Parkinson Disease Clinical Trial
— cogtipsOfficial title:
COGTIPS (COGnitive Training In Parkinson Study): The Effect of Online Cognitive Training on Cognition and Brain Networks in Parkinson's Disease
Verified date | October 2020 |
Source | VU University Medical Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study evaluates the efficacy of an eight-week online cognitive training program on objective and subjective cognitive functions in Parkinson's disease. Moreover, we intend to map the effect on brain network function, and if cognitive training can prevent the development of PD-MCI/PD-D after one- and two-year follow-up. In this study, two training groups will be compared (N: 70 vs 70). In a part of the participants MRI will be assessed (N: 40 vs. 40). We expect cognitive training to improve cognitive functions, and to improve the efficiency of brain network function. Moreover, we expect that cognitive training can decrease the risk of PD-MCI/PD-D at one- and two-year follow-up.
Status | Active, not recruiting |
Enrollment | 170 |
Est. completion date | September 2021 |
Est. primary completion date | July 17, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | N/A and older |
Eligibility | --- Parkinson's disease patients --- Inclusion Criteria: - Subjective cognitive complaints, measured by the Parkinson's Disease Cognitive Functional Rating Scale score > 3 (PD-CFRS). A score above 3 indicates significant cognitive complaints, that are milder than complaints associated with Parkinson's disease dementia. This questionnaire is filled in by the patient. - Participants' Hoehn & Yahr stage is lower than 4. Patients are stable on dopaminergic medication at least a month before starting the intervention. During the intervention, patient and neurologist will be asked to keep the dopaminergic medication dosage as stable as possible. - Participants have access to a computer or tablet, with access to the Internet. If the participant uses a computer, he or she is capable of using a keyboard and computer mouse. - Participants are willing to sign informed consent. Exclusion Criteria: General criteria: - Indications for a dementia syndrome, measured by the Self-administered Gerocognitive Examination score < 14 or the Montreal Cognitive Assessment score < 22. - Current drug- or alcohol abuse, measured by a score > 1 on the four CAGE AID-questions (according to the Trimbos guidelines). - The inability to undergo extensive neuropsychological assessment, or eight weeks of intervention. - Moderate to severe depressive symptoms, as defined by the Beck Depression Inventory score > 18. - An impulse control disorder, including internet addiction, screened by the impulse control disorder criteria interview. - Psychotic symptoms, screened by the Questionnaire for Psychotic Experiences. Benign hallucinations with insight are not contraindicated. - Traumatic brain injury, only in case of a contusio cerebri with 1) loss of consciousness for > 15 minutes and 2) posttraumatic amnesia > 1 hour. - A space occupying lesion defined by a radiologist, or significant vascular abnormalities (Fazekas > 1). For participation in MRI research: - Severe claustrophobia - Metal in the body (for example, deep brain stimulator or pacemaker) - Pregnancy - Problems with or shortness of breath during 60 minutes of lying still. - Healthy control subjects --- Inclusion criteria: - Participants are willing to sign informed consent. Exclusion criteria: - Indications for a neurological disease, such as Parkinson's disease, Alzheimer's disease, mild cognitive impairment, multiple sclerosis or Huntington's disease; - Indications for a dementia syndrome, measured by the Montreal Cognitive Assessment score < 22. - Indications for a current stroke or CVA, or in the past. - Indications for the presence of a psychotic or depressive disorder, measured with a positive screening on the SAPS-PD (benign hallucinations with insight are not contraindicated) and a BDI > 18 respectively. - Current drug- or alcohol abuse, measured by a score > 1 on the four CAGE AID-questions (according to the Trimbos guidelines). - The inability to undergo extensive neuropsychological assessment, or eight weeks of intervention. - Traumatic brain injury, only in case of a contusio cerebri with 1) loss of conciousness for > 15 minutes and 2) posttraumatic amnesia > 1 hour. - A space occupying lesion defined by a radiologist, or significant vascular abnormalities (Fazekas > 1). - Contra-indications for participation in MRI scanning (see above) |
Country | Name | City | State |
---|---|---|---|
Netherlands | VU University Medical Center | Amsterdam | Noord-Holland |
Lead Sponsor | Collaborator |
---|---|
VU University Medical Center | Dutch Parkinson Patient Association |
Netherlands,
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* Note: There are 19 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Age | Demographic characteristic: age at baseline. | Pre-intervention (T0) | |
Other | Sex | Demographic characteristic: sex. | Pre-intervention (T0) | |
Other | Educational level | Demographic characteristic: educational level. | Pre-intervention (T0) | |
Other | Disease duration | Disease characteristic: disease duration. | Pre-intervention (T0) | |
Other | Disease stage | Disease characteristic: disease stage (Hoehn and Yahr stage). | Pre-intervention (T0), one year (T3), two years (T4) | |
Other | Medication use | Disease characteristic: medication use. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Motor symptoms | Motor symptoms assessed by the Unified Parkinson's Disease Rating Scale - III | Pre-intervention (T0), one year (T3), two years (T4) | |
Other | Depressive symptom severity | Psychiatric symptom severity, depression (Beck Depression Inventory). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Anxiety symptom severity | Psychiatric symptom severity, including anxiety (Parkinson Anxiety Scale). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Impulse control disorder symptom severity | Psychiatric symptom severity, including impulse control disorders (QUIP-RS). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Psychotic symptom severity | Psychiatric symptom severity, including psychotic symptoms (Questionnaire for psychotic events). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Apathy symptom severity | Psychiatric symptom severity, including apathy (Apathy Scale). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Expectations of the intervention | Participants' expectation prior the intervention, measured by the credibility/expectancy questionnaire. | Pre-intervention (T0) | |
Other | Global cognitive functioning (1) | Global cognitive functioning assessed by the Montreal Cognitive Assessment (MoCA). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Global cognitive functioning (2) | Global cognitive functioning assessed by the Pentagon copy test, which is predictive of cognitive detoriation. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: attention/working memory (1) | Attention function, measured by the Stroop task part I: word naming. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: attention/working memory (2) | Working memory function, measured by the backwards digit span test of the Wechsler adult intelligence test (WAIS)-III. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: episodic memory (1) | Episodic memory function, measured by the Dutch version of the Auditory verbal learning test (RAVLT). | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: episodic memory (2) | Episodic memory function, measured by the Location learning task. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: language (1) | Language function, measured by the Boston naming task. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: language (2) | Language function, measured by the category fluency task. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: visuospatial/visuoconstructive function (1) | Visuospatial function, measured by the Benton visual form discrimination task. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Specific cognitive functioning: visuospatial/visuoconstructive function (2) | Visuospatial function, measured by the Rey complex figure task. | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Physical activity | Amount of estimated physical activity that a person performes, measured by the New Zealand Physical Activity Questionnaire | Pre-intervention (T0), eight weeks (T1), six months (T2), one year (T3), two years (T4) | |
Other | Cognitive reserve | Estimation of cognitive reserve measured with the Cognitive Reserve Index questionnaire | Two years (T4) | |
Primary | Efficacy of the online cognitive training on executive function (1) | Improvement in executive function after eight weeks of cognitive training as measured by the Tower of London | Eight weeks (T1) | |
Secondary | Efficacy of the online cognitive training on subjective cognitive complaints (1) | Improvement on subjective cognitive complaints after eight weeks of cognitive training, measured by the Parkinson's disease Cognitive Functional Rating Scale (PD-CFRS). | Eight weeks (T1) | |
Secondary | Efficacy of the online cognitive training on subjective cognitive complaints (2) | Improvement on subjective cognitive complaints after eight weeks of cognitive training, measured by the Cognitive failures questionnaire (CFQ). | Eight weeks (T1) | |
Secondary | Efficacy of the online cognitive training on executive cognitive functions (2) | Improvement on executive cognitive functions after eight weeks of cognitive training, measured by the Stroop color-word task. The color-word card (card III) will be corrected for color naming speed (measured by card II). | Eight weeks (T1) | |
Secondary | Efficacy of the online cognitive training on executive cognitive functions (3) | Improvement on executive cognitive functions after eight weeks of cognitive training, measured by the Letter fluency task. | Eight weeks (T1) | |
Secondary | Persistence of cognitive training effect on executive functions at six-month follow-up | Persistence of cognitive training effect on executive functions measured by the Tower of London task at six-month follow-up of no cognitive training. | Six months (T2) | |
Secondary | Persistence of cognitive training effect on executive functions at one-year follow-up | Persistence of cognitive training effect on executive functions measured by the Tower of London task at one-year follow-up of no cognitive training. | One year (T3) | |
Secondary | Persistence of cognitive training effect on executive functions at two-year follow-up | Persistence of cognitive training effect on executive functions measured by the Tower of London task at one-year follow-up of no cognitive training. | Two years (T4) | |
Secondary | Risk reduction of PD-MCI/PD-D development at follow-up | The reduction of the risk on developing PD-MCI or PD-D at six months and one year follow-up. Diagnostic criteria for Level II PD-MCI and probable PD-D will be used. | Six months (T2), one year (T3), two years (T4) | |
Secondary | Online cognitive training effect on brain morphology measured by MRI | The effect of online cognitive training on brain morphology using MRI. Structural changes will be assessed after eight weeks of training (T1). | Eight weeks (T1) | |
Secondary | Online cognitive training effect on structural brain connectivity measured by DTI | The effect of online cognitive training on structural brain connectivity using DTI. Structural changes will be assessed after eight weeks of training (T1). | Eight weeks (T1) | |
Secondary | Online cognitive training effect on brain activity measured by resting state fMRI | The effect of online cognitive training on brain activity using resting state fMRI. Regional activity and functional connectivity changes will be assessed after eight weeks of training (T1). | Eight weeks (T1) | |
Secondary | Online cognitive training effect on brain network topology relative to healthy control group | The effect of online cognitive training on brain network topology using resting state fMRI compared with brain network topology of healthy subjects. Healthy subjects will undergo (functional) MRI scanning once. | Eight weeks (T1) | |
Secondary | Difference between Parkinson's disease patients' brain network topology with or without cognitive impairment, and healthy control subjects. | Participants will be classified to cognitive impairment or no cognitive impairment, and their brain network topology will be compared with healthy subjects. | Pre-intervention (T0) |
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