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April 08, 2014; 82 (14) Article

Cognitive training in Parkinson disease

Cognition-specific vs nonspecific computer training

Ronan Zimmermann, Ute Gschwandtner, Nina Benz, Florian Hatz, Christian Schindler, Ethan Taub, Peter Fuhr
First published March 12, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000287
Ronan Zimmermann
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Ute Gschwandtner
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Nina Benz
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Florian Hatz
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Christian Schindler
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Ethan Taub
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Peter Fuhr
From the Departments of Neurology (R.Z., U.G., N.B., F.H., P.F.) and Neurosurgery (E.T.), Hospital of the University of Basel; and Swiss Tropical and Public Health Institute (C.S.), University of Basel, Switzerland.
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Citation
Cognitive training in Parkinson disease
Cognition-specific vs nonspecific computer training
Ronan Zimmermann, Ute Gschwandtner, Nina Benz, Florian Hatz, Christian Schindler, Ethan Taub, Peter Fuhr
Neurology Apr 2014, 82 (14) 1219-1226; DOI: 10.1212/WNL.0000000000000287

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Abstract

Objective: In this study, we compared a cognition-specific computer-based cognitive training program with a motion-controlled computer sports game that is not cognition-specific for their ability to enhance cognitive performance in various cognitive domains in patients with Parkinson disease (PD).

Methods: Patients with PD were trained with either a computer program designed to enhance cognition (CogniPlus, 19 patients) or a computer sports game with motion-capturing controllers (Nintendo Wii, 20 patients). The effect of training in 5 cognitive domains was measured by neuropsychological testing at baseline and after training. Group differences over all variables were assessed with multivariate analysis of variance, and group differences in single variables were assessed with 95% confidence intervals of mean difference. The groups were similar regarding age, sex, and educational level.

Results: Patients with PD who were trained with Wii for 4 weeks performed better in attention (95% confidence interval: −1.49 to −0.11) than patients trained with CogniPlus.

Conclusions: In our study, patients with PD derived at least the same degree of cognitive benefit from non–cognition-specific training involving movement as from cognition-specific computerized training. For patients with PD, game consoles may be a less expensive and more entertaining alternative to computer programs specifically designed for cognitive training.

Classification of evidence: This study provides Class III evidence that, in patients with PD, cognition-specific computer-based training is not superior to a motion-controlled computer game in improving cognitive performance.

GLOSSARY

BDI=
Beck Depression Inventory;
CI=
confidence interval;
MANOVA=
multivariate analysis of variance;
MMSE=
Mini-Mental State Examination;
PD=
Parkinson disease;
TMT=
Trail Making Test;
UPDRS=
Unified Parkinson's Disease Rating Scale

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received August 7, 2013.
  • Accepted in final form December 2, 2013.
  • © 2014 American Academy of Neurology
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Letters: Rapid online correspondence

  • Response to Dr. Sturm
    • Peter Fuhr, Neurologist, Hospital of the University of BaselPeter.Fuhr@usb.ch
    • Ronan Zimmermann, Basel, Switzerland; Ute Gschwandtner, Basel, Switzerland
    Submitted October 02, 2014
  • Cognitive training in Parkinson disease: Cognition-specific vs nonspecific computer training
    • Walter Sturm, Former head of Clinical Neuropsychology at the University Hospital Aachen, Prof. for Neuropsychology, retiredsturm@neuropsych.rwth-aachen.de
    Submitted June 23, 2014
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