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NPJ Parkinsons Dis. 2018 May 18;4:15. doi: 10.1038/s41531-018-0052-6. eCollection 2018.

Cognitive training for freezing of gait in Parkinson's disease: a randomized controlled trial.

Author information

1
1Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Camperdown, NSW Australia.
2
2Healthy Brain Ageing Program, Brain and Mind Centre & Charles Perkins Centre, University of Sydney, Sydney, NSW Australia.
3
3School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW Australia.
4
4Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
5
5School of Psychology, Stanford University, Palo Alto, CA USA.

Abstract

The pathophysiological mechanism of freezing of gait (FoG) has been linked to executive dysfunction. Cognitive training (CT) is a non-pharmacological intervention which has been shown to improve executive functioning in Parkinson's disease (PD). This study aimed to explore whether targeted CT can reduce the severity of FoG in PD. Patients with PD who self-reported FoG and were free from dementia were randomly allocated to receive either a CT intervention or an active control. Both groups were clinician-facilitated and conducted twice-weekly for seven weeks. The primary outcome was percentage of time spent frozen during a Timed Up and Go task, assessed both on and off dopaminergic medications. Secondary outcomes included multiple neuropsychological and psychosocial measures. A full analysis was first conducted on all participants randomized, followed by a sample of interest including only those who had objective FoG at baseline, and completed the intervention. Sixty-five patients were randomized into the study. The sample of interest included 20 in the CT group and 18 in the active control group. The primary outcome of percentage time spent frozen during a gait task was significantly improved in the CT group compared to active controls in the on-state. There were no differences in the off-state. Patients who received CT also demonstrated improved processing speed and reduced daytime sleepiness compared to those in the active control. The findings suggest that CT can reduce the severity of FoG in the on-state, however replication in a larger sample is required.

Conflict of interest statement

The authors declare no competing interests.

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