Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan.
Wakayama-Minami Radiology Clinic, Wakayama, Wakayama Prefecture, Japan.
PLoS One. 2022 Apr 6;17(4):e0266354. doi: 10.1371/journal.pone.0266354. eCollection 2022.
Impulse control disorders are detrimental neuropsychiatric symptoms of Parkinson's disease. Increased impulsivity is a predisposing factor for impulse control disorders and should therefore be controlled. Recently, mindfulness meditation as a non-drug therapy has been reported to be useful in improving neuropsychiatric symptoms, such as impulsivity.
We performed a prospective single-arm, open-label pilot trial to investigate the effectiveness of mindfulness meditation to control impulsivity in patients with Parkinson's disease (UMIN clinical trials registry: UMIN000037779).
Twenty patients with Parkinson's disease were enrolled in an 8-week mindfulness meditation program. As a primary outcome, we investigated whether the score of the Barratt Impulsiveness Scale (BIS-11) was significantly reduced after the intervention. As an exploratory examination, functional connectivity changes were also assessed by resting-state functional magnetic resonance imaging. After the intervention, the BIS-11 score was decreased from 59.5 [55.6, 63.3] (mean [95% confidence interval]) to 55.2 [50.3, 60.1] (ΔBIS-11: -4.2, [-7.5, -0.9]). Functional connectivity was increased in the default mode network (DMN) at a cluster including the precuneus, posterior cingulate gyrus, and left posterior lobe (false discovery rate-adjusted p [FDR-p] = 0.046) and in the right frontoparietal network (FPN) at the medial frontal lobe (FDR-p = 0.039).
This open-label, single-arm pilot study provided preliminary data for mindfulness meditation to control the impulsivity of patients with PD. A brief mindfulness meditation program may be effective in controlling impulsivity in PD and may change the functional connectivity of the DMN and right FPN.
冲动控制障碍是帕金森病的有害神经精神症状。冲动性增加是冲动控制障碍的一个诱发因素，因此应该加以控制。最近，正念冥想作为一种非药物治疗方法，已被报道可用于改善冲动等神经精神症状。
我们进行了一项前瞻性、单臂、开放标签的初步试验，以研究正念冥想对帕金森病患者控制冲动的有效性（UMIN 临床试验注册：UMIN000037779）。
20 例帕金森病患者参加了为期 8 周的正念冥想项目。作为主要结果，我们调查了干预后 Barratt 冲动量表（BIS-11）的评分是否显著降低。作为探索性检查，还通过静息态功能磁共振成像评估了功能连接变化。干预后，BIS-11 评分从 59.5[55.6，63.3]（平均值[95%置信区间]）降至 55.2[50.3，60.1]（BIS-11 变化量：-4.2，[-7.5，-0.9]）。默认模式网络（DMN）中包括楔前叶、后扣带回和左后叶的簇内的功能连接增加（经假发现率校正的 p 值[FDR-p] = 0.046），右侧额顶网络（FPN）中内侧额叶的功能连接增加（FDR-p = 0.039）。
这项开放标签、单臂初步研究提供了正念冥想控制 PD 患者冲动的初步数据。简短的正念冥想方案可能有效控制 PD 患者的冲动，并可能改变 DMN 和右侧 FPN 的功能连接。
