Cognitive Training in Parkinson's disease

Mild cognitive impairment is experienced by 30% of Parkinson’s disease patients (PD-MCI), often affecting executive functions. There is currently no pharmacological treatment for PD-MCI. The aim of this study was to test preliminary effects of two home-based cognitive interventions: Goal Management Training, adapted for PD-MCI (Adapted-GMT), and a psychoeducation program combined with mindfulness exercises. Twelve PD-MCI persons with executive dysfunctions, measured by extensive neuropsychological evaluation, were randomly assigned to one group. Both groups received five sessions each lasting 60-90 minutes for five weeks, in presence of caregiver. Measures were collected at baseline, mid-point, one-week, four-week and 12-week follow-ups. Primary outcomes were executive functions assessed by subjective (DEX questionnaire) and objective (Zoo Map Test) measures. Secondary outcomes included quality of life (PDQ-39), and global cognition (DRS-II). Repeated measures ANCOVAs were applied to outcomes. Both groups improved in DEX-patient and DEX-caregiver scores. PDQ-39 scores decreased at four-week follow-up in Psychoeducation/Mindfulness group whereas they were maintained in Adapted-GMT group. All other measures were maintained in both groups. Adapted-GMT and Psychoeducation/Mindfulness groups improved executive functioning. This is one of the first studies to test home-based approaches, tailored to participant’s cognitive needs, and involving caregivers.