Objective: To analyse the feasibility and effects on cognitive- and non-cognitive outcomes, and prediction of responsiveness of a computerized cognitive training (CT) in comparison to usual care in people with advanced Parkinson’s disease (PD).

Background: Mild cognitive impairment and dementia are frequent in PD and severely affect patients’ quality of life (QoL). Thus, effective pharmacological and non-pharmacological treatment strategies are needed. One approach is CT (i.e., standardized computerised tasks to improve cognitive functioning [e.g., memory, attention, executive functions]). CT has been shown to be effective in PD patients with no or mild cognitive impairment in Hoehn and Yahr stages I-III and without or only slight motor complications. However, studies examining CT effects in advanced PD patients are lacking.

Method: This ongoing monocentric, randomized controlled, single-blinded, two-armed intervention study (registered in the German Clinical Trials Register, ID: DRKS00028876) assesses the effects of a 5-week digital multi-domain CT “NEUROvitalis digital” (4 times/week for 45 minutes) in advanced PD according to the 5-2-1-criteria [1] (n=70) compared to usual care (n=70). Participants undergo extensive neuropsychological testing pre and post CT and at 3 months follow-up. Primary outcome is global cognition assessed by the Montréal Cognitive Assessment (MoCA). Secondary outcomes include, e.g., specific cognitive functions, depression, and QoL. Feasibility is assessed using a training diary on patients’ motivation and satisfaction and technical data from the CT (e.g., training progress, duration).

Results: After two months of recruitment, n=18 PD patients were included. Until now, we report n=2 screening failures (MoCA ≤21), n=0 dropouts, n=4 patients completed the CT already, and n=6 are currently in training. Regarding feasibility, patients follow the training schedule, show good motivation and satisfaction to participate in the CT, and some report minor technical issues.

Conclusion: The trial will inform whether computerised CT will be feasible in terms of technical handling, implementation in everyday life, and motivation and satisfaction of patients with advanced PD. We further expect the CT to improve global cognition as well as other cognitive and non-cognitive outcomes in the short and long term.

References: [1] Antonini, A. (2018): https://doi.org/10.1080/03007995.2018.1502165

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MDS Abstracts - https://www.mdsabstracts.org/abstract/computerized-cognitive-training-in-advanced-parkinsons-disease-preliminary-feasibility-data-of-an-ongoing-randomized-controlled-trial/