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Fortschr Neurol Psychiatr 2016; 84(S 01): S24-S35
DOI: 10.1055/s-0042-100724
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Kognitives Training bei Parkinson-Patienten – eine neue Therapieoption?

Cognitive Training in Parkinson’s Disease – A New Therapy Option?
E. Kalbe
,
A.-K. Folkerts
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Publication History

Publication Date:
18 May 2016 (online)

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Zusammenfassung

Kognitive Störungen stellen ein häufiges und klinisch relevantes Symptom bei Parkinson-Patienten (Parkinson’s disease, PD) dar. Angesichts limitierter pharmakologischer Therapieoptionen ziehen nicht-pharmakologische Interventionen zur Behandlung kognitiver Defizite bei PD-Patienten zunehmendes Interesse auf sich. Diese Überblicksarbeit fasst den aktuellen Forschungsstand zu Effekten kognitionsbasierter Interventionen bei PD zusammen. Eine systematische Literatursuche ergab elf publizierte randomisierte kontrollierte Studien, die kognitives Training (KT) verwendeten. Diese Arbeiten und auch eine unlängst erschienene Metaanalyse zum Thema zeigen überzeugend, dass sich v. a. exekutive und Gedächtnisleistungen durch KT bei PD verbessern lassen. Um eindeutige Therapieempfehlungen formulieren zu können, sollten zukünftige Studien große Stichproben an PD-Patienten mit klaren kognitiven Einschlusskriterien (ohne bzw. mit leichten kognitiven Störungen oder mit Demenz) inkludieren.

Abstract

Cognitive impairment is a frequent and clinically relevant symptom in patients with Parkinson’s disease (PD). Given that pharmacological therapy options are limited, non-pharmacological interventions for the prevention and treatment of cognitive impairment in PD patients are attracting increasing interest. This review summarizes the current state of research regarding cognition-based interventions in PD patients. Eleven randomized controlled studies (RCT) were found in a systematic literature search, all of which used cognitive training (CT). These studies and a recently published meta-analysis demonstrate that especially executive and memory functions can be enhanced by CT in PD patients. Future studies examining CT or cognitive stimulation should include large PD samples with well-defined cognitive inclusion criteria so that clear therapy recommendations can be defined for PD patients without cognitive dysfunctions, those with mild cognitive impairment, and those with dementia.

Schlüsselwörter

kognitives Training - neuropsychologische Therapie - Parkinson - leichte kognitive Störung - Demenz - Kognition

Key words

cognitive training - neuropsychological therapy - Parkinson’s disease - mild cognitive impairment - dementia - cognition
 

  • Literatur

  • 1 Muslimovic D, Post B, Speelman JD et al. Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 2005; 65: 1239-1245
    CrossrefPubMedGoogle Scholar
  • 2 Aarsland D, Bronnick K, Fladby T. Mild cognitive impairment in Parkinson’s disease. Curr Neurol Neurosci Rep 2011; 11: 371-378
    CrossrefPubMedGoogle Scholar
  • 3 Aarsland D. Cognitive impairment in Parkinson’s disease and dementia with Lewy bodies. Parkinsonism Relat Disord 2016; 22 (Suppl. 01) S144-S148
    CrossrefPubMedGoogle Scholar
  • 4 Lawson RA, Yarnall AJ, Duncan GW et al. Severity of mild cognitive impairment in early Parkinson’s disease contributes to poorer quality of life. Parkinsonism Relat Disord 2014; 20: 1071-1075
    CrossrefPubMedGoogle Scholar
  • 5 Leroi I, Harbishettar V, Andrews M et al. Carer burden in apathy and impulse control disorders in Parkinson’s disease. Int J Geriatr Psychiatry 2012; 27: 160-166
    CrossrefPubMedGoogle Scholar
  • 6 Bosboom JL, Stoffers D, Wolters EC. Cognitive dysfunction and dementia in Parkinson’s disease. J Neural Transm (Vienna) 2004; 111: 1303-1315
    CrossrefPubMedGoogle Scholar
  • 7 de Lau LM, Verbaan D, Marinus J et al. Survival in Parkinson’s disease. Relation with motor and non-motor features. Parkinsonism Relat Disord 2014; 20: 613-616
    CrossrefPubMedGoogle Scholar
  • 8 Hilker R, Benecke R, Deuschl G et al. Tiefe Hirnstimulation bei idiopathischem Parkinson-Syndrom. Empfehlungen der Deutschen Arbeitsgemeinschaft Tiefe Hirnstimulation. Nervenarzt 2009; 80: 646-655
    CrossrefPubMedGoogle Scholar
  • 9 Aarsland D, Larsen JP, Tandberg E et al. Predictors of nursing home placement in Parkinson’s disease: a population-based, prospective study. J Am Geriatr Soc 2000; 48: 938-942
    CrossrefPubMedGoogle Scholar
  • 10 Seppi K, Weintraub D, Coelho M et al. The Movement Disorder Society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord 2011; 26 (Suppl. 03) S42-S80
    CrossrefPubMedGoogle Scholar
  • 11 Rolinski M, Fox C, Maidment I et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev 2012; 3: CD006504
    PubMedGoogle Scholar
  • 12 Wang HF, Yu JT, Tang SW et al. Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson’s disease, Parkinson’s disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis. J Neurol Neurosurg Psychiatry 2015; 86: 135-143
    CrossrefPubMedGoogle Scholar
  • 13 Hindle JV, Petrelli A, Clare L et al. Nonpharmacological enhancement of cognitive function in Parkinson’s disease: a systematic review. Mov Disord 2013; 28: 1034-1049
    CrossrefPubMedGoogle Scholar
  • 14 Dirnberger G, Jahanshahi M. Executive dysfunction in Parkinson’s disease: a review. J Neuropsychol 2013; 7: 193-224
    CrossrefPubMedGoogle Scholar
  • 15 Robbins TW, Cools R. Cognitive deficits in Parkinson’s disease: a cognitive neuroscience perspective. Mov Disord 2014; 29: 597-607
    CrossrefPubMedGoogle Scholar
  • 16 Leung IH, Walton CC, Hallock H et al. Cognitive training in Parkinson disease: A systematic review and meta-analysis. Neurology 2015; 85: 1843-1851
    CrossrefPubMedGoogle Scholar
  • 17 Folstein MF, Folstein SE, McHugh RH. „Mini-Mental State“. A practice method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198
    CrossrefPubMedGoogle Scholar
  • 18 Biundo R, Weis L, Fiorenzato E et al. Double-blind randomized trial of t-DCS versus sham in Parkinson patients with mild cognitive impairment receiving cognitive training. Brain Stimul 2015; 8: 1223-1225
    CrossrefPubMedGoogle Scholar
  • 19 Costa A, Peppe A, Serafini F et al. Prospective memory performance of patients with Parkinson’s disease depends on shifting aptitude: evidence from cognitive rehabilitation. J Int Neuropsychol Soc 2014; 20: 717-726
    CrossrefPubMedGoogle Scholar
  • 20 Clare L, Woods RT. Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer’s disease: a review. Neuropsychological Rehabilitation 2004; 14: 385-401
    CrossrefPubMedGoogle Scholar
  • 21 Woods B, Aguirre E, Spector AE et al. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev 2012; 2: CD005562
    PubMedGoogle Scholar
  • 22 Calleo J, Burrows C, Levin H et al. Cognitive rehabilitation for executive dysfunction in Parkinson’s disease: application and current directions. Parkinson’s Dis DOI: 10.1155/2012/512892.
    PubMedGoogle Scholar
  • 23 Bloem BR, de Vries NM, Ebersbach G. Nonpharmacological treatments for patients with Parkinson’s disease. Mov Disord 2015; 30: 1504-1520
    CrossrefPubMedGoogle Scholar
  • 24 Cerasa A, Gioia MC, Salsone M et al. Neurofunctional correlates of attention rehabilitation in Parkinson’s disease: an explorative study. Neurol Sci 2014; 35: 1173-1180
    CrossrefPubMedGoogle Scholar
  • 25 Sammer G, Reuter I, Hullmann K et al. Training of executive functions in Parkinson’s disease. J Neurol Sci 2006; 248: 115-119
    CrossrefPubMedGoogle Scholar
  • 26 París AP, Saleta HG, de la Cruz CM et al. Blind randomized controlled study of the efficacy of cognitive training in Parkinson’s disease. Mov Disord 2011; 26: 1251-1258
    CrossrefPubMedGoogle Scholar
  • 27 Reuter I, Mehnert S, Sammer G et al. Efficacy of a multimodal cognitive rehabilitation including psychomotor and endurance Training in Parkinson’s disease. J Aging Res DOI: 10.1155/2012/235765.
    PubMedGoogle Scholar
  • 28 Pompeu JE, Mendes FA, Silva KG et al. Effect of Nintendo Wii(tm)-based motor and cognitive training on activities of daily living in patients with Parkinson’s disease: a randomised clinical trial. Physiotherapy 2012; 98: 196-204
    CrossrefPubMedGoogle Scholar
  • 29 Petrelli A, Kaesberg S, Barbe MT et al. Effects of cognitive training in Parkinson’s disease: a randomized controlled trial. Parkinsonism Relat Disord 2014; 20: 1196-1202
    CrossrefPubMedGoogle Scholar
  • 30 Petrelli A, Kaesberg S, Barbe MT et al. Cognitive training in Parkinson’s disease reduces cognitive decline in the long term. Eur J Neurol 2015; 22: 640-647
    CrossrefPubMedGoogle Scholar
  • 31 Litvan I, Goldman JG, Tröster AI et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 2012; 27: 349-356
    CrossrefPubMedGoogle Scholar
  • 32 Zimmerman R, Gschwandtner U, Benz N et al. Cognitive training in Parkinson disease: cognition-specific vs nonspecific computer training. Neurology 2014; 82: 1219-1226
    CrossrefPubMedGoogle Scholar
  • 33 Edwards JD, Hauser RA, O'Connor ML et al. Randomized trial of cognitive speed of processing training in Parkinson disease. Neurology 2013; 81: 1284-1290
    CrossrefPubMedGoogle Scholar
  • 34 Peña J, Ibarretxe-Bilbao N, Garcia-Gorostiaga I et al. Improving functional disability and cognition in Parkinson disease. Neurology 2014; 83: 2167-2174
    CrossrefPubMedGoogle Scholar
  • 35 Moher D, Hopewell S, Schulz KF et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340: c869
    CrossrefPubMedGoogle Scholar
  • 36 Litvan I, Aarsland D, Adler CH et al. MDS Task Force on mild cognitive impairment in Parkinson’s disease: critical review of PD-MCI. Mov Disord 2011; 26: 1814-1824
    CrossrefPubMedGoogle Scholar
  • 37 Rahe J, Becker J, Fink GR et al. Cognitive training with and without additional physical activity in healthy older adults: cognitive effects, neurobiological mechanisms, and prediction of training success. Front Aging Neurosci DOI: 10.3389/fnagi.2015.00187.
    PubMedGoogle Scholar
  • 38 Whitlock LA, McLaughlin AC, Allaire JC. Individual differences in response to cognitive training: using a multi-modal, attentionally demanding game-based intervention for older adults. Comput Hum Behav 2012; 28: 1091-1096
    CrossrefPubMedGoogle Scholar
  • 39 Fairchild JK, Friedman L, Rosen AC et al. Which older adults maintain benefit from cognitive training? Use of signal detection methods to identify long-term treatment gains. Int Psychogeriatr 2012; 25: 607-616
    PubMedGoogle Scholar
  • 40 Rahe J, Kalbe E. Effekte kombinierten kognitiven und physischen Trainings auf die Kognition gesunder älterer Menschen: ein Literaturüberblick. Fortschr Neurol Psychiatr 2015; 83: 18-29
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN), Deutsche Gesellschaft für Neurologie (DGN) Hrsg. Diagnose und Behandlungsleitlinie Demenz. Interdisziplinäre S3 Praxisleitlinien. Berlin, Heidelberg, New York: Springer-Verlag; 2009
    Google Scholar
  • 42 Huntley JD, Gould RL, Liu K et al. Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ Open DOI: 10.1136/bmjopen-2014-005247.
    PubMedGoogle Scholar
  • 43 Brehmer Y, Kalpouzos G, Wenger E et al. Plasticity of brain and cognition in older adults. Psychol Res 2014; 78: 790-802
    CrossrefPubMedGoogle Scholar
  • 44 Nombela C, Bustillo PJ, Castell PF et al. Cognitive rehabilitation in Parkinson’s disease: evidence from neuroimaging. Front Neurol DOI: 10.3389/fneur.2011.00082.
    PubMedGoogle Scholar
  • 45 Bergamaschi S, Arcara G, Calza A et al. One-year repeated cycles of cognitive training (CT) for Alzheimer’s disease. Aging Clin Exp Res 2013; 25: 421-426
    CrossrefPubMedGoogle Scholar
  • 46 Chapman SB, Weiner MF, Rackley A et al. Effects of cognitive-communication stimulation for Alzheimer’s disease patients treated with donepezil. J Speech Lang Hear Res 2004; 47: 1149-1163
    CrossrefPubMedGoogle Scholar
  • 47 Giordano M, Dominguez LJ, Vitrano T et al. Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer’s disease (AD). Arch Gerontol Geriatr 2010; 51: 245-249
    CrossrefPubMedGoogle Scholar
  • 48 Matsuda O, Shido E, Hashikai A et al. Short-term effect of combined drug therapy and cognitive stimulation therapy on the cognitive function of Alzheimer’s disease. Psychogeriatrics 2010; 10: 167-172
    CrossrefPubMedGoogle Scholar
  • 49 Onder G, Zanetti O, Giacobini E et al. Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomised controlled trial. Br J Psychiatry 2005; 187: 450-455
    CrossrefPubMedGoogle Scholar
  • 50 Rahe J, Liesk J, Rosen JB et al. Sex differences in cognitive training effects of patients with amnestic mild cognitive impairment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2015; 22: 620-638
    CrossrefPubMedGoogle Scholar
  • 51 Aguirre E, Hoare Z, Streater A et al. Cognitive stimulation therapy (CST) for people with dementia – who benefits most?. International Journal of Geriatric Psychiatry 2012; 28: 284-290
    PubMedGoogle Scholar
  • 52 Baron S, Ulstein I, Werheid K. Psychosocial interventions in Alzheimer’s disease and amnestic mild cognitive impairment: evidence for gender bias in clinical trials. Aging Ment Health 2015; 19: 290-305
    CrossrefPubMedGoogle Scholar
  • 53 Berg D, Postuma RB, Adler CH et al. MDS research criteria for prodromal Parkinson’s disease. Mov Disord 2015; 30: 1600-1611
    CrossrefPubMedGoogle Scholar
  • 54 Kivipelto M, Solomon A, Ahtiluoto S et al. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): study design and progress. Alzheimers Dement 2013; 9: 657-665
    CrossrefPubMedGoogle Scholar
  • 55 Ngandu T, Lehtisalo J, Solomon A et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 2015; 385: 2255-2263
    CrossrefPubMedGoogle Scholar