Tagliente Serena, Minafra Brigida, Aresta Simona, Santacesaria Paola, Buccoliero Andrea, Palmirotta Cinzia, Lagravinese Gianvito, Mongelli Davide, Gelao Christian, Macchitella Luigi, Pazzi Stefania, Scrutinio Domenico, Baiardi Paola, Battista Petronilla
Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Neuropsychology of Bari Institute, Bari, Italy.
Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Bari Institute, Bari, Italy.
Front Psychol. 2025 Jan 9;15:1531688. doi: 10.3389/fpsyg.2024.1531688. eCollection 2024.
Cognitive symptoms are common in Parkinson's Disease (PD), and digital interventions like telerehabilitation other an accessible way to manage these symptoms. This study aimed to assess the effectiveness of a Home-Based Computerized Cognitive Training (HB-CCT) program in individuals with PD using a pilot randomized cross-over design.
Twenty-five participants (mean age 69.32 ± 7.21 years, mean MDS-UPDRS III 33.76 ± 14.25) with PD and mild cognitive impairment were enrolled. They underwent neuropsychological assessments at three time points (5-week intervals): Baseline, after the HB-CCTi, and after Standard Care. The HB-CCT consisted of the Neurotablet platform that was used to target cognitive domains such as Attention, Memory, Perception, Executive Functioning and Language. All participants completed both the Neurotablet intervention and Standard Care blocks in a randomized order. After a Shapiro-Wilk test, non-parametric repeated measures analyses of variance (Friedman's test) and comparisons corrected with the Benjamini-Hochberg approach were performed to compare the effects on primary and secondary cognitive outcomes over experimental intervention and Standard Care.
The results from the Friedman analysis revealed significant improvements in Word List Immediate Recall, Digit Span Forward and Complex Figure Recall (all < 0.001) following the HB-CCT, compared to the Baseline. Additionally, Naming performance showed significant improvement after the HB-CCT ( = 0.02). Significant differences were also observed when comparing the HB-CCT with Standard Care, with improved performance in TMT-A ( = 0.02), Phonemic Fluency ( < 0.01), and Digit Span Forward ( < 0.01).
These findings suggest that HB-CCT via Neurotablet can effectively enhance specific cognitive abilities in PD, supporting the role of digital, home-based interventions as feasible strategies to mitigate cognitive decline.
认知症状在帕金森病（PD）中很常见，像远程康复这样的数字干预是管理这些症状的一种可及方式。本研究旨在采用试点随机交叉设计评估基于家庭的计算机化认知训练（HB-CCT）项目对帕金森病患者的有效性。
招募了25名患有帕金森病且有轻度认知障碍的参与者（平均年龄69.32±7.21岁，平均MDS-UPDRS III评分为33.76±14.25）。他们在三个时间点（间隔5周）接受神经心理学评估：基线期、HB-CCTi之后以及标准护理之后。HB-CCT由Neurotablet平台组成，用于针对注意力、记忆、感知、执行功能和语言等认知领域。所有参与者以随机顺序完成Neurotablet干预和标准护理模块。在进行Shapiro-Wilk检验后，进行非参数重复测量方差分析（Friedman检验）以及采用Benjamini-Hochberg方法校正的比较，以比较实验干预和标准护理对主要和次要认知结果的影响。
Friedman分析结果显示，与基线期相比，HB-CCT后单词列表即时回忆、数字广度顺背和复杂图形回忆均有显著改善（均P<0.001）。此外，HB-CCT后命名表现有显著改善（P = 0.02）。将HB-CCT与标准护理进行比较时也观察到显著差异，在TMT-A（P = 0.02）、语音流畅性（P<0.01）和数字广度顺背（P<0.01）方面表现有所改善。
这些发现表明，通过Neurotablet进行的HB-CCT可以有效提高帕金森病患者的特定认知能力，支持基于家庭的数字干预作为减轻认知衰退的可行策略的作用。
