Resting state EEG as biomarker of cognitive training and physical activity's joint effect in Parkinson's patients with mild cognitive impairment

Carlos Trenado; Paula Trauberg; Saskia Elben; Karina Dimenshteyn; Ann-Kristin Folkerts; Karsten Witt; Daniel Weiss; Inga Liepelt-Scarfone; Elke Kalbe; Lars Wojtecki

doi:10.1186/s42466-023-00273-5

Resting state EEG as biomarker of cognitive training and physical activity's joint effect in Parkinson's patients with mild cognitive impairment

Neurol Res Pract. 2023 Sep 14;5(1):46. doi: 10.1186/s42466-023-00273-5.

Authors

Carlos Trenado^#^{1

2

3}, Paula Trauberg^#², Saskia Elben^{1

2}, Karina Dimenshteyn², Ann-Kristin Folkerts⁴, Karsten Witt^{5

6}, Daniel Weiss⁷, Inga Liepelt-Scarfone^{7

8}, Elke Kalbe⁴, Lars Wojtecki^{9

10

11}

Affiliations

¹ Center for Movement Disorders and Neuromodulation, Departmemt of Neurology, University Clinic Duesseldorf, Duesseldorf, Germany.
² Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.
³ Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany.
⁴ Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
⁵ Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller- Str. 3, 24105, Kiel, Germany.
⁶ Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Heiligengeisthöfe 4, 26121, Oldenburg, Germany.
⁷ German Center of Neurodegenerative Diseases (DZNE) and Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
⁸ IB Hochschule für Gesundheit und Soziales, Paulinenstr. 45, 70178, Stuttgart, Germany.
⁹ Center for Movement Disorders and Neuromodulation, Departmemt of Neurology, University Clinic Duesseldorf, Duesseldorf, Germany. Lars.Wojtecki@artemed.de.
¹⁰ Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany. Lars.Wojtecki@artemed.de.
¹¹ Departmemt of Neurology and Neurorehabilitation, Hospital Zum Heiligen Geist, Academic Teaching Hospital of the Heinrich-Heine-University Duesseldorf, Von-Broichhausen-Allee 1, 47906, Kempen, Germany. Lars.Wojtecki@artemed.de.

^# Contributed equally.

Abstract

Background: Cognitive decline is a major factor for the deterioration of the quality of life in patients suffering from Parkinson's disease (PD). Recently, it was reported that cognitive training (CT) in PD patients with mild cognitive impairment (PD-MCI) led to an increase of physical activity (PA) accompanied by improved executive function (EF). Moreover, PA has been shown to alter positively brain function and cognitive abilities in PD. Both observations suggest an interaction between CT and PA.

Objectives: A previous multicenter (MC) study was slightly significant when considering independent effects of interventions (CT and PA) on EF. Here, we use MC constituent single center data that showed no effect of interventions on EF. Thus, this exploratory study considers pooling data from both interventions to gain insight into a recently reported interaction between CT and PA and provide a proof of principle for the usefulness of resting state EEG as a neurophysiological biomarker of joint intervention's effect on EF and attention in PD-MCI.

Methods: Pre- and post-intervention resting state EEG and neuropsychological scores (EF and attention) were obtained from 19 PD-MCI patients (10 (CT) and 9 (PA)). We focused our EEG analysis on frontal cortical areas due to their relevance on cognitive function.

Results: We found a significant joint effect of interventions on EF and a trend on attention, as well as trends for the negative correlation between attention and theta power (pre), the positive correlation between EF and alpha power (post) and a significant negative relationship between attention and theta power over time (post-pre).

Conclusions: Our results support the role of theta and alpha power at frontal areas as a biomarker for the therapeutic joint effect of interventions.

Keywords: Cognitive decline; Diagnostic marker; Mild cognitive impairment; Neurovitalis; Parkinson’s disease; electroencephalogram, non-pharmacological, intervention, physical activity.