Non-pharmacological management of cognitive impairment in Parkinson’s disease

Pupíková, Monika; Rektorová, Irena

doi:10.1007/s00702-019-02113-w

Neurology and Preclinical Neurological Studies - Review Article
Published: 10 December 2019

Non-pharmacological management of cognitive impairment in Parkinson’s disease

Journal of Neural Transmission volume 127, pages 799–820 (2020)Cite this article

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Abstract

We evaluated the therapeutic effects of non-pharmacological interventions (cognitive training, physical activity, and non-invasive brain stimulation) on cognitive symptoms in Parkinson’s disease. A comprehensive literature search for non-pharmacological intervention randomized controlled trials was performed and effect sizes were calculated for each suitable study intervention approach and cognitive domain. Despite the heterogeneity of the study results, we report level B evidence for the probable efficacy of cognitive training in improving or maintaining attention/working memory and memory domains. Level C (possible efficacy) evidence was found for specific physical training types with respect to enhancing executive functions. Non-invasive brain stimulation techniques and combinatorial approaches show preliminary but promising results. Prediction markers evaluating distinct treatment responses should be identified that would help to choose the best candidates for specific treatment strategies and cognitive symptoms. Future directions and recommendations are discussed.

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Acknowledgements

This work was supported by the NV18–04–00256 grant from the Czech Ministry of Health and by the project CEITEC 2020 (LQ1601) from the Ministry of Education, Youth and Sports of the Czech Republic (MEYS CR).

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Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic
Monika Pupíková & Irena Rektorová
Department of Neurology, St. Anne’s University Hospital and School of Medicine, Masaryk University, Brno, Czech Republic
Irena Rektorová

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Monika Pupíková
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Irena Rektorová
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Correspondence to Irena Rektorová.

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702_2019_2113_MOESM2_ESM.tif

Fig. 1 Forest plot of effect sizes (ES and 95% CI) forcognitive outcome measures in patients with Parkinson’s disease after combined approach with a referenceanother treatment group Supplementary material 1 (TIF 243 kb)

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Pupíková, M., Rektorová, I. Non-pharmacological management of cognitive impairment in Parkinson’s disease. J Neural Transm 127, 799–820 (2020). https://doi.org/10.1007/s00702-019-02113-w

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Received: 23 November 2019
Accepted: 28 November 2019
Published: 10 December 2019
Issue Date: May 2020
DOI: https://doi.org/10.1007/s00702-019-02113-w

Keywords

Brain stimulation
Cognitive training
Mild cognitive impairment
Non-pharmacological interventions
Parkinson’s disease
Physical therapy