Randomized trial of cognitive speed of processing training in Parkinson disease

Edwards, Jerri D.; Hauser, Robert A.; Melissa O’Connor; Valdés, Elise G.; Zesiewicz, Theresa A.; Uc, Ergun Y. · 2013 · OpenAlex-citations

DOI: 10.1212/wnl.0b013e3182a823ba

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Summary

This study investigated the efficacy of cognitive speed of processing training (SOPT) in individuals with Parkinson disease (PD), addressing the need for nonpharmacologic interventions to mitigate cognitive decline associated with poorer prognosis and reduced quality of life. Specifically, the research aimed to determine if SOPT could improve useful field of view (UFOV) performance, a robust predictor of driving safety, and whether these improvements would transfer to secondary outcomes such as cognitive self-perceptions and depressive symptoms. The study also sought to identify moderators that might influence responsiveness to the training. The researchers conducted a randomized controlled trial involving 87 adults aged 40 or older with idiopathic PD in Hoehn & Yahr stages 1–3. Participants were randomized into two groups: one received 20 hours of self-administered SOPT using InSight software over approximately three months, while the other served as a no-contact control group. The primary outcome measure was UFOV performance, assessed at baseline and post-intervention. Secondary outcomes included cognitive self-perceptions and depressive symptoms. The study analyzed potential moderators, including age at onset, disease duration, medication dosage, and mental status, using multivariate analysis of variance and regression analyses. Results demonstrated that participants in the SOPT group experienced significantly greater improvements in UFOV performance compared to the control group (p = 0.032). However, the training did not yield significant immediate improvements in secondary outcomes, including cognitive self-perceptions or depressive symptoms. Analysis of moderators revealed that greater training gains were associated with longer disease duration, younger age at diagnosis, and higher levodopa equivalent doses. These factors were significantly correlated with UFOV improvement, suggesting that individuals with more advanced disease characteristics or specific medication profiles may benefit more from the intervention. The study concludes that SOPT is a feasible and effective intervention for improving cognitive speed of processing in patients with mild to moderate PD. The authors provide Class III evidence that self-administered SOPT enhances UFOV performance, which is critical for maintaining driving mobility and safety. While immediate transfer to subjective cognitive perceptions or mood was not observed, the findings suggest potential for longitudinal benefits similar to those seen in older adults, such as reduced risk of driving cessation. The authors recommend further research to establish long-term functional benefits and to determine optimal training protocols for diverse PD populations.

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• useful field of view