Review Article

Neurorehabilitation in Parkinson’s Disease: A Critical Review of Cognitive Rehabilitation Effects on Cognition and Brain

Table 1

Summary of the randomized controlled trials in assessing the efficacy of cognitive rehabilitation programs in PD.

AuthorsSampleH&YCognitive rehabilitation programTests1Predictors of greater improvementMRI (Table 2)ResultsLong-term follow-up (Table 3)Limitations/risk of bias
DurationPaper-pencil—P
Computerized—C
Cogn. domains trainedFormat

París et al. [35]28 PD
16 CR
12 ACG
1–312 sessions
4 weeks
3 times/week
45 min/session
CR—“SmartBrain tool” (P + C)
ACG—
speech therapy
(i) Attention
(ii) WM
(iii) Memory
(iv) Psychomotor speed
(v) EF
(vi) Visuospatial ability
(vii) Language
(viii) Calculation skills
(ix) Culture
Group + home(i) Attention
(ii) WM
(iii) EF
(iv) Processing speed
(v) Verbal memory
(vi) Visual memory
(vii) Visuoconstruction
(viii) Visuospatial ability
(ix) Verbal fluency
(x) Depression
(xi) Quality of life
(xii) Daily living activities
Improvements
(i) Attention/WM
(ii) Information processing speed
(iii) Visual memory
(iv) Visuospatial ability
(v) Visuoconstructive ability
(vi) Semantic fluency
(vii) EF
Small sample size

Edwards et al. [34]74 PD
32 CR
42 CG
1–336 sessions
3 months
3 times/week
1 h/session
CR—“InSight version of SOPT” (C)(i) Information processing speedHome(i) Speed of processing
(self-reported)
(ii) Perception of cognitive and everyday functioning
(self-reported)
(iii) Depression
<Age at PD diagnosis
>Disease duration
Improvements
(i) Speed of processing
No ACG
Only 1 domain trained
Self-reported test for cognition and functionality

Cerasa et al. [33]15 PD
8 CR
7 ACG
1–312 sessions
6 weeks
2 times/week
1 h/session
CR—“RehaCom” (C)
ACG—visuomotor coordination tapping task. In-house software (C)
(i) Attention
(ii) Information processing
Group(i) Attention/processing speed
(ii) EF
(iii) WM
(iv) Spatial memory
(v) Verbal memory
(vi) Visuospatial orientation
(vii) Verbal fluency
(viii) Depression
(ix) Anxiety
(x) Quality of life
YesImprovements
(i) Attention/processing speed
(ii) WM
Small sample size

Zimmermann et al. [37]39 PD
19 CR
20 ACG
2a12 sessions
4 weeks
3 times/week
CR—“CogniPlus” (C)
ACG—“Nintendo Wii” (C)
(i) Attention
(ii) Working memory
(iii) EF
Group(i) Attention
(ii) WM
(iii) EF
(iv) Episodic memory
(v) Visuoconstruction
(i) WM score
(ii) Flexibility score
(i) ACG improved attention compared to CRSmall sample size
No change in functionality evaluated
Petrelli et al. [32]65 PD
22 CR-NV
22 CR-MT
21 CG
1–312 sessions
6 weeks
2 times/week
90 min/session
P
“NEUROvitalis”—NV
P
“mentally fit”—MF
NV
(i) Attention
(ii) Memory
(iii) EF
MF
(i) Attention
(ii) Memory
(iii) Creativity
Group + individual(i) Attention
(ii) Memory
(iii) EF
(iv) Visuoconstruction
(v) Depression
(vi) Quality of life
Improvements
NV versus CG
(i) Working memory
(ii) Short-term memory
Improvements
MF versus CG
(i) Depression
Improvements
NV versus MT
(i) Working memory
12 monthsSmall sample size
No ACG

Peña et al. [31]42 PD
20 PD-CR
22 PD-ACG
1–339 sessions
13 weeks
3 times/week
1 h/session
CR—“REHACOP” (P)
ACG—occupational activities (P)
(i) Attention
(ii) Memory
(iii) Language
(iv) EF
(v) Social cognition
(vi) PS
Group(i) Processing speed
(ii) Memory
(iii) Executive functions
(iv) Social cognition
(v) Functional disability
(vi) Apathy
(vii) Depression
YesImprovements
PD-CR versus PD-ACG
(i) Processing speed
(ii) Visual memory
(iii) Social cognition
(iv) Functional disability
18 monthsSmall sample size

ACG = active control group; CG = control group; CR = cognitive rehabilitation; EF = executive functions; HC = healthy controls; H&Y = Hoehn and Yahr; MRI = magnetic resonance image; PD = Parkinson’s disease; WM = working memory. 1Tests assessing mood, clinical, and functionality aspects are shown in italics. aMedian.