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Giehl K, Ophey A, Reker P, Rehberg S, Hammes J, Barbe MT, Zokaei N, Eggers C, Husain M, Kalbe E, van Eimeren T. Effects of Home-Based Working Memory Training on Visuo-Spatial Working Memory in Parkinson's Disease: A Randomized Controlled Trial. J Cent Nerv Syst Dis 2020; 12:1179573519899469. [PMID: 32002011 PMCID: PMC6966247 DOI: 10.1177/1179573519899469] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/08/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Cognitive impairment is a very frequent and severe nonmotor symptom of Parkinson's disease (PD). Early intervention in this at-risk group for cognitive decline may be crucial for long-term preservation of cognitive functions. Computerized working memory training (WMT) has been proven beneficial in non-PD patient populations, but such evidence is still needed for patients with PD. OBJECTIVE This study aimed to evaluate the effect of WMT on visuo-spatial working memory (WM) in cognitively unimpaired patients with PD. METHODS A single-blind randomized controlled trial encompassing 76 patients with PD but no cognitive impairment according to level II diagnostic criteria was conducted. Thirty-seven patients engaged in home-based adaptive WMT 5 times per week for a period of 5 weeks, whereas the remaining patients were in the waiting list arm of the study (control group [CG]). Working memory performance was evaluated using a computerized task before and after intervention and at 14-week follow-up, allowing to quantify the precision of WM on a continuous scale, ie, to test not only if an item was remembered but also how well the location of this item was retained. RESULTS Coincidently, the WMT group showed slightly worse WM performance compared with the CG at baseline, which was ameliorated after WMT. This training-induced effect remained stable until follow-up. CONCLUSION Patients showing relatively low WM performance, despite not formally diagnosable as Parkinson's disease with mild cognitive impairment (PD-MCI), seem to benefit from home-based WMT. Thus, WMT could potentially be implemented in future trials as a time- and cost-efficient route to counteract subtle cognitive changes in early disease stages. TRIAL REGISTRATION German Clinical Trial Register (drks.de, DRKS00009379).
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Affiliation(s)
- Kathrin Giehl
- Multimodal Neuroimaging Group,
Department of Nuclear Medicine, University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
| | - Anja Ophey
- Department of Medical Psychology,
Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and
Intervention (CeNDI), University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
| | - Paul Reker
- Department of Neurology, University
Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne,
Germany
| | - Sarah Rehberg
- Department of Medical Psychology,
Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and
Intervention (CeNDI), University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
| | - Jochen Hammes
- Multimodal Neuroimaging Group,
Department of Nuclear Medicine, University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
| | - Michael T Barbe
- Department of Neurology, University
Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne,
Germany
| | - Nahid Zokaei
- Oxford Centre for Human Brain Activity,
Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University
of Oxford, Oxford, UK
| | - Carsten Eggers
- Department of Neurology, University
Hospital of Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg,
Germany
- Center for Mind, Brain and Behavior,
Philipps-University of Marburg and Justus Liebig University Giessen, Marburg,
Germany
| | - Masud Husain
- Nuffield Department of Clinical
Neurosciences, University of Oxford, Oxford, UK
- Department of Experimental Psychology,
University of Oxford, Oxford, UK
| | - Elke Kalbe
- Department of Medical Psychology,
Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and
Intervention (CeNDI), University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group,
Department of Nuclear Medicine, University Hospital of Cologne, Faculty of Medicine,
University of Cologne, Cologne, Germany
- Department of Neurology, University
Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne,
Germany
- German Center for Neurodegenerative
Diseases (DZNE), Bonn, Germany
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