Neural Plasticity / 2018 / Article / Tab 3

Review Article

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

Table 3

Summary of cognitive rehabilitation studies in PD with longitudinal follow-up evaluation.

AuthorsSampleH&YCognitive rehabilitation programTests1MRI (Table 2)Results (pre- and posttreatment)Long-term follow-up (T0/T1/T2)Limitations/risk of bias
DurationPaper-pencil—P
Computerized—C
Cogn. domains trainedFormat

Nonrandomized/noncontrolled trials
Sinforiani et al. [39]20 PD1.5 ± 0.612 sessions
6 weeks + 12 h MT
C
“TNP”
(i) Attention
(ii) Abstract reasoning
(iii) Visuospatial
Group(i) MMSE
(ii) Digit span
(iii) Corsi’s test
(iv) Babcock’s story
(v) FAS phonetic
(vi) Raven matrix
(vii) WCST
(viii) Stroop test
Improvements:
(i) Babcock (recall)
(ii) FAS phonetic
(iii) Raven matrix
6 months without training: maintenance (no statistical data)
(i) Babcock (recall)
(ii) FAS phonetic
(iii) Raven matrix
No CG
No differentiation of the efficacy of motor or cognitive training
No statistical data at follow-up

Reuter et al. [40]222 PD
Gr A—CR = 71
Gr B—CR-TT = 75
Gr C—CR-TT-MT = 76
(plus psychoeducation with caregivers)
2–414 sessions
4 weeks
4 times/week
60 min/session
P + C
Group A: cognitive training
Group B:
cognitive + transfer training
Group C: cognitive + transfer + motor training
(i) Attention
(ii) Concentration
(iii) EF
(iv) WM
(v) Memory
(vi) Processing speed
Individual(i) ADAS-Cog
(ii) SCOPA-Cog
(iii) EF-BADS
(iv) PS-PASAT
(v) Depression
(vi) Anxiety
(vii) PDQ-39
Improvements in all groups:
(i) ADAS-Cog
(ii) BADS
(iii) PASAT
Greater improvements in group C:
(i) ADAS-Cog
(ii) SCOPA-Cog
(iii) BADS
(iv) PASAT
6 months with home training: group C performed more training sessions (T2 > T0)
(i) ADAS-Cog
(ii) SCOPA-Cog
(iii) BADS
(iv) PASAT
No ACG
No PDQ-39 scores at baseline
Different number of sessions between posttreatment and long-term evaluation

Adamski et al. [45]6 PD-CR
12 HC-CR
7 HC-CG
16 sessions
4 weeks
4 times/week
45 min/session
C
“BrainStim”
(i) WM
(ii) Encoding
(iii) Recall
(iv) EF
(v) Visuospatial ability
Group(i) Attention
(ii) WM
(iii) Short-term memory
(iv) Long-term memory
(v) PS
(vi) EF
(vii) Depression
(viii) Fatigue
Improvements in PD group:
(i) Short-term memory
(ii) Long-term memory
Improvements in HC groups:
(iii) Diverse cognitive domains
3 months without training: PD group increased (T2 > T0)
(i) Short-term memory
Small sample size
No PD-ACG
Baseline differences between groups

Randomized controlled trials
Petrelli et al. [42]65 PD
22 CR-NV
22 CR-MF
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 in NV versus CG:
(i) Working memory
(ii) Short-term memory
Improvements in MF versus CG:
(i) Depression
Improvements in NV versus MT:
(i) Working memory
12 months without training: NV group maintenance (T2 = T0)
(i) MMSE
(ii) DemTect
Small sample size
No ACG
Long-term evaluation with screening tests

Díez-Cirarda et al. [41]42 PD
20 PD-CR
22 PD-ACG
1–339 sessions
13 weeks
3 times/week
60 min/session
CR—“REHACOP” (P)
ACG—occupational activities (P)
(i) Attention
(ii) Memory
(iii) Language
(iv) EF
(v) Social cognition
(vi) PS
Group(i) PS
(ii) Memory
(iii) Executive functions
(iv) Social cognition
(v) Functional disability
(vi) Apathy
(vii) Depression
YesImprovements in PD-CR versus PD-ACG:
(i) PS
(ii) Visual memory
(iii) Social cognition
(iv) Functional disability
(v) Brain functional changes
18 months without training: PD-CR increased (T2 > T0):
(i) Verbal memory
(ii) Visual memory
(iii) EF
(iv) ToM
(v) Functional disability
(vi) Brain functional activity
Small sample size
Absence of CG at follow-up

ACG = active control group; CG = control group; CR = cognitive rehabilitation; EF = executive functions; FAS = phonetic fluency test; HC = healthy controls; H&Y = Hoehn and Yahr; MMSE = minimental state examination; MRI = magnetic resonance image; MT = motor training; TT = transfer training; PD = Parkinson’s disease; PS = processing speed; WCST = Wisconsin card sorting task; WM = working memory. 1Tests assessing mood, clinical, and functionality aspects are shown in italics.