Background. Meta-analyses have demonstrated cognitive training (CT) benefits in Parkinson’s disease (PD) patients. However, the patients’ cognitive status has only rarely been based on established criteria. Also, prediction analyses of CT success have only sparsely been conducted. Objective. To determine CT effects in PD patients with mild cognitive impairment (PD-MCI) on cognitive and noncognitive outcomes compared to an active control group (CG) and to analyze CT success predictors. Methods. Sixty-four PD-MCI patients (age: 67.61 ± 7.70; UPDRS-III: 26.58 ± 13.54; MoCA: 24.47 ± 2.78) were randomized to either a CT group or a low-intensity physical activity CG for six weeks (twice weekly, 90 minutes). Outcomes were assessed before and after training. MANOVAs with follow-up ANOVAs and multiple regression analyses were computed. Results. Both interventions were highly feasible (participation, motivation, and evaluation); the overall dropout rate was 4.7%. Time × group interaction effects favoring CT were observed for phonemic fluency as a specific executive test (, ) and a statistical trend for overall executive functions (, ). A statistical trend for a time × group interaction effect favoring CG was shown for the digit span backward as a working memory test (, ). Regression analyses revealed cognitive baseline levels, education, levodopa equivalent daily dose, motor scores, and ApoE status as significant predictors for CT success. Conclusions. CT is a safe and feasible therapy option in PD-MCI, yielding executive functions improvement. Data indicate that vulnerable individuals may show the largest cognitive gains. Longitudinal studies are required to determine whether CT may also attenuate cognitive decline in the long term. This trial is registered with DRKS00010186.

中文翻译：

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帕金森病和轻度认知障碍患者通过多域群体认知训练增强执行功能而非记忆：一项多中心随机对照试验

背景。荟萃分析已证明认知训练 (CT) 对帕金森病 (PD) 患者的益处。然而，患者的认知状态很少基于既定标准。此外，对 CT 成功率的预测分析也很少进行。客观。与积极对照组 (CG) 相比，确定轻度认知障碍 (PD-MCI) PD 患者的 CT 对认知和非认知结果的影响，并分析 CT 成功预测因素。方法. 64 名 PD-MCI 患者（年龄：67.61 ± 7.70；UPDRS-III：26.58 ± 13.54；MoCA：24.47 ± 2.78）被随机分配到 CT 组或低强度体力活动 CG 组，为期六周（每周两次， 90 分钟）。在培训前后评估结果。计算了具有后续 ANOVA 和多元回归分析的 MANOVA。结果。两种干预措施都是高度可行的（参与、动机和评估）；整体辍学率为4.7%。对于音素流畅性，观察到有利于 CT 的时间 × 组交互效应作为特定的执行测试（, )和整体执行功能的统计趋势 (, ）。作为工作记忆测试，向后数字跨度显示了有利于 CG 的时间 × 组交互效应的统计趋势（, ）。回归分析显示认知基线水平、教育、左旋多巴当量日剂量、运动评分和 ApoE 状态是 CT 成功的重要预测因素。结论。CT 是 PD-MCI 中安全可行的治疗选择，可改善执行功能。数据表明，弱势个体可能表现出最大的认知收益。需要进行纵向研究来确定 CT 是否也可以长期减轻认知能力下降。该试验已在 DRKS00010186 注册。