Pilot Study to Determine if Working Memory Training Aids Cognitive Functioning in Patients With Parkinson's Disease

Parkinson Disease Clinical Trial

— PDWM  

Official title:

Beyond the Physical: Enhancing Psychosocial Functioning in Parkinson's Disease

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01647698
• Other study ID #: PDWM-2012-07
• Status: Active, not recruiting
• Phase: N/A
• Start date: October 2013
• Est. completion date: December 31, 2024

Study information

• Verified date: May 2023
• Source: Nova Scotia Health Authority
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This project will investigate the feasibility and preliminary effectiveness of an intensive and focused working memory training program for patients in the early stages of PD receiving dopaminergic therapy. The investigators hypothesize that working memory training will be an effective method of improving working memory and related cognitive and behavioural functions in PD patients.

Description:

Parkinson's disease (PD) is not an exclusively motor disease; more than half of individuals with PD experience cognitive impairment even in the early stages of the disease and many develop dementia as the disease progresses. As a result, attention, memory, planning and organizational skills can be affected, interfering with everyday functioning (e.g. shopping, managing finances, job skills). Thus, interventions to improve cognitive abilities are needed to enhance psychosocial function and overall quality of life. Some cognitive deficits, such as problems with working memory, are apparent even in the early stages of the disease. Working memory (WM) is the ability to actively maintain and manipulate information in one's mind and is needed for many complex tasks such as learning, communication and problem-solving . Individuals with PD often show deficits in both WM maintenance (e.g., holding a phone number in mind to make a call) and manipulation (e.g.,mental calculation at the grocery store checkout) skills, depending upon the stage of the disease and progression of damage to frontal-subcortical circuits. Attempts to identify pharmacological agents that ameliorate cognitive dysfunction have been largely unsuccessful or associated with undesirable side effects (e.g. Vale, 2009). The investigators propose that specific cognitive training to improve WM could provide direct benefit to psychosocial function of PD patients; it could potentially enhance any positive benefits or reduce the negative effects of pharmacological treatment without an added risk of side effects as well. Promising interventions focused on intensive and direct WM training are emerging and have been shown to generalize to other cognitive domains, such as fluid intelligence. Cognitive training has been successful in patients with traumatic brain injury, who also show WM deficits as a result of damage to frontal-subcortical circuits. In addition, successful WM training is associated with changes in dopamine receptor density as well as changes in patterns of neural activity in task-relevant areas of the brain. To date, a limited number of small group studies provide preliminary evidence that some aspects of cognitive function can be enhanced by training in PD patients also receiving dopaminergic therapy, although few use control groups to account for potential repeated testing practice effects.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 30
• Est. completion date: December 31, 2024
• Est. primary completion date: December 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• clinical diagnosis of idiopathic Parkinson's disease
• self-reported concerns about their working memory, or working memory deficits that were identified by a clinical examination
• be classified as Hohn & Yahr Stage 1 or 2
• be receiving a stable dose of dopaminergic therapy

Exclusion Criteria:

• presence of dementia or other significant neurological or psychiatric conditions, as determined by clinical history
• Classification as Hohm & Yahr Stage 3 or 4
• Not on a stable dos of dopaminergic therapy

Related Conditions & MeSH terms

• Parkinson Disease

Intervention

Behavioral:
• Adaptive working memory training task
The working memory training task will consist of an adaptive working memory computer program that will test and extend patients' working memory capacity. Adaptive refers to the increase in the number of items that the patient is required to remember.
• Non-adaptive working memory training task (i.e. an active control task)
Active control task will consist of a non-adaptive working memory task.
• No training
No training during the experiment.

Locations

Country	Name	City	State
Canada	Dalhousie University	Halifax	Nova Scotia

Sponsors (2)

Lead Sponsor	Collaborator
Gail Eskes	Nova Scotia Health Authority

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Baseline Working memory function	Working memory will be measured using the operation span task, the symmetry span task and the Sternberg memory scanning tasks.; Operation span - This is a dual-task in which participants complete mathematical reasoning (e.g. solving a mathematical equation) while using short-term verbal memory to remember words.; Symmetry span: This is a dual task in which participants discriminate about the symmetry of visual stimuli while using short-term spatial memory to remember the locations of stimuli.; Sternberg memory scanning task - number memory test	baseline
Primary	Change in working memory function between baseline and 5 weeks post training onset		5 weeks post training onset
Primary	Change in working memory function between baseline and 10 weeks post training onset		10 weeks post training onset
Primary	Change in working memory function between baseline and 22 weeks post training onset		22 weeks post training onset
Secondary	Baseline fluid intelligence	Fluid intelligence will be measured using Cattell's Culture Fair Intelligence Test, a measure of analogical reasoning, and Raven's Progressive Matrices, a measure of spatial reasoning.	Baseline
Secondary	change in fluid intelligence between baseline and 5 weeks post training onset		5 weeks post training onset
Secondary	Change in fluid intelligence between baseline and 10 weeks post training onset		10 weeks post training onset
Secondary	Change in fluid intelligence between baseline and 22 weeks post training onset		22 weeks post training onset
Secondary	Baseline Executive functioning	Executive functioning will be measured using the Dysexecutive Questionnaire. It is a self-report and other-report of everyday behaviours reflecting executive function.	Baseline
Secondary	Change in executive functioning between baseline and 5 weeks post training onset		5 weeks post training onset
Secondary	Change in executive functioning between baseline and 10 weeks post training onset		10 weeks post training onset
Secondary	Change in executive function between baseline and 22 weeks post training onset		22 weeks post training onset