Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review
Identifieur interne : 000400 ( Istex/Corpus ); précédent : 000399; suivant : 000401Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review
Auteurs : John V. Hindle ; Annette Petrelli ; Linda Clare ; Elke KalbeSource :
- Movement Disorders [ 0885-3185 ] ; 2013-07.
Abstract
Cognitive decline and dementia are frequent in patients with Parkinson's disease (PD). The evidence for nonpharmacological therapies in Alzheimer's disease and other dementias has been studied systematically, but the evidence is unclear for their efficacy in cognition and dementia in PD. An international collaboration produced a comprehensive, systematic review of the effectiveness and of nonpharmacological and noninvasive therapies in cognitively intact, cognitively impaired, and PD dementia groups. The interventions included cognitive rehabilitation, physical rehabilitation, exercise, and brain stimulation techniques but excluded invasive treatments, such as surgery and deep brain stimulation. The potential biases and evidence levels for controlled trials (CTs) were analyzed based on Cochrane and National Institute for Health and Clinical Excellence criteria. After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. There is an urgent need for rigorous RCTs of nonpharmacological treatments for cognitive impairment and dementia in PD. © 2013 Movement Disorder Society
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DOI: 10.1002/mds.25377
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Hindle</name><affiliation><mods:affiliation>School of Medical Sciences, Bangor University, Bangor, United Kingdom</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Care of the Elderly, Betsi Cadwaladr University Health Board, Llandudno Hospital, Conwy, United Kingdom</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: j.v.hindle@bangor.ac.uk</mods:affiliation></affiliation></author><author><name sortKey="Petrelli, Annette" sort="Petrelli, Annette" uniqKey="Petrelli A" first="Annette" last="Petrelli">Annette Petrelli</name><affiliation><mods:affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Clare, Linda" sort="Clare, Linda" uniqKey="Clare L" first="Linda" last="Clare">Linda Clare</name><affiliation><mods:affiliation>School of Psychology, Bangor University, Bangor, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Kalbe, Elke" sort="Kalbe, Elke" uniqKey="Kalbe E" first="Elke" last="Kalbe">Elke Kalbe</name><affiliation><mods:affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:3F22BAEB633F1005240B809FB3EEBAFBD9C2C08C</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1002/mds.25377</idno><idno type="url">https://api.istex.fr/document/3F22BAEB633F1005240B809FB3EEBAFBD9C2C08C/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000400</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000400</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review</title><author><name sortKey="Hindle, John V" sort="Hindle, John V" uniqKey="Hindle J" first="John V." last="Hindle">John V. Hindle</name><affiliation><mods:affiliation>School of Medical Sciences, Bangor University, Bangor, United Kingdom</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Care of the Elderly, Betsi Cadwaladr University Health Board, Llandudno Hospital, Conwy, United Kingdom</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: j.v.hindle@bangor.ac.uk</mods:affiliation></affiliation></author><author><name sortKey="Petrelli, Annette" sort="Petrelli, Annette" uniqKey="Petrelli A" first="Annette" last="Petrelli">Annette Petrelli</name><affiliation><mods:affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Clare, Linda" sort="Clare, Linda" uniqKey="Clare L" first="Linda" last="Clare">Linda Clare</name><affiliation><mods:affiliation>School of Psychology, Bangor University, Bangor, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Kalbe, Elke" sort="Kalbe, Elke" uniqKey="Kalbe E" first="Elke" last="Kalbe">Elke Kalbe</name><affiliation><mods:affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><date type="published" when="2013-07">2013-07</date><biblScope unit="volume">28</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1034">1034</biblScope><biblScope unit="page" to="1049">1049</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">3F22BAEB633F1005240B809FB3EEBAFBD9C2C08C</idno><idno type="DOI">10.1002/mds.25377</idno><idno type="ArticleID">MDS25377</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Cognitive decline and dementia are frequent in patients with Parkinson's disease (PD). The evidence for nonpharmacological therapies in Alzheimer's disease and other dementias has been studied systematically, but the evidence is unclear for their efficacy in cognition and dementia in PD. An international collaboration produced a comprehensive, systematic review of the effectiveness and of nonpharmacological and noninvasive therapies in cognitively intact, cognitively impaired, and PD dementia groups. The interventions included cognitive rehabilitation, physical rehabilitation, exercise, and brain stimulation techniques but excluded invasive treatments, such as surgery and deep brain stimulation. The potential biases and evidence levels for controlled trials (CTs) were analyzed based on Cochrane and National Institute for Health and Clinical Excellence criteria. After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. There is an urgent need for rigorous RCTs of nonpharmacological treatments for cognitive impairment and dementia in PD. © 2013 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>John V. Hindle MBBS, FRCP, FRCPsych</name><affiliations><json:string>School of Medical Sciences, Bangor University, Bangor, United Kingdom</json:string><json:string>Department of Care of the Elderly, Betsi Cadwaladr University Health Board, Llandudno Hospital, Conwy, United Kingdom</json:string><json:string>E-mail: j.v.hindle@bangor.ac.uk</json:string></affiliations></json:item><json:item><name>Annette Petrelli MSc</name><affiliations><json:string>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</json:string><json:string>Department of Neurology, University Hospital Cologne, Cologne, Germany</json:string></affiliations></json:item><json:item><name>Linda Clare MA, MSc, PhD</name><affiliations><json:string>School of Psychology, Bangor University, Bangor, United Kingdom</json:string></affiliations></json:item><json:item><name>Elke Kalbe PhD</name><affiliations><json:string>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</json:string><json:string>Department of Neurology, University Hospital Cologne, Cologne, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>training</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>exercise</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cognition</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dementia</value></json:item></subject><articleId><json:string>MDS25377</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>reviewArticle</json:string></originalGenre><abstract>Cognitive decline and dementia are frequent in patients with Parkinson's disease (PD). The evidence for nonpharmacological therapies in Alzheimer's disease and other dementias has been studied systematically, but the evidence is unclear for their efficacy in cognition and dementia in PD. An international collaboration produced a comprehensive, systematic review of the effectiveness and of nonpharmacological and noninvasive therapies in cognitively intact, cognitively impaired, and PD dementia groups. The interventions included cognitive rehabilitation, physical rehabilitation, exercise, and brain stimulation techniques but excluded invasive treatments, such as surgery and deep brain stimulation. The potential biases and evidence levels for controlled trials (CTs) were analyzed based on Cochrane and National Institute for Health and Clinical Excellence criteria. After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. 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After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. There is an urgent need for rigorous RCTs of nonpharmacological treatments for cognitive impairment and dementia in PD. © 2013 Movement Disorder Society</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Parkinson's disease</term></item><item><term>training</term></item><item><term>exercise</term></item><item><term>cognition</term></item><item><term>dementia</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Review</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2012-11-28">Received</change><change when="2013-01-03">Registration</change><change when="2013-01-17">Created</change><change when="2013-07">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/3F22BAEB633F1005240B809FB3EEBAFBD9C2C08C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en" xml:id="mds25377"><header><publicationMeta level="product"><doi origin="wiley" registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="80"><doi>10.1002/mds.v28.8</doi><copyright ownership="publisher">Copyright © 2013 Movement Disorder Society</copyright><numberingGroup><numbering type="journalVolume" number="28">28</numbering><numbering type="journalIssue">8</numbering></numberingGroup><coverDate startDate="2013-07">July 2013</coverDate></publicationMeta><publicationMeta level="unit" position="70" type="reviewArticle" status="forIssue"><doi>10.1002/mds.25377</doi><idGroup><id type="unit" value="MDS25377"></id></idGroup><countGroup><count type="pageTotal" number="16"></count></countGroup><titleGroup><title type="articleCategory">Review</title><title type="tocHeading1">Review</title></titleGroup><copyright ownership="publisher">Copyright © 2013 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2012-11-28"></event><event type="manuscriptRevised" date="2012-12-27"></event><event type="manuscriptAccepted" date="2013-01-03"></event><event type="xmlCreated" agent="Cenveo Publisher Services" date="2013-01-17"></event><event type="publishedOnlineEarlyUnpaginated" date="2013-02-20"></event><event type="publishedOnlineFinalForm" date="2013-08-12"></event><event type="firstOnline" date="2013-02-20"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-05"></event></eventGroup><numberingGroup><numbering type="pageFirst">1034</numbering><numbering type="pageLast">1049</numbering></numberingGroup><correspondenceTo><b>Correspondence to:</b> Dr. Hindle, Llandudno Hospital, Llandudno, Conwy LL30 1LB, UK; <email>j.v.hindle@bangor.ac.uk</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS25377.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review</title><title type="short">Nonpharmacological Therapy Pd Cognition</title><title type="shortAuthors">Hindle et al.</title></titleGroup><creators><creator affiliationRef="#mds25377-aff-0001 #mds25377-aff-0002" corresponding="yes" noteRef="#mds25377-note-0001" creatorRole="author" xml:id="mds25377-cr-0001"><personName><givenNames>John V.</givenNames><familyName>Hindle</familyName><degrees>MBBS, FRCP, FRCPsych</degrees></personName></creator><creator affiliationRef="#mds25377-aff-0003 #mds25377-aff-0004" noteRef="#mds25377-note-0001" creatorRole="author" xml:id="mds25377-cr-0002"><personName><givenNames>Annette</givenNames><familyName>Petrelli</familyName><degrees>MSc</degrees></personName></creator><creator affiliationRef="#mds25377-aff-0005" creatorRole="author" xml:id="mds25377-cr-0003"><personName><givenNames>Linda</givenNames><familyName>Clare</familyName><degrees>MA, MSc, PhD</degrees></personName></creator><creator affiliationRef="#mds25377-aff-0003 #mds25377-aff-0004" creatorRole="author" xml:id="mds25377-cr-0004"><personName><givenNames>Elke</givenNames><familyName>Kalbe</familyName><degrees>PhD</degrees></personName></creator></creators><affiliationGroup><affiliation countryCode="GB" type="organization" xml:id="mds25377-aff-0001"><orgDiv>School of Medical Sciences</orgDiv><orgName>Bangor University</orgName><address><city>Bangor</city><country>United Kingdom</country></address></affiliation><affiliation countryCode="GB" type="organization" xml:id="mds25377-aff-0002"><orgDiv>Department of Care of the Elderly</orgDiv><orgName>Betsi Cadwaladr University Health Board, Llandudno Hospital</orgName><address><city>Conwy</city><country>United Kingdom</country></address></affiliation><affiliation countryCode="DE" type="organization" xml:id="mds25377-aff-0003"><orgDiv>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention</orgDiv><orgName>University of Vechta</orgName><address><city>Vechta</city><country>Germany</country></address></affiliation><affiliation countryCode="DE" type="organization" xml:id="mds25377-aff-0004"><orgDiv>Department of Neurology</orgDiv><orgName>University Hospital Cologne</orgName><address><city>Cologne</city><country>Germany</country></address></affiliation><affiliation countryCode="GB" type="organization" xml:id="mds25377-aff-0005"><orgDiv>School of Psychology</orgDiv><orgName>Bangor University</orgName><address><city>Bangor</city><country>United Kingdom</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="mds25377-kwd-0001">Parkinson's disease</keyword><keyword xml:id="mds25377-kwd-0002">training</keyword><keyword xml:id="mds25377-kwd-0003">exercise</keyword><keyword xml:id="mds25377-kwd-0004">cognition</keyword><keyword xml:id="mds25377-kwd-0005">dementia</keyword></keywordGroup><abstractGroup><abstract type="main"><title type="main">ABSTRACT</title><p>Cognitive decline and dementia are frequent in patients with Parkinson's disease (PD). The evidence for nonpharmacological therapies in Alzheimer's disease and other dementias has been studied systematically, but the evidence is unclear for their efficacy in cognition and dementia in PD. An international collaboration produced a comprehensive, systematic review of the effectiveness and of nonpharmacological and noninvasive therapies in cognitively intact, cognitively impaired, and PD dementia groups. The interventions included cognitive rehabilitation, physical rehabilitation, exercise, and brain stimulation techniques but excluded invasive treatments, such as surgery and deep brain stimulation. The potential biases and evidence levels for controlled trials (CTs) were analyzed based on Cochrane and National Institute for Health and Clinical Excellence criteria. After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. There is an urgent need for rigorous RCTs of nonpharmacological treatments for cognitive impairment and dementia in PD. © 2013 <i>Movement</i> Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="mds25377-note-0001"><p>The first two authors contributed equally to this article.</p></note><note xml:id="mds25377-note-0002"><p>Relevant conflicts of interest/financial disclosures: Nothing to report.</p></note><note xml:id="mds25377-note-0003"><p>Full financial disclosures and author roles may be found in the Acknowledgments section online.</p></note><note xml:id="mds25377-note-0004"><p><b>Funding agencies:</b> John V. Hindle was funded in Wales as a Research Fellow by a grant from Academic Health Science Collaboration‐National Institute for Social Care and Health Research.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Nonpharmacological Therapy Pd Cognition</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review</title></titleInfo><name type="personal"><namePart type="given">John V.</namePart><namePart type="family">Hindle</namePart><namePart type="termsOfAddress">MBBS, FRCP, FRCPsych</namePart><affiliation>School of Medical Sciences, Bangor University, Bangor, United Kingdom</affiliation><affiliation>Department of Care of the Elderly, Betsi Cadwaladr University Health Board, Llandudno Hospital, Conwy, United Kingdom</affiliation><description>The first two authors contributed equally to this article.</description><affiliation>E-mail: j.v.hindle@bangor.ac.uk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Annette</namePart><namePart type="family">Petrelli</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</affiliation><affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</affiliation><description>The first two authors contributed equally to this article.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Linda</namePart><namePart type="family">Clare</namePart><namePart type="termsOfAddress">MA, MSc, PhD</namePart><affiliation>School of Psychology, Bangor University, Bangor, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elke</namePart><namePart type="family">Kalbe</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Institute of Gerontology and Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany</affiliation><affiliation>Department of Neurology, University Hospital Cologne, Cologne, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-07</dateIssued><dateCreated encoding="w3cdtf">2013-01-17</dateCreated><dateCaptured encoding="w3cdtf">2012-11-28</dateCaptured><dateValid encoding="w3cdtf">2013-01-03</dateValid><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Cognitive decline and dementia are frequent in patients with Parkinson's disease (PD). The evidence for nonpharmacological therapies in Alzheimer's disease and other dementias has been studied systematically, but the evidence is unclear for their efficacy in cognition and dementia in PD. An international collaboration produced a comprehensive, systematic review of the effectiveness and of nonpharmacological and noninvasive therapies in cognitively intact, cognitively impaired, and PD dementia groups. The interventions included cognitive rehabilitation, physical rehabilitation, exercise, and brain stimulation techniques but excluded invasive treatments, such as surgery and deep brain stimulation. The potential biases and evidence levels for controlled trials (CTs) were analyzed based on Cochrane and National Institute for Health and Clinical Excellence criteria. After exclusions, 18 studies were reviewed, including 5 studies of cognitive training, 4 of exercise and physical therapies, 4 of combined cognitive and physical interventions, and 5 of brain stimulation techniques. The methodology, study populations, interventions, outcomes, control groups, analyses, results, limitations, biases, and evidence levels of all reviewed studies were described. There were 9 CTs, including 6 randomized CTs (RCTs). Although 5 trials showed positive results, only 1 study of cognitive training achieved evidence grading of 1+ with a low risk of bias. There were no studies on PD dementia. Current research on nonpharmacological therapies for cognitive dysfunction and dementia in PD is very limited in quantity and quality. There is an urgent need for rigorous RCTs of nonpharmacological treatments for cognitive impairment and dementia in PD. © 2013 Movement Disorder Society</abstract><subject><genre>keywords</genre><topic>Parkinson's disease</topic><topic>training</topic><topic>exercise</topic><topic>cognition</topic><topic>dementia</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov Disord.</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Review</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>28</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>1034</start><end>1049</end><total>16</total></extent></part></relatedItem><identifier type="istex">3F22BAEB633F1005240B809FB3EEBAFBD9C2C08C</identifier><identifier type="DOI">10.1002/mds.25377</identifier><identifier type="ArticleID">MDS25377</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2013 Movement Disorder SocietyCopyright © 2013 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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