Premium
Long‐term effects of cognitive rehabilitation on brain, functional outcome and cognition in Parkinson's disease
Author(s) -
DíezCirarda M.,
Ojeda N.,
Peña J.,
CabreraZubizarreta A.,
LucasJiménez O.,
GómezEsteban J. C.,
GómezBeldarrain M. Á.,
IbarretxeBilbao N.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13472
Subject(s) - cognition , white matter , cognitive rehabilitation therapy , medicine , neuroimaging , grey matter , effects of sleep deprivation on cognitive performance , rehabilitation , neuroscience , physical medicine and rehabilitation , cognitive decline , functional magnetic resonance imaging , functional neuroimaging , magnetic resonance imaging , psychology , disease , dementia , radiology
Background and purpose Cognitive rehabilitation has demonstrated efficacy in producing short‐term cognitive and brain changes in patients with Parkinson's disease ( PD ). To date, no study has assessed the long‐term effects of cognitive rehabilitation using neuroimaging techniques in PD . The aim was to assess the longitudinal effects of a 3‐month cognitive rehabilitation programme evaluating the cognitive, behavioural and neuroimaging changes after 18 months. Methods Fifteen patients with PD underwent a cognitive, behavioural and neuroimaging assessment at pre‐treatment (T 0 ), post‐treatment (T 1 ) and after 18 months (T 2 ). This study examined the long‐term effects (from T 0 to T 2 ) and the maintenance of the changes (from T 1 to T 2 ). T1‐weighted, diffusion‐weighted, functional magnetic resonance imaging during both a resting‐state and a memory paradigm were acquired. Voxel‐based morphometry and tract‐based spatial statistics were used for grey and white matter analyses. A region‐of‐interest‐to‐region‐of‐interest approach was used for resting‐state functional connectivity ( FC ) and a model‐based approach was used for brain activation during the memory paradigm. Results Patients with PD showed increased cognitive performance, decreased functional disability, increased brain FC and activation at T 2 compared with T 0 ( P < 0.05, FDR ). Moreover, patients showed maintenance of the improvements in cognition and functionality, and maintenance of the increased brain FC and activation at T 2 compared with T 1 . However, significant grey matter reduction and alterations of white matter integrity were found at T 2 ( P < 0.05, FWE ). Conclusions Findings suggest that the improved cognitive performance and increased brain FC and activation after cognitive rehabilitation were significantly maintained after 18 months in patients with PD , despite the structural brain changes, consistent with a progression of neurodegenerative processes.