title: Increased brain connectivity and activation after cognitive rehabilitation in Parkinson's disease: a randomized controlled trial.
abstract: Cognitive rehabilitation programs have demonstrated efficacy in improving cognitive functions in Parkinson's disease (PD), but little is known about cerebral changes associated with an integrative cognitive rehabilitation in PD. To assess structural and functional cerebral changes in PD patients, after attending a three-month integrative cognitive rehabilitation program (REHACOP). Forty-four PD patients were randomly divided into REHACOP group (cognitive rehabilitation) and a control group (occupational therapy). T1-weighted, diffusion weighted and functional magnetic resonance images (fMRI) during resting-state and during a memory paradigm (with learning and recognition tasks) were acquired at pre-treatment and post-treatment. Cerebral changes were assessed with repeated measures ANOVA 2 × 2 for group x time interaction. During resting-state fMRI, the REHACOP group showed significantly increased brain connectivity between the left inferior temporal lobe and the bilateral dorsolateral prefrontal cortex compared to the control group. Moreover, during the recognition fMRI task, the REHACOP group showed significantly increased brain activation in the left middle temporal area compared to the control group. During the learning fMRI task, the REHACOP group showed increased brain activation in the left inferior frontal lobe at post-treatment compared to pre-treatment. No significant structural changes were found between pre- and post-treatment. Finally, the REHACOP group showed significant and positive correlations between the brain connectivity and activation and the cognitive performance at post-treatment. This randomized controlled trial suggests that an integrative cognitive rehabilitation program can produce significant functional cerebral changes in PD patients and adds evidence to the efficacy of cognitive rehabilitation programs in the therapeutic approach for PD.
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Díez-Cirarda
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ojeda
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Peña
authors.affiliation: OSATEK, MR Unit, Hospital of Galdakao, Galdakao, Basque Country, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cabrera-Zubizarreta
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain.
authors.forename: Olaia
authors.initials: O
authors.lastname: Lucas-Jiménez
authors.affiliation: Neurodegenerative Unit, Biocruces Research Institute; Neurology Service, Cruces University Hospital, Bilbao, Biskay, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Gómez-Esteban
authors.affiliation: Neurology Service, Hospital of Galdakao, Galdakao, Basque Country, Spain.
authors.forename: Maria Ángeles
authors.initials: MÁ
authors.lastname: Gómez-Beldarrain
authors.affiliation: Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain. naroa.ibarretxe@deusto.es.
authors.forename: Naroa
authors.initials: N
authors.lastname: Ibarretxe-Bilbao
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007858:Learning / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D009483:Neuropsychological Tests; D009929:Organ Size; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000534:rehabilitation*; D012146:Rest; D016896:Treatment Outcome
keywords: Brain activation; Brain connectivity; Cerebral changes; Parkinson’s disease; Plasticity; Randomized controlled trial