此已采用替代方法,包括认知训练(CT)。

目的

确定认知训练对参加医院神经康复项目的帕金森病(PD)患者认知及生活质量指标的影响。

方法

根据运动障碍协会的标准,39名患有MCI-PD的个体被随机分为两组:实验组和对照组,两组在人口统计学和临床特征方面相匹配。两组在研究开始时和干预方案结束时均接受认知和生活质量评估。使用以下工具评估认知和生活质量:Addenbrooke认知检查III、数字广度、连线测验(TMT,A和B)以及帕金森病生活质量问卷。实验组(EG)进行认知训练,而对照组(CG)参加一般康复项目活动。

结果

未发现基线评估差异。组间分析显示,ACE-III的总分(1.977,p = 0.0480)和视觉空间领域(-2.636,p = 0.0084)等指标存在差异,实验组表现更好,此外TMT-B错误方面表现也更好(-1.928,p = 0.0439)。组内分析表明,实验组几乎所有认知变量以及自我报告的生活质量(总分和移动性、日常生活活动、身体不适维度)均有显著改善。

结论

参与认知活动与PD-MCI患者更好的认知能力相关。未来研究应考虑此类干预的长期效果及其对功能活动的影响。

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