Freezing of gait (FoG) is a disabling symptom of Parkinson’s Disease, characterised by patients becoming stuck while walking and unable to move forward. It is well-known to lead to falls and lower quality of life, making it an important target for treatment.
Research has linked FoG to aspects of attention and cognitive control. Patients with Parkinson’s Disease who self-reported FoG and who were free from dementia were randomly allocated to receive either a cognitive training intervention or an active control.
65 patients were randomised into the study. 20 patients were randomly assigned to the cognitive training intervention and 18 were randomised to the active control group. Both groups were clinician-led and conducted twice-weekly for seven weeks. The primary outcome was the percentage of time spent frozen during a ‘Timed Up and Go’ task, assessed while patients were both on and off dopaminergic medications.
A large and statistically significant reduction in FoG severity was shown in patients in the cognitive training group on dopaminergic medication, compared to participants in the active control group on dopaminergic medication. Patients who received cognitive training also showed improved cognitive processing speed and reduced daytime sleepiness compared to those in the active control while accounting for the effect of dopaminergic medication. There was no difference between groups when they were tested without their regular dopaminergic medication. More studies using larger samples are needed to investigate this initial finding that cognitive training can reduce the severity of freezing of gait in Parkinson’s diseases patients.
The EU Joint Programme – Neurodegenerative Disease Research (JPND) initiative has announced a joint transnational call for multinational research on personalised medicine for neurodegenerative diseases.
Neurodegenerative diseases are debilitating and still largely untreatable conditions. These diseases are characterised by a large variability in their origins, mechanisms and clinical expression, requiring treatments that will need to take into account all these specificities. Deciphering this variability is one of the biggest challenges in the treatment of neurodegenerative diseases and the way forward is Precision Medicine, supported by highly personalised approaches for the greatest benefit of the patients.
In this context, in partnership with the European Commission, JPND announced today a new call, inviting multinational research teams to submit proposals for ambitious, innovative, multinational and multidisciplinary collaborative research projects to change the trajectory of these debilitating diseases through the development of Precision Medicine approaches.
JPND has chosen to focus in the area of Precision Medicine, which relates to the targeting of specific elements responsible for pathology in a given individual at a particular point in time. It is an emerging approach for disease prevention, diagnosis and treatment that takes into account individual variability in genes, biological/molecular characteristics together with environmental and lifestyle factors.
According to Professor Philippe Amouyel, University of Lille (France) and Chair of the JPND Management Board:
Professor Philippe Amouyel, Chair of JPND
“During the last ten years, researchers have progressively uncovered the high complexity and wide diversity of neurodegenerative diseases. We need now to complete and use this massive amount of knowledge to develop targeted approaches to more efficiently fight the dramatic progression of these diseases.”
According to Professor Thomas Gasser, University of Tübingen (Germany) and Chair of the JPND Scientific Advisory Board:
“Progresses in precision medicine will be a unique way to develop innovative approaches to prevent, slow down and cure neurodegenerative diseases. This call aims to harness the necessary expertise across Europe and globally, to address this research challenge. ”
Professor Amouyel added: “With this in mind, JPND participating countries in close collaboration with the European Commission have identified precision medicine as a major issue to tackle the global challenge of neurodegenerative diseases.”
Proposals submitted under this call, which is open to applicants in 24 countries, must focus on Precision Medicine in one or several of the following research areas:
Diagnosis (e.g. biomarkers, imaging data, omics approaches, big data analyses)
Prevention (e.g. biomarkers for studying novel treatments and interventions, co-morbidities, digital technologies, stratification within cohort studies and clinical trials)
Care (e.g. improvement of social and health care systems, molecular profiling, imaging, lifestyle data)
Proposals must also relate to any or several of the following neurodegenerative diseases: Alzheimer’s disease and other dementias, Parkinson’s disease and PD-related disorders, Prion diseases, Motor Neuron diseases, Hungtington’s disease, Spinocerebellar ataxia and Spinal muscular atrophy. JPND is committed to Patient and Public Involvement, and proposals are expected to engage patients, carers and the public.
Pre-proposals must be submitted no later than 15:00h C.E.T. on March 12, 2019.
For more information about the call, please click here.
The EU Joint Programme on Neurodegenerative Disease Research (JPND) was established to better coordinate research efforts across countries and disciplines to more rapidly find causes, develop cures and identify better ways to care for people with neurodegenerative disease. Today more than 40 million people worldwide are estimated to be living with Alzheimer’s disease and related disorders – the most common class of neurodegenerative disease – and this figure is expected to rise in the coming decades. The JPND Research and Innovation Strategy identified research priorities and provided a framework for future investment and is available for download here.
Final call information will be published on the JPND website (www.jpnd.eu).
Moderate to high intensity exercise does not slow cognitive impairment in older people with dementia, a trial published by The BMJ finds. The view that exercise might slow cognitive decline has gained popularity, however, recent reviews of trials of exercise training in people with dementia have shown conflicting results.
A team of UK researchers decided to estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with dementia. 494 people with mild to moderate dementia living in the community across 15 regions of England were involved. Participants were randomly assigned to either a supervised exercise and support programme or to usual care. The main outcome was an Alzheimer’s disease assessment score (ADAS-cog) at 12 months. Other (secondary) outcomes included activities of daily living, number of falls, and quality of life.
Compliance with exercise was good and participants were assessed again at six and 12 months. The researchers found that cognitive impairment declined over the 12-month follow-up in both groups. The exercise group showed improved physical fitness in the short term, but higher ADAS-cog scores at 12 months (25.2 v 23.8) compared with the usual care group, indicating worse cognitive impairment.