Abstract Details

Title Cognitive Improvement After Six-Week Action Observation and Motor Imagery Training in Patients with Parkinson’s Disease

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-035

Objective

To test whether six-week Action Observation and Motor Imagery Training (AOT-MI) improves cognitive functions in patients with Parkinson’s disease (PD); and to detect the relationship between cognitive and functional MRI (fMRI) activity changes.

Background AOT-MI is known to potentiate motor learning mechanisms.

Design/Methods Twenty PD patients were randomized into two groups: AOT-MI-group performed a 6-week (W6) gait/balance training consisting of AOT-MI combined with practicing the observed-imagined exercises; LANDSCAPE-group performed the same exercises combined with watching landscape videos. Patients underwent pre- and post-treatment fMRI scans while performing a dual-task. Neurological, physiotherapeutic and neuropsychological evaluations were performed at study entry, after training (W6), and after 14 weeks from baseline (W14). Cognitive changes over time were evaluated through computer-based sessions. The effect of training on cognitive performance and the relationship between cognitive and fMRI activity changes were assessed.

Results

At W6, AOT-MI patients improved accuracy and reaction times in subtests assessing the attention switching and the visuospatial localization, and at W14 in subtests assessing the spatial working and recognition memory. At W6 and W14, LANDSCAPE patients improved reaction times in a subtest assessing visuospatial localization. In AOT-MI patients, cognitive improvement related with a greater functional recruitment of fronto-occipital brain areas and affective-cognitive sub-regions of cerebellum and with a reduced recruitment of thalamus and motor sub-regions of cerebellum. On the contrary, LANDSCAPE patient cognitive improvement was related with a greater recruitment of the motor sub-regions of cerebellum.

Conclusions In all patients, a cognitive improvement was observed after a six-week training and persisted after a relatively long-term period. In the AOT-MI group, which showed the most substantial cognitive changes, the greater involvement of extra-motor and the lower involvement of the motor areas after training seem to be crucial for obtaining high cognitive performance, likely reflecting the integration between these circuits.

Authors/Disclosures
Elisa Canu (Ospedale San Raffaele) PRESENTER	The institution of Elisa Canu has received research support from Italian Ministry of Health .
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.
Michela Leocadi, MSc (IRCCS San Raffaele Scientific Institute)	Dr. Leocadi has nothing to disclose.
Elisabetta Sarasso	Elisabetta Sarasso has nothing to disclose.
	No disclosure on file
Sebastiano Galantucci (San Raffaele Scientific Institute)	Mr. Galantucci has nothing to disclose.
Andrea Tettamanti	No disclosure on file
	No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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