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09-10-2013 | Parkinson's disease | Article

Computer training for Parkinson’s patients improves driving performance marker

Abstract

Free abstract

medwireNews: A self-administered, nonpharmalogic intervention significantly improves the useful field of view (UFOV) of patients with Parkinson’s disease (PD), shows a randomized trial.

As reported in Neurology, the 44 patients in the intervention group undertook 20 hours of cognitive speed of processing training (SOPT), using commercially available computer software.

But although the intervention is simple, editorialists Kelvin Chou (University of Michigan, Ann Arbor, USA) and Alice Cronin-Golomb (Boston University, Massachusetts, USA) caution that “SOPT requires a substantial time commitment, so it is difficult to know whether patients will embrace it.”

Despite the clinical trial setting, 27% of patients assigned to the SOPT group dropped out before the 3-month follow-up, with two of these five patients saying they were too busy with family and/or work.

Patients in the SOPT group completed an average of 21.37 hours of training, with 69% completing at least 20 hours. Their baseline score on the UFOV test was 507.15 ms, and this improved to 359.21 ms by the follow-up assessment. The change was significantly larger than the change among the 43 patients in the no-intervention control group, whose average score decreased from 429.94 to 367.23 ms.

Improvement in UFOV significantly correlated with measures of more severe disease and of longer duration, suggesting that the most impaired patients derived the greatest benefits from the training.

UFOV test performance predicts driving ability in PD patients, say lead researcher Jerri Edwards (University of South Florida, Tampa, USA) and co-workers, although they add that more study is needed to establish if improvements from the SOPT intervention actually translate into longer and safer driving.

However, the improvement in UFOV had no effect on secondary outcomes, they report. Depressive symptoms did not significantly improve in the SOPT versus controls groups, and neither did patients’ scores on the cognitive self-report questionnaire.

Chou and Cronin-Golomb comment that the lack of improvement in the latter outcome “may further discourage patients from continuing with SOPT.”

They caution that follow-up is needed to see if the effects of the intervention are lasting, but conclude that “there is a clear need for nonpharmacologic interventions in the treatment of cognitive dysfunction in PD, and SOPT looks like a promising option.”

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Eleanor McDermid, Senior medwireNews Reporter

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