A double-blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods i
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ORIGINAL ARTICLE
A double‑blind randomized controlled trial of the efficacy of cognitive training delivered using two different methods in mild cognitive impairment in Parkinson’s disease: preliminary report of benefits associated with the use of a computerized tool Sara Bernini1 · Silvia Panzarasa2 · Marica Barbieri1 · Elena Sinforiani1 · Silvana Quaglini2 · Cristina Tassorelli1,3 · Sara Bottiroli4,1 Received: 24 May 2020 / Accepted: 18 July 2020 © Springer Nature Switzerland AG 2020
Abstract Background The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. Aims To evaluate the efficacy of CCT in patients with Parkinson’s disease and mild cognitive impairment (PD-MCI). Methods In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure. Results Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/ demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found. Conclusion CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia. Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019). Keywords Computer-based cognitive training · Randomized controlled trial · Neurodegenerative disease · Mild cognitive impairment · Parkinson’s disease · Multi-domain stimulation
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40520-020-01665-2) contains supplementary material, which is available to authorized users. * Sara Bernini [email protected] 1
IRCCS Mondino Foundation, Pavia, Italy
2
Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
3
Dept. of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
4
Giustino Fortunato University, Benevento, Italy
Cognitive training (CT) is a non-pharmacological intervention that has long been used to target cognition in a range of neurological disorders, including age-related cognitive decline [1–3]. CT can be delivered using traditional paperand-pencil techniques (PCT) or by means of
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