TY - JOUR
T1 - Cognitive training in Parkinson disease
T2 - a systematic review and meta-analysis
AU - Leung, Isabella H. K.
AU - Walton, Courtney C.
AU - Hallock, Harry
AU - Lewis, Simon J. G.
AU - Valenzuela, Michael
AU - Lampit, Amit
N1 - Copyright the American Academy of Neurology 2015. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2015/11/24
Y1 - 2015/11/24
N2 - Objective: To quantify the effects of cognitive training (CT) on cognitive and behavioral outcome measures in patients with Parkinson disease (PD). Methods: We systematically searched 5 databases for randomized controlled trials (RCTs) of CT in patients with PD reporting cognitive or behavioral outcomes. Efficacy was measured as standardized mean difference (Hedges g) of post-training change. Results: Seven studies encompassing 272 patients with Hoehn & Yahr Stages 1-3 were included. The overall effect of CT over and above control conditions was small but statistically significant (7 studies: g 0.23, 95% confidence interval [CI] 0.014-0.44, p 0.037). True heterogeneity across studies was low (I 2 0%) and there was no evidence of publication bias. Larger effect sizes were noted on working memory (4 studies: g 0.74, CI 0.32-1.17, p 0.001), processing speed (4 studies: g 0.31, CI 0.01-0.61, p 0.04), and executive function (5 studies: g 0.30, CI 0.01-0.58, p 0.042), while effects on measures of global cognition (4 studies), memory (5 studies), visuospatial skills (4 studies), and depression (5 studies), as well as attention, quality of life, and instrumental activities of daily living (3 studies each), were not statistically significant. No adverse events were reported. Conclusions: Though still small, the current body of RCT evidence indicates that CT is safe and modestly effective on cognition in patients with mild to moderate PD. Larger RCTs are necessary to examine the utility of CT for secondary prevention of cognitive decline in this population.
AB - Objective: To quantify the effects of cognitive training (CT) on cognitive and behavioral outcome measures in patients with Parkinson disease (PD). Methods: We systematically searched 5 databases for randomized controlled trials (RCTs) of CT in patients with PD reporting cognitive or behavioral outcomes. Efficacy was measured as standardized mean difference (Hedges g) of post-training change. Results: Seven studies encompassing 272 patients with Hoehn & Yahr Stages 1-3 were included. The overall effect of CT over and above control conditions was small but statistically significant (7 studies: g 0.23, 95% confidence interval [CI] 0.014-0.44, p 0.037). True heterogeneity across studies was low (I 2 0%) and there was no evidence of publication bias. Larger effect sizes were noted on working memory (4 studies: g 0.74, CI 0.32-1.17, p 0.001), processing speed (4 studies: g 0.31, CI 0.01-0.61, p 0.04), and executive function (5 studies: g 0.30, CI 0.01-0.58, p 0.042), while effects on measures of global cognition (4 studies), memory (5 studies), visuospatial skills (4 studies), and depression (5 studies), as well as attention, quality of life, and instrumental activities of daily living (3 studies each), were not statistically significant. No adverse events were reported. Conclusions: Though still small, the current body of RCT evidence indicates that CT is safe and modestly effective on cognition in patients with mild to moderate PD. Larger RCTs are necessary to examine the utility of CT for secondary prevention of cognitive decline in this population.
UR - http://www.scopus.com/inward/record.url?scp=84947913712&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000002145
DO - 10.1212/WNL.0000000000002145
M3 - Review article
C2 - 26519540
AN - SCOPUS:84947913712
SN - 0028-3878
VL - 85
SP - 1843
EP - 1851
JO - Neurology
JF - Neurology
IS - 21
ER -