Cognitive Rehabilitation in Parkinson's Disease
| Status: | Completed |
|---|---|
| Conditions: | Parkinsons Disease |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 55 - 75 |
| Updated: | 4/21/2016 |
| Start Date: | July 2010 |
| End Date: | August 2015 |
PC-based Rehabilitation of Motor Planning Deficits in Parkinson Disease
We are testing a computer game-style rehabilitation program for people with Parkinson's
disease (PD). People with PD often have difficulty with motor planning, such as initiating
or starting movements. We believe that our program will improve performance on a movement
initiation task as well as on activities of daily living, such as walking, preparing a meal
or opening a medicine bottle. We will measure brain function using functional MRI before and
after training to identify brain areas that are involved in improved performance. If
effective, computer based training will be an inexpensive treatment for motor planning
deficits in PD that is free from side effects and easy to administer to a large number of
patients.
disease (PD). People with PD often have difficulty with motor planning, such as initiating
or starting movements. We believe that our program will improve performance on a movement
initiation task as well as on activities of daily living, such as walking, preparing a meal
or opening a medicine bottle. We will measure brain function using functional MRI before and
after training to identify brain areas that are involved in improved performance. If
effective, computer based training will be an inexpensive treatment for motor planning
deficits in PD that is free from side effects and easy to administer to a large number of
patients.
Our approach is to use PD-based adaptive training to improve performance on IG movement
initiation in patients with PD. We have three aims, 1) to systematically evaluate cognitive
rehabilitation in people with Parkinson's disease (PD), 2) to examine the neural mechanisms
subserving cognitive rehabilitation in PD and 3) to assess the ecological validity of
cognitive rehabilitation in PD. We will focus on a single aspect of cognitive function, the
decision to initiate a movement. Movements can be internally generated (IG) or externally
cued, and motor deficits in PD are typically linked to IG movements. The protocol is
designed to drive beneficial neuroplastic changes using a paradigm similar to those that
have shown promising results in traumatic brain injury patients. In addition, we will use
fMRI to measure activity in underlying basal ganglia-thalamocortical circuits. Finally,
because the goal of any research regarding the pathophysiology of disease is to improve the
lives of patients with the disease, behavioral and neuropsychological measures will be
correlated with fMRI measured functional abnormalities before and after training.
Improvement in the initiation of movement has the potential to dramatically improve daily
functioning including reducing falls, improving language production and improving
proficiency of activities of daily living.
initiation in patients with PD. We have three aims, 1) to systematically evaluate cognitive
rehabilitation in people with Parkinson's disease (PD), 2) to examine the neural mechanisms
subserving cognitive rehabilitation in PD and 3) to assess the ecological validity of
cognitive rehabilitation in PD. We will focus on a single aspect of cognitive function, the
decision to initiate a movement. Movements can be internally generated (IG) or externally
cued, and motor deficits in PD are typically linked to IG movements. The protocol is
designed to drive beneficial neuroplastic changes using a paradigm similar to those that
have shown promising results in traumatic brain injury patients. In addition, we will use
fMRI to measure activity in underlying basal ganglia-thalamocortical circuits. Finally,
because the goal of any research regarding the pathophysiology of disease is to improve the
lives of patients with the disease, behavioral and neuropsychological measures will be
correlated with fMRI measured functional abnormalities before and after training.
Improvement in the initiation of movement has the potential to dramatically improve daily
functioning including reducing falls, improving language production and improving
proficiency of activities of daily living.
Inclusion Criteria:
- Clinical diagnosis of PD dominant on the right side with a Hx of response to dopamine
replacement.
Exclusion Criteria:
- Contraindication to MRI
- History of stroke or significant head trauma
- Significant vision impairment
- Hx of brain surgery or claustrophobia
- Medication change <4 weeks
- Atypical PD
- Severe tremor
- Presence of motor fluctuations or dyskinesia
- Significantly impaired limb or joint function
- Significant memory impairment
- Depression or daytime sleepiness
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