Training of executive functions in Parkinson's disease

Department of Psychology, Justus-Liebig-University of Giessen, Germany.
Journal of the Neurological Sciences (Impact Factor: 2.47). 11/2006; 248(1-2):115-9. DOI: 10.1016/j.jns.2006.05.028
Source: PubMed


Cognitive disturbances are common in Parkinson's disease (PD). Examination of cognitive function often reveals deficits in executive functions, including maintenance and inhibition of attention, flexibility in thinking, and planning. The involvement of the dopaminergic system in cognitive executive functions has been suggested by numerous studies. The aim of the present study was to analyze the effect of cognitive training on cognitive performance of PD-patients (N=26). Half of the patients participated in a cognitive training regimen, while the other patients only received standard treatment. The outcome showed improved performance of the group with cognitive treatment in two executive tasks after the training period, while no improvement was seen in the standard-treatment group. The results indicate that specific training is required for improvement of executive functions, while general rehabilitation is not sufficient. Thus, PD-patients might benefit from a short-term cognitive executive function training program that is tailored to the individual patient's needs.

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Available from: Gebhard Sammer, Aug 28, 2014
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    • "The use of ambulatory aids, though beneficial in preventing falls, may instead increase the number of freezing episodes (Cubo et al. 2003). Cognitive training could be useful in ameliorating FOG (Sammer et al. 2006) (Table 2). Second, pharmacological treatment poses complex issues, but accurate observation of the response of FOG to various drugs is recommended (Giladi 2008). "
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    ABSTRACT: In recent years, the management of Parkinson's disease (PD) has come a long way, leading to an increase in therapeutic options that now include oral and transdermal drug delivery, infusion as well as surgical treatments. Nonetheless, in the evolution of this complex neurodegenerative disorder, several symptoms remain refractory to dopaminergic therapy. It is our aim to review the literature to date and to bring them into focus, as well as emphasizing on pathophysiological mechanisms, profile of risk factors in their development, and therapeutic options. We will focus on freezing of gait, camptocormia, dysphagia and dysphonia, as well as cognitive impairment and dementia because they represent the far end of therapy-resistant symptoms, encompassing poor health-related quality of life and often a more reserved prognosis with either a rapid evolution of the disease, and/or merely a more severe clinical picture. Pathophysiological mechanisms and brain neurotransmitter abnormalities behind these symptoms seem to overlap to some extent, and a better understanding of these correlations is desirable. We believe that further research is paramount to expand our knowledge of the dopamine-resistant symptoms and, consequently, to develop specific therapeutic strategies.
    Full-text · Article · Sep 2015 · Journal of Neural Transmission
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    • "In particular, Mohlman et al. (2011) found, in PD patients, a significant generalized improvement after a working memory training on different executive measures, as assessed by the Behavioral Assessment of the Dysexecutive Syndrome battery. Sammer et al. (2006) reported that a training focused on various cognitive functions including planning, working memory and strategic control, significantly improved PD patients' performance on set-shifting and planning measures. A more recent study also document that the administration of a complex rehabilitative training that included also planning, working memory and problem solving, significantly improved PD patients' working memory performance (Petrelli et al., 2014). "
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    ABSTRACT: Brain-derived neurotrophic factor (BDNF) is a trophic factor regulating cell survival and synaptic plasticity. Recent findings indicate that BDNF could be a potential regulatory factor for cognitive functioning in normal and/or neuropathological conditions. With regard to neurological disorders, recent data suggest that individuals with Parkinson's disease (PD) may be affected by cognitive deficits and that they have altered BDNF production. Therefore, the hypothesis can be advanced that BDNF levels are associated with the cognitive state of these patients. With this in mind, the present study was aimed at exploring the relationship between BDNF serum levels and cognitive functioning in PD patients with mild cognitive impairment (MCI). Thirteen PD patients with MCI were included in the study. They were administered an extensive neuropsychological test battery that investigated executive, episodic memory, attention, visual-spatial and language domains. A single score was obtained for each cognitive domain by averaging z-scores on tests belonging to that specific domain. BDNF serum levels were measured by enzyme-linked immunoassay (ELISA). Pearson's correlation analyses were performed between BDNF serum levels and cognitive performance. Results showed a significant positive correlation between BDNF serum levels and both attention (p < 0.05) and executive (p < 0.05) domains. Moreover, in the executive domain we found a significant correlation between BDNF levels and scores on tests assessing working memory and self-monitoring/inhibition. These preliminary data suggest that BDNF serum levels are associated with cognitive state in PD patients with MCI. Given the role of BDNF in regulating synaptic plasticity, the present findings give further support to the hypothesis that this trophic factor may be a potential biomarker for evaluating cognitive changes in PD and other neurological syndromes associated with cognitive decline.
    Full-text · Article · Sep 2015 · Frontiers in Behavioral Neuroscience
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    • "Moreover, these findings support experimental studies documenting improvements in cognitive performance in rodent models of HD after environmental enrichment (Wood et al. 2010, 2011). While evidence is limited in HD, an increasing number of studies are showing that motor and cognitive interventions positively impact on cognitive function in the elderly (Liu-Ambrose et al. 2010; Erickson et al. 2011; Bherer et al. 2013) and those suffering with MCI (Hampstead et al. 2011, 2012; Smith et al. 2013), MS (Solari et al. 2004; Flavia et al. 2010; Mattioli et al. 2010; Shatil et al. 2010) and PD (Sammer et al. 2006; Calleo et al. 2011; Par ıs et al. 2011). It is likely that the improvements in verbal learning and memory observed in this study resulted from the positive impact of multidisciplinary rehabilitation on caudate and DLPFC structures. "
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    ABSTRACT: Background There is a wealth of evidence detailing gray matter degeneration and loss of cognitive function over time in individuals with Huntington's disease (HD). Efforts to attenuate disease-related brain and cognitive changes have been unsuccessful to date. Multidisciplinary rehabilitation, comprising motor and cognitive intervention, has been shown to positively impact on functional capacity, depression, quality of life and some aspects of cognition in individuals with HD. This exploratory study aimed to evaluate, for the first time, whether multidisciplinary rehabilitation can slow further deterioration of disease-related brain changes and related cognitive deficits in individuals with manifest HD.Methods Fifteen participants who manifest HD undertook a multidisciplinary rehabilitation intervention spanning 9 months. The intervention consisted of once-weekly supervised clinical exercise, thrice-weekly self-directed home based exercise and fortnightly occupational therapy. Participants were assessed using MR imaging and validated cognitive measures at baseline and after 9 months.ResultsParticipants displayed significantly increased gray matter volume in the right caudate and bilaterally in the dorsolateral prefrontal cortex after 9 months of multidisciplinary rehabilitation. Volumetric increases in gray matter were accompanied by significant improvements in verbal learning and memory (Hopkins Verbal Learning-Test). A significant association was found between gray matter volume increases in the dorsolateral prefrontal cortex and performance on verbal learning and memory.Conclusions This study provides preliminary evidence that multidisciplinary rehabilitation positively impacts on gray matter changes and cognitive functions relating to verbal learning and memory in individuals with manifest HD. Larger controlled trials are required to confirm these preliminary findings.
    Full-text · Article · Jan 2015 · Brain and Behavior
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