VCU news

By Frances Dumenci

The Michael J. Fox Foundation for Parkinson’s Research has awarded a grant to Sarah K. Lageman, Ph.D., a clinician-investigator with the Virginia Commonwealth University Parkinson’s and Movement Disorders Center and an assistant professor of neurology.

The three-year Clinical Intervention Award, totaling more than $107,000, will support research on the benefits of memory and problem-solving training compared to supportive therapy in people with Parkinson’s disease and mild cognitive impairment (MCI).

The project investigates therapies that target neurocognitive symptoms such as thinking difficulties and declines in mood. These neurocognitive symptoms of Parkinson’s often result in significant and progressive decrease in individuals’ activity levels, quality of life and independence, and are a major source of disability for Parkinson’s patients. Neurocognitive decline is a common cause of nursing home admissions for these patients.

Participants in the study will be randomly assigned to receive memory and problem-solving training (cognitive therapy) or supportive therapy for eight weekly sessions. A six-month follow-up evaluation will take place after the end of the sessions. Participants are encouraged to bring a support person with them to the sessions.

To help with memory, cognitive therapy participants will practice keeping a calendar that includes appointments and a to-do list, but also features extra room for more details. “It is a modified personal calendar that is designed for people needing more memory support,” said Lageman.

The problem-solving technique entails a system with five steps to help break down a problem into more manageable pieces. Sample problems may include taking medications, following a diet and exercise regimen, completing household chores or starting a new hobby.

“The problem-solving technique is completely patient-driven. The system remains the same, but patients work on their own chosen goals. They tell us what problems they would like to focus on during the sessions,” Lageman said. “During the pilot study, we had one person who loved to read the newspaper from front to back every morning, but due to MCI, he was unable to maintain his focus on reading the entire paper. He eventually dropped this activity and simply stopped reading the paper. The training helped him by breaking down his problem and thinking of new solutions so he could still enjoy this pastime. For example, picking the best time to read, limiting the period of reading time and picking his favorite parts of the paper to read.”

Participants who are randomly selected for the supportive therapy also go to the center for eight weekly sessions. These therapy sessions are completely patient-driven and provide patients the opportunity to discuss and reflect upon both Parkinson’s and non-Parkinson’s related problems.

The impact of both cognitive and supportive therapies on thinking abilities, physical health and patient and support person ratings of thinking skills, mood and quality of life will be evaluated.

Results from this study will help determine whether these therapies are beneficial for individuals with Parkinson’s and MCI and which therapy might be the most helpful to patients. If positive benefit is observed during this project, these therapies offer strategies that patients can use as their symptoms change, with minimal cost and no known side effects. These therapies could help individuals maintain or improve their thinking skills and mood and also positively impact their daily lives.

For more information about the VCU Parkinson’s and Movement Disorders Center, visit

http://www.parkinson.vcu.edu.