Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease

Joseph DeGutis; Courtney Aul; Olivier J Barthelemy; Breanna L Davis; Shaikhah Alshuaib; Anna Marin; Shraddha B Kinger; Terry D Ellis; Alice Cronin-Golomb

doi:10.1016/j.neuropsychologia.2023.108698

Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease

Neuropsychologia. 2023 Nov 5:190:108698. doi: 10.1016/j.neuropsychologia.2023.108698. Epub 2023 Oct 6.

Authors

Joseph DeGutis¹, Courtney Aul², Olivier J Barthelemy³, Breanna L Davis³, Shaikhah Alshuaib³, Anna Marin³, Shraddha B Kinger³, Terry D Ellis⁴, Alice Cronin-Golomb⁵

Affiliations

¹ Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
² Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA.
³ Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
⁴ Department of Physical Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, MA, USA.
⁵ Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA. Electronic address: alicecg@bu.edu.

PMID: 37806442
DOI: 10.1016/j.neuropsychologia.2023.108698

Abstract

Objective: Parkinson's disease (PD) side of motor symptom onset has been associated with distinct cognitive deficits; individuals with left-side onset (LPD) show more visuospatial impairments, whereas those with right-side onset (RPD) show more verbal impairments. Non-spatial attention is a critical cognitive ability associated with motor functioning that is right hemisphere lateralized but has not been characterized with regard to PD side of onset. We compared individuals with LPD and RPD on non-spatial attention tasks and examined differential responses to a 4-week sustained attention training program.

Method: Participants included 9 with LPD and 12 with RPD, who performed both brief and extended go/no-go continuous performance tasks and an attentional blink task. Participants also engaged in an at-home sustained attention training program, Tonic and Phasic Alertness Training (TAPAT), 5 days/week for 4 weeks. We assessed cognitive and motor symptoms before and after training, and after a 4-week no-contact period.

Results: At baseline, participants with LPD exhibited worse performance than those with RPD on the extended continuous performance task, indicating specific deficits in sustaining attention. Poorer attention was associated with worse clinical motor scores. Notably, side of onset had a significant effect on clinical motor changes after sustained attention training, with only LPD participants improving after training, and 4/9 showing clinically meaningful improvements.

Conclusions: Compared to RPD, participants with LPD had poorer sustained attention pre-training and were more likely to improve on clinical motor functioning after sustained attention training. These findings support mechanistic differences between LPD and RPD and suggest potential differential treatment approaches.

Keywords: Cognitive training; Parkinson's Disease; Side of motor onset effects; Sustained attention.

MeSH terms

Cognition Disorders*
Functional Laterality / physiology
Humans
Neuropsychological Tests
Parkinson Disease* / complications
Parkinson Disease* / psychology
Psychomotor Performance / physiology