More than just a movement disorder
Why cognitive training is needed in Parkinson disease
Abstract
Parkinson disease (PD) is a movement disorder with cardinal motor symptoms of resting tremor, bradykinesia, freezing of gait, and rigidity.1 Most PD treatments aim to manage motor symptoms through pharmacologic and surgical interventions such as deep brain stimulation. Although these treatments can improve or slow decline in motor symptoms, they can also have adverse side effects, such as debilitating motor fluctuations, and costs are an estimated $25 billion per year in the United States alone.2,3 In addition, nonmotor symptoms, including cognitive impairments, can be as troublesome as motor symptoms, but are not responsive to current PD treatments.4 Results from an extensive review by Seppi et al.4 show a lack of evidence for the effectiveness of pharmacologic treatments for cognitive decline in PD, with the exception of rivastigmine for the treatment of dementia. Cognitive difficulties in domains such as speed of processing, memory, and visuospatial and attentional executive functioning are common in PD, may appear before motor symptom onset, and can affect approximately 25% of patients at disease onset.5 Even subtle cognitive decline can negatively affect quality of life. Furthermore, those experiencing cognitive difficulties early in disease progression are at higher risk for cognitive decline, with 80% developing dementia.6 Therefore, there is a great need to explore nonpharmacologic, noninvasive interventions that are effective in treating cognitive symptoms in order to help patients with PD maintain daily functioning, independence and quality of life.
Get full access to this article
View all available purchase options and get full access to this article.
REFERENCES
1.
Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry 2008;79:368–376.
2.
Faulkner M. Safety overview of FDA-approved medications for the treatment of motor symptoms of Parkinson's disease. Expert Opin Drug Saf 2014;13:1055–1069.
3.
Valldeoriola F, Puig-Junoy J, Puig-Peiro R; Workgroup of the SCOPE study. Cost analysis of the treatments for patients with advanced Parkinson's disease: SCOPE study. J Med Econ 2012;16:191–201.
4.
Seppi K, Weintraub D, Coelho M, et al. The Movement Disorder Society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson's disease. Mov Disord 2011;26(suppl 3):S42–S80.
5.
Aarsland D, Bronnick K, Larsen JP, Tysnes OB, Alves G; for the ParkWest Study Group. Cognitive impairment in incident, untreated Parkinson disease: the Norwegian Park West study. Neurology 2009;72:1121–1126.
6.
Weintraub D, Simuni T, Caspell-Garcia C, et al. Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease. Mov Disord 2015;30:919–927.
7.
Cicerone KD, Langenbahn DM, Braden C, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 2003–2008. Arch Phys Med Rehabil 2011;92:519–530.
8.
Leung IHK, Walton CC, Hallock H, Lewis SJG, Valenzuela M, Lampit A. Cognitive training in Parkinson disease: a systematic review and meta-analysis. Neurology 2015;85:1843–1851.
9.
Edwards JD, Wadley VG, Vance DE, Roenker DL, Ball KK. The impact of speed of processing training on cognitive and everyday performance. Aging Ment Health 2005;9:262–271.
10.
Ball KK, Edwards JD, Ross LA, McGwin G. Cognitive training decreases motor vehicle collision involvement of older drivers. J Am Geriatr Soc 2010;58:2107–2113.
Information & Authors
Information
Published In
Copyright
© 2015 American Academy of Neurology.
Publication History
Published online: October 30, 2015
Published in print: November 24, 2015
Disclosure
M. Ventura reports no disclosures. J. Edwards has served on a data safety monitoring board for the NIH; has receiving funding for travel and/or speaker honoraria from the University of Cologne, Germany, and the University of Victoria, Canada; has served on the editorial board of the Journal of Gerontology: Psychological Sciences; is employed by the University of South Florida; has consulted for Posit Science, Inc. and Visual Awareness, Inc.; has received research support from the National Endowment of the Arts, Southeastern Transportation Center, University of South Florida College of Behavioral and Community Sciences; and has served as an expert consultant for Wilson Sonsini Goodrich & Rosati. D. Barnes has received research support from UCB Pharma, Inc., Department of Defense, Department of Veterans Affairs, National Institutes of Health, Patient Centered Outcomes Research Institute, Osher Center for Integrative Medicine, University of California, San Francisco, NARSAD (Brain & Behavior Research Foundation), and S.D. Bechtel Jr. Foundation; and has made donations and provided research support to Posit Science. Go to Neurology.org for full disclosures.
Study Funding
No targeted funding reported.
Authors
Metrics & Citations
Metrics
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
Cited By
- Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson’s disease, BMC Neurology, 23, 1, (2023).https://doi.org/10.1186/s12883-023-03389-y
- Research trends and frontiers in exercise for movement disorders: A bibliometric analysis of global research from 2010 to 2021, Frontiers in Aging Neuroscience, 14, (2022).https://doi.org/10.3389/fnagi.2022.977100
- Impact of cognitive intervention on cognitive symptoms and quality of life in idiopathic Parkinson’s disease: a randomized and controlled study, Dementia & Neuropsychologia, 15, 1, (51-59), (2021).https://doi.org/10.1590/1980-57642021dn15-010005
- Physiotherapy Versus Physiotherapy Plus Cognitive Training on Cognition and Quality of Life in Parkinson Disease, American Journal of Physical Medicine & Rehabilitation, 98, 6, (460-468), (2019).https://doi.org/10.1097/PHM.0000000000001128
- Cognitive training for freezing of gait in Parkinson’s disease: a randomized controlled trial, npj Parkinson's Disease, 4, 1, (2018).https://doi.org/10.1038/s41531-018-0052-6
- Assessing functional performance using computer-based simulations of everyday activities, Schizophrenia Research, 183, (130-136), (2017).https://doi.org/10.1016/j.schres.2016.11.014
Loading...
View Options
Get Access
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
Purchase this article to get full access to it.