title: Neurofunctional correlates of attention rehabilitation in Parkinson's disease: an explorative study.
abstract: The effectiveness of cognitive rehabilitation (CR) in Parkinson's disease (PD) is in its relative infancy, and nowadays there is insufficient information to support evidence-based clinical protocols. This study is aimed at testing a validated therapeutic strategy characterized by intensive computer-based attention-training program tailored to attention deficits. We further investigated the presence of synaptic plasticity by means of functional magnetic resonance imaging (fMRI). Using a randomized controlled study, we enrolled eight PD patients who underwent a CR program (Experimental group) and seven clinically/demographically-matched PD patients who underwent a placebo intervention (Control group). Brain activity was assessed using an 8-min resting state (RS) fMRI acquisition. Independent component analysis and statistical parametric mapping were used to assess the effect of CR on brain function. Significant effects were detected both at a phenotypic and at an intermediate phenotypic level. After CR, the Experimental group, in comparison with the Control group, showed a specific enhanced performance in cognitive performance as assessed by the SDMT and digit span forward. RS fMRI analysis for all networks revealed two significant groups (Experimental vs Control) × time (T0 vs T1) interaction effects on the analysis of the attention (superior parietal cortex) and central executive neural networks (dorsolateral prefrontal cortex). We demonstrated that intensive CR tailored for the impaired abilities impacts neural plasticity and improves some aspects of cognitive deficits of PD patients. The reported neurophysiological and behavioural effects corroborate the benefits of our therapeutic approach, which might have a reliable application in clinical management of cognitive deficits.
authors.affiliation: Istituto di Bioimmagini e Fisiologia Molecolare, Consiglio Nazionale delle Ricerche, Unità di Ricerca Neuroimmagini, Germaneto (CZ), 88100, Catanzaro, Italy, a.cerasa@unicz.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cerasa
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Gioia
authors.forename: Maria
authors.initials: M
authors.lastname: Salsone
authors.forename: Giulia
authors.initials: G
authors.lastname: Donzuso
authors.forename: Carmelina
authors.initials: C
authors.lastname: Chiriaco
authors.forename: Sabrina
authors.initials: S
authors.lastname: Realmuto
authors.forename: Alessandra
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bellavia
authors.forename: Aurelia
authors.initials: A
authors.lastname: Banco
authors.forename: Marco
authors.initials: M
authors.lastname: D'amelio
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D001288:Attention / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009415:Nerve Net; D009473:Neuronal Plasticity; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D010300:Parkinson Disease / Q000523:psychology / Q000534:rehabilitation*; D010641:Phenotype; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology; D025341:Principal Component Analysis; D011597:Psychomotor Performance; D016037:Single-Blind Method; D013028:Space Perception / Q000502:physiology; D013813:Therapy, Computer-Assisted; D014796:Visual Perception / Q000502:physiology