Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease

Abstract

Background and Purpose: Cognition has been linked to rehabilitation outcomes in stroke populations, but this remains unexplored in individuals with Parkinson's disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to skill performance after motor training in individuals with PD.Methods: Twenty-three participants with idiopathic PD completed 3 days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either “on” or “off” their dopamine replacement medication. Baseline, training, and 48-h retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Linear regression examined whether MoCA score predicted longer-term retention at nine-day follow-up; baseline motor task performance, age, PD severity, depressive symptoms, and group (medication “on”/“off”) were included as covariates. Baseline and follow-up motor task performance were assessed for all participants while “on” their medication.Results: MoCA score was positively related to follow-up motor task performance, such that individuals with better cognition were faster than those with poorer cognition. Baseline task performance, age, PD severity, depressive symptoms, and medication status were unrelated to follow-up performance.Discussion and Conclusions: Results of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD and support the premise that cognitive training prior to or concurrent with motor training may enhance rehabilitative outcomes for individuals with PD. Findings also suggest that assessing cognition in individuals with PD could provide prognostic information about their responsiveness to motor rehabilitation.

Sensorimotor Network Segregation Predicts Long-Term Learning of Writing Skills in Parkinson’s Disease

“…After correcting for baseline writing performance, only sex, unimanual dexterity and disease severity measures (disease duration, motor severity and FOG presence) showed associations with writing gains across any time points. Cognition has often been shown to predict learning following training [19,54,59] and hence the lack of association here is surprising. However, this sample showed relatively preserved cognitive capacity, and the task itself was minimally cognitively demanding, reducing the likelihood of cognition being a driving or limiting factor for learning.…”

“…Demographic and clinical predictors were selected based on previous literature [15,18,[53][54][55][56] and consisted of age, gender, MDS-UPDRS-III, disease duration, Purdue Pegboard test, LEDD, HADS, sleep complaints, FOG presence and MOCA. Improvements in writing over time were analyzed with a repeated measurement analysis of variance with time as a within-subject condition.…”

A novel socially assistive robotic platform for cognitive-motor exercises for individuals with Parkinson's Disease: a participatory-design study from conception to feasibility testing with end users

“…10.3389/frobt.2023.1267458 (Lingo VanGilder et al, 2021). PD is the second most prevalent neurodegenerative condition after Alzheimer's disease, and its incidence is expected to increase to 8-9 million individuals in Western Europe by 2030 due to the aging of the world population aging (Dorsey et al, 2007;Driver et al, 2009).…”

“…For example, combining movement (specifically, dance) training with music has been shown to improve cognitive skills and delaying the decline of executive functions and memory in IwPD (Pereira et al, 2019). Also, cognitive training before or concurrently with motor training has been suggested to optimize treatment outcomes for IwPD (Lingo VanGilder et al, 2021).…”