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，是残疾和生活质量下降的重要来源。现有的PD干预措施并没有解决认知障碍，因此它目前被认为是治疗优化的主要目标。本指导患者导向职业发展奖（K23）的目的是使候选人能够开发一个资助的研究项目，将基础认知科学转化为实用有效的PD认知干预。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患者的功能结果。为了实现这一目标，我们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)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由专家导师和顾问组成的跨学科团队的支持下实施。它检验了来自实验性认知研究的有针对性的干预策略是否能改善PD患者的前瞻记忆（记住做某事，例如，记住按处方服药）。具体而言，本项目将确定(1)该策略是否在实验室环境中改善帕金森病患者的前瞻记忆，以及(2)旨在帮助帕金森病患者在日常生活中应用该策略改善其前瞻记忆的新干预措施的可行性和潜在功效。该项目将采用随机对照设计和严格系统的方法来开发新的行为治疗方法。前瞻记忆对于富有成效和独立的生活是必不可少的，对于遵守医生和治疗师规定的健康行为是必要的。重要的是，前瞻记忆障碍与PD患者生活质量下降有关。因此，有效管理前瞻性记忆障碍的策略可以改善该人群的功能和生活质量，并显著影响临床护理。这项研究的数据和经验将支持R01应用程序的开发，以在更大的对照疗效试验中测试新的前瞻性记忆干预。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，并将她置于一个独特的位置，以提高我们治疗PD认知障碍的知识和能力。最终，这项工作将导致PD的全面认知康复计划，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。

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.