Evaluation of the efficacy of physical therapy on cognitive decline at 6-month follow-up in Parkinson disease patients with mild cognitive impairment: a randomized controlled trial.
Mild cognitive impairment
Non-pharmacological interventions
Parkinson’s disease
Physical therapy
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
07
04
2021
accepted:
15
04
2021
pubmed:
13
5
2021
medline:
16
12
2021
entrez:
12
5
2021
Statut:
ppublish
Résumé
In Parkinson's disease (PD), physical activity may represent a possible non-pharmacological intervention not only for improving motor symptoms but also for modulating cognitive impairment. To evaluate the efficacy of an intensive physical program on cognitive functions in mid-stage PD patients with mild cognitive impairment (PD-MCI) over a 6-month follow-up. This is a 6-month randomized controlled follow-up study. 40 PD-MCI patients were randomized to receive physical therapy (PT) or no specific intervention beside drug treatment (CT). Cognitive and motor assessments were performed at baseline (T0), 4 weeks after baseline (T1) and 6 months after T0. In a previous study, we reported a significant improvement in global cognitive functioning and attention/working-memory at T1. Here, we evaluated the residual effect of the training intervention at 6 months on both cognitive and motor performances. Intra-group analysis showed that at T2 most of cognitive and motor performances remained stable in the PT when compared to T0, while a significant worsening was observed in the CT. Between-group comparison at T2 showed significantly better results in PT than CT as regards MoCA and motor scales. The percentage change of cognitive and motor performances between T1 and T2 confirmed the benefit of physical therapy on global cognitive functioning scores (MMSE and MoCA). In this follow-up extension of a longitudinal randomized controlled study, we demonstrated that physical therapy has a positive effect on cognitive functions, which extends beyond the duration of the treatment itself to, at least temporarily, reducing cognitive decline. Trial registration number (ClinicalTrials.gov): NCT04012086 (9th July 2019).
Sections du résumé
BACKGROUND
BACKGROUND
In Parkinson's disease (PD), physical activity may represent a possible non-pharmacological intervention not only for improving motor symptoms but also for modulating cognitive impairment.
AIMS
OBJECTIVE
To evaluate the efficacy of an intensive physical program on cognitive functions in mid-stage PD patients with mild cognitive impairment (PD-MCI) over a 6-month follow-up.
METHODS
METHODS
This is a 6-month randomized controlled follow-up study. 40 PD-MCI patients were randomized to receive physical therapy (PT) or no specific intervention beside drug treatment (CT). Cognitive and motor assessments were performed at baseline (T0), 4 weeks after baseline (T1) and 6 months after T0. In a previous study, we reported a significant improvement in global cognitive functioning and attention/working-memory at T1. Here, we evaluated the residual effect of the training intervention at 6 months on both cognitive and motor performances.
RESULTS
RESULTS
Intra-group analysis showed that at T2 most of cognitive and motor performances remained stable in the PT when compared to T0, while a significant worsening was observed in the CT. Between-group comparison at T2 showed significantly better results in PT than CT as regards MoCA and motor scales. The percentage change of cognitive and motor performances between T1 and T2 confirmed the benefit of physical therapy on global cognitive functioning scores (MMSE and MoCA).
CONCLUSIONS
CONCLUSIONS
In this follow-up extension of a longitudinal randomized controlled study, we demonstrated that physical therapy has a positive effect on cognitive functions, which extends beyond the duration of the treatment itself to, at least temporarily, reducing cognitive decline.
TRIAL REGISTRATION
BACKGROUND
Trial registration number (ClinicalTrials.gov): NCT04012086 (9th July 2019).
Identifiants
pubmed: 33978924
doi: 10.1007/s40520-021-01865-4
pii: 10.1007/s40520-021-01865-4
doi:
Banques de données
ClinicalTrials.gov
['NCT04012086']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
3275-3284Subventions
Organisme : Ministero della Salute
ID : Ricerca Corrente 2017-2019
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Gallagher DA, Lees AJ, Schrag A (2010) What are the most important nonmotor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord 25:2493–2500. https://doi.org/10.1002/mds.23394
doi: 10.1002/mds.23394
pubmed: 20922807
Litvan I, Aarsland D, Adler CH et al (2011) MDS task force on mild cognitive impairment in Parkinson’s disease: critical review of PD-MCI. Mov Disord 26:1814–1824. https://doi.org/10.1002/mds.23823
doi: 10.1002/mds.23823
pubmed: 21661055
pmcid: 3181006
Goldman JG, Weintraub D (2015) Advances in the treatment of cognitive impairment in Parkinson’s disease. Mov Disord 30:1471–1489. https://doi.org/10.1002/mds.26352
doi: 10.1002/mds.26352
pubmed: 26297863
Livingston G, Sommerlad A, Orgeta V et al (2017) Dementia prevention, intervention, and care. Lancet 390:2673–2734. https://doi.org/10.1016/S0140-6736(17)31363-6
doi: 10.1016/S0140-6736(17)31363-6
pubmed: 28735855
Bernini S, Alloni A, Panzarasa S et al (2019) A computer-based cognitive training in Mild Cognitive Impairment in Parkinson’s Disease. NeuroRehabilitation 44:555–567. https://doi.org/10.3233/NRE-192714
doi: 10.3233/NRE-192714
pubmed: 31256092
Leung IHK, Walton CC, Hallock H et al (2015) Cognitive training in Parkinson disease: a systematic review and meta-analysis. Neurology 85:1843–1851. https://doi.org/10.1212/WNL.0000000000002145
doi: 10.1212/WNL.0000000000002145
pubmed: 26519540
pmcid: 4662707
Stuckenschneider T, Askew CD, Menêses AL et al (2019) The effect of different exercise modes on domain-specific cognitive function in patients suffering from Parkinson’s disease: a systematic review of randomized controlled trials. J Parkinsons Dis 9:73–95. https://doi.org/10.3233/JPD-181484
doi: 10.3233/JPD-181484
pubmed: 30741688
Salgado S, Williams N, Kotian R et al (2013) An evidence-based exercise regimen for patients with mild to moderate Parkinson’s disease. Brain Sci 3:87–100. https://doi.org/10.3390/brainsci3010087
doi: 10.3390/brainsci3010087
pubmed: 24961308
pmcid: 4061827
Reynolds GO, Otto MW, Ellis TD et al (2016) The therapeutic potential of exercise to improve mood, cognition, and sleep in Parkinson’s disease. Mov Disord 31:23–38. https://doi.org/10.1002/mds.26484
doi: 10.1002/mds.26484
pubmed: 26715466
Murray DK, Sacheli MA, Eng JJ et al (2014) The effects of exercise on cognition in Parkinson’s disease: a systematic review. Transl Neurodegener 3:1–13. https://doi.org/10.1186/2047-9158-3-5
doi: 10.1186/2047-9158-3-5
Da Silva FC, Iop RDR, De Oliveira LC et al (2018) Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: a systematic review of randomized controlled trials of the last 10 years. PLoS ONE 13:1–19. https://doi.org/10.1371/journal.pone.0193113
doi: 10.1371/journal.pone.0193113
Picelli A, Varalta V, Melotti C et al (2016) Effects of treadmill training on cognitive and motor features of patients with mild to moderate Parkinson’s disease: a pilot, single-blind, randomized controlled trial. Funct Neurol 31:25–31. https://doi.org/10.11138/fneur/2016.31.1.025
doi: 10.11138/fneur/2016.31.1.025
pubmed: 27027891
pmcid: 4819815
Pietrelli A, Lopez-Costa J, Goñi R et al (2012) Aerobic exercise prevents age-dependent cognitive decline and reduces anxiety-related behaviors in middle-aged and old rats. Neuroscience 202:252–266. https://doi.org/10.1016/j.neuroscience.2011.11.054
doi: 10.1016/j.neuroscience.2011.11.054
pubmed: 22183054
Tuon T, Valvassori SS, Dal Pont GC et al (2014) Physical training prevents depressive symptoms and a decrease in brain-derived neurotrophic factor in Parkinson’s disease. Brain Res Bull 108:106–112. https://doi.org/10.1016/j.brainresbull.2014.09.006
doi: 10.1016/j.brainresbull.2014.09.006
pubmed: 25264157
Ferrazzoli D, Ortelli P, Cucca A et al (2020) Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson’s disease. Neurodegener Dis Manag 10:41–55. https://doi.org/10.2217/nmt-2019-0025
doi: 10.2217/nmt-2019-0025
pubmed: 32039653
Banks SJ, Bayram E, Shan G et al (2019) Non-motor predictors of freezing of gait in Parkinson’s disease. Gait Posture 68:311–316. https://doi.org/10.1016/j.gaitpost.2018.12.009
doi: 10.1016/j.gaitpost.2018.12.009
pubmed: 30553992
McKee KE, Hackney ME (2013) The effects of adapted tango on spatial cognition and disease severity in Parkinson’s disease. J Mot Behav 45:519–529. https://doi.org/10.1080/00222895.2013.834288
doi: 10.1080/00222895.2013.834288
pubmed: 24116748
Pompeu JE, dos Santos Mendes FA, da Silva KG et al (2012) Effect of Nintendo Wii
doi: 10.1016/j.physio.2012.06.004
Nadeau A, Pourcher E, Corbeil P (2014) Effects of 24 wk of treadmill training on gait performance in Parkinson’s disease. Med Sci Sport Exerc 46:645–655. https://doi.org/10.1249/MSS.0000000000000144
doi: 10.1249/MSS.0000000000000144
David FJ, Robichaud JA, Leurgans SE et al (2015) Exercise improves cognition in Parkinson’s disease: the PRET-PD randomized, clinical trial. Mov Disord 30:1657–1663. https://doi.org/10.1002/mds.26291
doi: 10.1002/mds.26291
pubmed: 26148003
pmcid: 4609235
Silveira CRA, Roy EA, Intzandt BN, Almeida QJ (2018) Aerobic exercise is more effective than goal-based exercise for the treatment of cognition in Parkinson’s disease. Brain Cogn 122:1–8. https://doi.org/10.1016/j.bandc.2018.01.002
doi: 10.1016/j.bandc.2018.01.002
pubmed: 29331916
Avenali M, Picascia M, Minafra B et al (2019) Intensive physical therapy mitigates cognitive decline in people with Parkinson’ s disease. J Alzheimers Dis Park 9:475. https://doi.org/10.4172/2161-0460.1000475
doi: 10.4172/2161-0460.1000475
Postuma RB, Berg D, Stern M et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30:1591–1601. https://doi.org/10.1002/mds.26424
doi: 10.1002/mds.26424
pubmed: 26474316
Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442. https://doi.org/10.1212/wnl.17.5.427
doi: 10.1212/wnl.17.5.427
pubmed: 6067254
Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 27:349–356. https://doi.org/10.1002/mds.24893
doi: 10.1002/mds.24893
pubmed: 22275317
pmcid: 3641655
Magni E, Binetti G, Bianchetti A et al (1996) Mini-Mental State Examination: a normative study in Italian elderly population. Eur J Neurol 3:198–202. https://doi.org/10.1111/j.1468-1331.1996.tb00423.x
doi: 10.1111/j.1468-1331.1996.tb00423.x
pubmed: 21284770
Conti S, Bonazzi S, Laiacona M et al (2015) Montreal Cognitive Assessment (MoCA)-Italian version: regression based norms and equivalent scores. Neurol Sci 36:209–214. https://doi.org/10.1007/s10072-014-1921-3
doi: 10.1007/s10072-014-1921-3
pubmed: 25139107
Spinnler H (1987) Italian standardization and classification of Neuropsychological tests. The Italian Group on the Neuropsychological Study of Aging. Ital J Neurol Sci Suppl 8:1–120
Carlesimo GA, Caltagirone C, Gainotti G et al (1996) The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. Eur Neurol 36:378–384. https://doi.org/10.1159/000117297
doi: 10.1159/000117297
pubmed: 8954307
Appollonio I, Leone M, Isella V et al (2005) The Frontal Assessment Battery (FAB): normative values in an Italian population sample. Neurol Sci 26:108–116. https://doi.org/10.1007/s10072-005-0443-4
doi: 10.1007/s10072-005-0443-4
pubmed: 15995827
Giovagnoli AR, Del Pesce M, Mascheroni S et al (1996) Trail making test: normative values from 287 normal adult controls. Ital J Neurol Sci 17:305–309. https://doi.org/10.1007/BF01997792
doi: 10.1007/BF01997792
pubmed: 8915764
Goetz CG, Tilley BC, Shaftman SR et al (2008) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Mov Disord 23:2129–2170. https://doi.org/10.1002/mds.22340
doi: 10.1002/mds.22340
pubmed: 19025984
Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34:119–126. https://doi.org/10.1111/j.1532-5415.1986.tb05480.x
doi: 10.1111/j.1532-5415.1986.tb05480.x
pubmed: 3944402
Hauser SL, Dawson DM, Lehrich JR et al (1983) Intensive immunosuppression in progressive multiple sclerosis. N Engl J Med 308:173–180. https://doi.org/10.1056/NEJM198301273080401
doi: 10.1056/NEJM198301273080401
pubmed: 6294517
Uc EY, Doerschug KC, Magnotta V et al (2014) Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting. Neurology 83:413–425. https://doi.org/10.1212/WNL.0000000000000644
doi: 10.1212/WNL.0000000000000644
pubmed: 24991037
pmcid: 4132568
Hou L, Chen W, Liu X et al (2017) Exercise-induced neuroprotection of the Nigrostriatal dopamine system in Parkinson’s disease. Front Aging Neurosci 9:358. https://doi.org/10.3389/fnagi.2017.00358
doi: 10.3389/fnagi.2017.00358
pubmed: 29163139
pmcid: 5675869
Petzinger GM, Fisher BE, McEwen S et al (2013) Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s disease. Lancet Neurol 12:716–726. https://doi.org/10.1016/S1474-4422(13)70123-6
doi: 10.1016/S1474-4422(13)70123-6
pubmed: 23769598
pmcid: 3690528
Smith PJ, Blumenthal JA, Hoffman BM et al (2010) Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med 72:239–252. https://doi.org/10.1097/PSY.0b013e3181d14633
doi: 10.1097/PSY.0b013e3181d14633
pubmed: 20223924
pmcid: 2897704
Intzandt B, Beck EN, Silveira CRA (2018) The effects of exercise on cognition and gait in Parkinson’s disease: a scoping review. Neurosci Biobehav Rev 95:136–169. https://doi.org/10.1016/j.neubiorev.2018.09.018
doi: 10.1016/j.neubiorev.2018.09.018
pubmed: 30291852
Weng TB, Pierce GL, Darling WG et al (2017) The acute effects of aerobic exercise on the functional connectivity of human brain networks. Brain Plast 2:171–190. https://doi.org/10.3233/BPL-160039
doi: 10.3233/BPL-160039
pubmed: 29765855
pmcid: 5928541
Fontanesi C, Kvint S, Frazzitta G et al (2016) Intensive rehabilitation enhances lymphocyte BDNF-TrkB signaling in patients with Parkinson’s disease. Neurorehabil Neural Repair 30:411–418. https://doi.org/10.1177/1545968315600272
doi: 10.1177/1545968315600272
pubmed: 26253177
Leckie RL, Oberlin LE, Voss MW et al (2014) BDNF mediates improvements in executive function following a 1-year exercise intervention. Front Hum Neurosci 8:985. https://doi.org/10.3389/fnhum.2014.00985
doi: 10.3389/fnhum.2014.00985
pubmed: 25566019
pmcid: 4263078
Ahlskog JE (2011) Does vigorous exercise have a neuroprotective effect in Parkinson disease? Neurology 77:288–294. https://doi.org/10.1212/WNL.0b013e318225ab66
doi: 10.1212/WNL.0b013e318225ab66
pubmed: 21768599
pmcid: 3136051
Nagano-Saito A, Martinu K, Monchi O (2014) Function of basal ganglia in bridging cognitive and motor modules to perform an action. Front Neurosci 8:187. https://doi.org/10.3389/fnins.2014.00187
doi: 10.3389/fnins.2014.00187
pubmed: 25071432
pmcid: 4086202
Leisman G, Melillo R (2013) The basal ganglia: motor and cognitive relationships in a clinical neurobehavioral context. Rev Neurosci 24:9–25. https://doi.org/10.1515/revneuro-2012-0067
doi: 10.1515/revneuro-2012-0067
pubmed: 23241666