Impellizzeri Federica, Maggio Maria Grazia, De Pasquale Paolo, Bonanno Mirjam, Bonanno Lilla, De Luca Rosaria, Paladina Giuseppe, Alibrandi Angela, Milardi Demetrio, Thaut Michael, Hurt Corene, Quartarone Angelo, Calabrò Rocco Salvatore
IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy.
Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy.
Clin Park Relat Disord. 2024 Oct 21;11:100277. doi: 10.1016/j.prdoa.2024.100277. eCollection 2024.
Parkinson's disease (PD) is one the most common neurodegenerative movement disorder, leading to motor and non-motor symptoms, including deficits in executive functions (EF), memory, visuospatial abilities, and psychomotor speed. Current treatments are primarily symptomatic, involving pharmacological, surgical strategies. Neurologic Music Therapy (NMT) has gained recognition for its effectiveness in neurorehabilitation of PD patients and improving motor and cognitive domains, such as EF. This study combines NMT with the virtual reality (VR) platform Computer-Assisted Rehabilitation Environment (CAREN), offering customizable environments for rhythmic cue practice to provide an innovative approach to Parkinson's rehabilitation.
In our single-blind quasi-randomized controlled trial, forty patients were assigned to either an experimental group (EG = 20) or a control group (CG = 20). Both groups underwent two months of training with CAREN scenarios (three times a week for 24 sessions). The experimental group additionally received NMT applied to the selected scenarios. Participants were evaluated by a neuropsychologist at baseline and immediately after training.
Intra-group analysis showed significant improvements in the EG for MOCA (p = 0.007), FAB (p = 0.008), Stroop Error (p = 0.003), Stroop Time (p < 0.001), and Visual Search (p < 0.001). The CG showed a significant difference only in Stroop Error (p = 0.02).
This pilot study is the first to combine NMT with CAREN in PD patients. Our findings suggest that NMT, within an immersive VR environment, effectively improves cognitive and EF in PD. Music structured within NMT techniques, coupled with advanced audio-visual feedback from VR, offers an innovative and potentially more effective approach for managing cognitive and executive deficits associated with PD.
帕金森病(PD)是最常见的神经退行性运动障碍之一,会导致运动和非运动症状,包括执行功能(EF)、记忆、视觉空间能力和精神运动速度方面的缺陷。目前的治疗主要是对症治疗,包括药物治疗和手术策略。神经音乐疗法(NMT)因其在帕金森病患者神经康复以及改善运动和认知领域(如EF)方面的有效性而获得认可。本研究将NMT与虚拟现实(VR)平台计算机辅助康复环境(CAREN)相结合,提供可定制的环境进行节奏提示练习,为帕金森病康复提供了一种创新方法。
在我们的单盲准随机对照试验中,40名患者被分为实验组(EG = 20)或对照组(CG = 20)。两组均接受为期两个月的CAREN场景训练(每周三次,共24节)。实验组还在选定场景中接受NMT。参与者在基线时和训练结束后立即由神经心理学家进行评估。
组内分析显示,实验组在蒙特利尔认知评估量表(MOCA)(p = 0.007)、额叶评估量表(FAB)(p = 0.008)、斯特鲁普错误(p = 0.003)、斯特鲁普时间(p < 0.