Long-term effects of cognitive rehabilitation on brain, functional outcome and cognition in Parkinson's disease
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2018-01
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Blackwell Publishing Ltd.
Resumen
Cognitive rehabilitation has demonstrated efficacy inproducing short-term cognitive and brain changes in patients with Parkinson’sdisease (PD). To date, no study has assessed the long-term effects of cognitiverehabilitation using neuroimaging techniques in PD. The aim was to assess thelongitudinal effects of a 3-month cognitive rehabilitation programme evaluatingthe cognitive, behavioural and neuroimaging changes after 18 months. Fifteen patients with PD underwent a cognitive, behavioural andneuroimaging assessment at pre-treatment (T 0), post-treatment (T 1 ) and after18 months (T 2 ). This study examined the long-term effects (from T 0 to T2)and the maintenance of the changes (from T1 to T2 ). T1-weighted, diffusion-weighted, functional magnetic resonance imaging during both a resting-stateand a memory paradigm were acquired. Voxel-based morphometry and tract-based spatial statistics were used for grey and white matter analyses. A region-of-interest-to-region-of-interest approach was used for resting-state functionalconnectivity (FC) and a model-based approach was used for brain activationduring the memory paradigm. Patients with PD showed increased cognitive performance, decreasedfunctional disability, increased brain FC and activation at T2 compared with T0(P < 0.05, FDR). Moreover, patients showed maintenance of the improvementsin cognition and functionality, and maintenance of the increased brain FC andactivation at T2 compared with T1. However, significant grey matter reductionand alterations of white matter integrity were found at T2 (P < 0.05, FWE). Findings suggest that the improved cognitive performance andincreased brain FC and activation after cognitive rehabilitation were signifi-cantly maintained after 18 months in patients with PD, despite the structuralbrain changes, consistent with a progression of neurodegenerative processes.
Palabras clave
Brain changes
Brain plasticity
Cognitive rehabilitation
Functional disability
Longitudinal
Parkinson's disease
Brain plasticity
Cognitive rehabilitation
Functional disability
Longitudinal
Parkinson's disease
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Díez-Cirarda, Ojeda, Peña, Cabrera-Zubizarreta, Lucas-Jiménez, Gómez-Esteban, Gómez-Beldarrain, & Ibarretxe-Bilbao. (2018). Long-term effects of cognitive rehabilitation on brain, functional outcome and cognition in Parkinson’s disease. European Journal of Neurology, 25(1), 5-12. https://doi.org/10.1111/ENE.13472