Explain the research in the context of the physiology and pathophysiology presented in the article (LO1)
Analyse and critique the research using the Population Intervention Comparisons Outcomes (PICO) framework (L02)
Analyse the relevance of this research to clinical practice (LO2)
Effects of working memory training in patients with Parkinson’s disease without cognitive impairment: A randomized controlled trial
Cognitive decline is a common non-motor symptom in Parkinson’s Disease (PD)  interfering with the quality of life and increasing the risk of developing PD dementia (PDD) . Working Memory (WM) and executive functions are considered the most vulnerable cognitive domains in PD [3,4], with deficits in these domains even occurring in the absence of global clinically relevant cognitive decline.
Meanwhile, alterations in corresponding neural networks  and dopaminergic functions  occur early in the disease course as well [7,8]. Given that pharmacotherapy is limited, non-pharmacological interventions
Our aim was to investigate the feasibility and efficacy of WMT in PD by conducting an RCT evaluating WMT in PD including not only a post-intervention evaluation, but also a 3-months follow-up, and an elaborated neuropsychological characterization of the patients’ cognitive status.
The study was designed as a single-blind RCT to evaluate the effects of a 5-week computerized WMT compared to a waiting list control group (CG). Clinical and neuropsychological assessment took place at baseline, the week after the 5-week training/waiting period (posttest, 5.67 ± 0.58 weeks after baseline), and at 3-months follow-up (14.03 ± 0.86 weeks after posttest).
The study also involved an optout fMRI imaging module, for which the results will be published elsewhere. The study took place between September 2016 and July 2018. Patients were recruited via regional neurologists and PD support groups and the University Hospital of Cologne, Germany. Outcome assessors were blinded for group allocation, patients were not.
The study was conducted in compliance with the World Medical Association Declaration of Helsinki. The study protocol was approved by the local ethics committee of the Medical Faculty of the University of Cologne (vote-no.16–043) and registered with the German Clinical Trials Register (drks.de, DRKS00009379). All participants gave written informed consent for participation before the baseline assessment. The reporting of this RCT follows the CONSORT guidelines (CONSORT Checklist, see Supplementary Material 1).
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