COGNITIVE REHABILITATION FOR EVERYDAY EXECUTIVE DYSFUNCTION IN PARKINSON DISEASE

描述（由申请人提供）：认知障碍在帕金森病（PD）患者中很常见，是残疾和生活质量降低的重要原因。现有的PD干预措施不能解决认知障碍，因此目前认为它是治疗优化的主要目标。该指导以患者为导向的职业发展奖（K23）的目的是使候选人能够开发一个受资助的研究计划，将基础认知科学转化为PD的实用和有效的认知干预措施候选人的长期目标是成为一名独立的临床研究者，能够开发，评估和实施认知康复方法，最大限度地提高PD患者的功能效果。为了实现这一目标，提出了三个关键领域的培训和指导：（1）干预试验的设计和实施，（2）与PD认知康复相关的神经和认知机制，以及（3）翻译认知干预的发展。该奖项的研究计划将在培训计划和专家导师和顾问的跨学科团队的支持下实施。它检查了来自实验认知研究的有针对性的干预策略是否能改善前瞻性记忆（记住做事情;例如，记得按处方服药）。具体而言，该项目将确定（1）该策略是否在实验室环境中改善PD参与者的前瞻性记忆，以及（2）旨在帮助PD参与者应用该策略改善日常生活中前瞻性记忆的新型干预措施的可行性和潜在有效性。该项目将采用随机对照设计和严格和系统的方法来开发新的行为治疗方法。前瞻性记忆对于富有成效和独立的生活至关重要，对于遵守医生和治疗师规定的健康行为也是必要的。重要的是，前瞻性记忆障碍与PD患者的生活质量下降有关。因此，有效管理前瞻性记忆障碍的策略可以改善功能和生活质量，并显着影响该人群的临床护理。本研究的数据和经验将支持R01应用程序的开发，以在更大规模的对照疗效试验中测试新型前瞻性记忆干预。本提案中概述的培训和研究活动将补充候选人在职业治疗和PD相关认知研究方面的背景，并使她处于独特的地位，以提高我们治疗PD认知障碍的知识和能力。最终，这项工作将为PD提供全面的认知康复计划，这些计划可以与现有的以身体为重点的康复计划相结合，以改善这些人的生活。 公共卫生相关性：帕金森病（PD）是第二常见的神经退行性疾病。超过90%的PD患者存在一定程度的认知障碍，这是导致残疾和生活质量下降的重要原因。不幸的是，目前还没有成功的干预措施来解决PD中的认知障碍。该提案将使候选人能够开发认知康复方法，最大限度地提高PD患者的功能和生活质量。

DESCRIPTION (provided by applicant): Cognitive impairment is common among individuals with Parkinson disease (PD) and is a significant source of disability and reduced quality of life. Existing interventions for PD do not address cognitive impairment, so it is currently considered a prime target for treatment optimization. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program that translates basic cognitive science into practical and effective cognitive interventions for PD The candidate's long term goal is to become an independent clinical investigator able to develop, evaluate and implement cognitive rehabilitation approaches that maximize functional outcomes for individuals with PD. To achieve this goal, training and mentorship are proposed in three key areas: (1) the design and conduct of intervention trials, (2) the neural and cognitive mechanisms relevant to cognitive rehabilitation for PD, and (3) the development of translational cognitive interventions. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. It examines whether a targeted intervention strategy derived from experimental cognitive research improves prospective memory (remembering to do things; e.g., remembering to take medications as prescribed) in PD. Specifically, this project will determine (1) if the strategy improves PD participants' prospective memory in a laboratory setting, and (2) the feasibility and potential efficacy of a novel intervention designed to help PD participants apply the strategy to improve their prospective memory in everyday life. The project will employ a randomized controlled design and a rigorous and systematic approach to new behavioral treatment development. Prospective memory is essential for productive and independent living and necessary for compliance with physician- and therapist-prescribed health behaviors. Importantly, prospective memory impairment is associated with reduced quality of life among individuals with PD. Therefore, strategies to effectively manage prospective memory impairment could improve function and quality of life and significantly impact clinical care for this population. Data and experience from this study will support the development of an R01 application to test the novel prospective memory intervention in a larger controlled efficacy trial. The training and research activities outlined in this proposal will complement the candidate's background in occupational therapy and PD-related cognitive research and place her in a unique position to advance our knowledge and ability to treat cognitive impairment in PD. Ultimately, this work will lead to comprehensive cognitive rehabilitation programs for PD which can be integrated with existing physically-focused rehabilitation programs to improve the lives of these individuals. PUBLIC HEALTH RELEVANCE: Parkinson disease (PD) is the second most common neurodegenerative disease. Over 90% of individuals with PD experience some degree of cognitive impairment, which is a significant source of disability and reduced quality of life in ths population. Unfortunately, there are currently no successful interventions to address cognitive impairment in PD. This proposal will enable the candidate to develop cognitive rehabilitation approaches that maximize function and quality of life for individuals with PD.