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Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease?
Background: The cognitive status is generally considered as a major determinant of rehabilitation outcome in Parkinson’s disease (PD). No studies about the effect of cognitive impairment on motor rehabilitation outcomes in PD have been performed before. Objective: This study is aimed to evaluate the...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980388/ https://www.ncbi.nlm.nih.gov/pubmed/27563290 http://dx.doi.org/10.3389/fnagi.2016.00192 |
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author | Ferrazzoli, Davide Ortelli, Paola Maestri, Roberto Bera, Rossana Giladi, Nir Ghilardi, Maria Felice Pezzoli, Gianni Frazzitta, Giuseppe |
author_facet | Ferrazzoli, Davide Ortelli, Paola Maestri, Roberto Bera, Rossana Giladi, Nir Ghilardi, Maria Felice Pezzoli, Gianni Frazzitta, Giuseppe |
author_sort | Ferrazzoli, Davide |
collection | PubMed |
description | Background: The cognitive status is generally considered as a major determinant of rehabilitation outcome in Parkinson’s disease (PD). No studies about the effect of cognitive impairment on motor rehabilitation outcomes in PD have been performed before. Objective: This study is aimed to evaluate the impact of cognitive decline on rehabilitation outcomes in patients with PD. Methods: We retrospectively identified 485 patients with PD hospitalized for a 4-week Multidisciplinary Intensive Rehabilitation Treatment (MIRT) between January 2014 and September 2015. According to Mini Mental State Examination (MMSE), patients were divided into: group 1—normal cognition (score 27–30), group 2—mild cognitive impairment (score 21–26), group 3—moderate or severe cognitive impairment (score ≤ 20). According to Frontal Assessment Battery (FAB), subjects were divided into patients with normal (score ≥13.8) and pathological (score <13.8) executive functions. The outcome measures were: Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Disability Scale (PDDS), Six Minutes Walking Test (6MWT), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS). Results: All scales had worse values with the increase of cognitive impairment and passing from normal to pathological executive functions. After rehabilitation, all the outcome measures improved in all groups (p < 0.0001). Between groups, the percentage of improvement was significantly different for total UPDRS (p = 0.0009, best improvement in normal MMSE group; p = 0.019, best improvement in normal FAB group), and BBS (p < 0.0001, all pairwise comparisons significant, best improvement in patients with worse MMSE score; p < 0.0001, best improvement in patients with pathological FAB). TUG (p = 0.006) and BBS (p < 0.0001) improved in patients with pathological FAB score, more than in those with normal FAB score. Conclusions: Patients gain benefit in the rehabilitative outcomes, regardless of cognition. Our data suggest that rehabilitation could be effective also in Parkinsonian subjects with cognitive impairment, as well as with dysexecutive syndrome. |
format | Online Article Text |
id | pubmed-4980388 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-49803882016-08-25 Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? Ferrazzoli, Davide Ortelli, Paola Maestri, Roberto Bera, Rossana Giladi, Nir Ghilardi, Maria Felice Pezzoli, Gianni Frazzitta, Giuseppe Front Aging Neurosci Neuroscience Background: The cognitive status is generally considered as a major determinant of rehabilitation outcome in Parkinson’s disease (PD). No studies about the effect of cognitive impairment on motor rehabilitation outcomes in PD have been performed before. Objective: This study is aimed to evaluate the impact of cognitive decline on rehabilitation outcomes in patients with PD. Methods: We retrospectively identified 485 patients with PD hospitalized for a 4-week Multidisciplinary Intensive Rehabilitation Treatment (MIRT) between January 2014 and September 2015. According to Mini Mental State Examination (MMSE), patients were divided into: group 1—normal cognition (score 27–30), group 2—mild cognitive impairment (score 21–26), group 3—moderate or severe cognitive impairment (score ≤ 20). According to Frontal Assessment Battery (FAB), subjects were divided into patients with normal (score ≥13.8) and pathological (score <13.8) executive functions. The outcome measures were: Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Disability Scale (PDDS), Six Minutes Walking Test (6MWT), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS). Results: All scales had worse values with the increase of cognitive impairment and passing from normal to pathological executive functions. After rehabilitation, all the outcome measures improved in all groups (p < 0.0001). Between groups, the percentage of improvement was significantly different for total UPDRS (p = 0.0009, best improvement in normal MMSE group; p = 0.019, best improvement in normal FAB group), and BBS (p < 0.0001, all pairwise comparisons significant, best improvement in patients with worse MMSE score; p < 0.0001, best improvement in patients with pathological FAB). TUG (p = 0.006) and BBS (p < 0.0001) improved in patients with pathological FAB score, more than in those with normal FAB score. Conclusions: Patients gain benefit in the rehabilitative outcomes, regardless of cognition. Our data suggest that rehabilitation could be effective also in Parkinsonian subjects with cognitive impairment, as well as with dysexecutive syndrome. Frontiers Media S.A. 2016-08-11 /pmc/articles/PMC4980388/ /pubmed/27563290 http://dx.doi.org/10.3389/fnagi.2016.00192 Text en Copyright © 2016 Ferrazzoli, Ortelli, Maestri, Bera, Giladi, Ghilardi, Pezzoli and Frazzitta. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution and reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Ferrazzoli, Davide Ortelli, Paola Maestri, Roberto Bera, Rossana Giladi, Nir Ghilardi, Maria Felice Pezzoli, Gianni Frazzitta, Giuseppe Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title | Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title_full | Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title_fullStr | Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title_full_unstemmed | Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title_short | Does Cognitive Impairment Affect Rehabilitation Outcome in Parkinson’s Disease? |
title_sort | does cognitive impairment affect rehabilitation outcome in parkinson’s disease? |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980388/ https://www.ncbi.nlm.nih.gov/pubmed/27563290 http://dx.doi.org/10.3389/fnagi.2016.00192 |
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