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@ARTICLE{Giehl:889195,
      author       = {Giehl, Kathrin and Ophey, Anja and Hammes, Jochen and
                      Rehberg, Sarah and Lichtenstein, Thorsten and Reker, Paul
                      and Eggers, Carsten and Kalbe, Elke and van Eimeren, Thilo},
      title        = {{W}orking memory training increases neural efficiency in
                      {P}arkinson’s disease: a randomized controlled trial},
      journal      = {Brain communications},
      volume       = {2},
      number       = {2},
      issn         = {2632-1297},
      address      = {[Großbritannien]},
      publisher    = {Guarantors of Brain},
      reportid     = {FZJ-2021-00105},
      pages        = {fcaa115},
      year         = {2020},
      abstract     = {Impairment of working memory and executive functions is
                      already frequently observed in early stages of Parkinson’s
                      disease. Improvements in working memory performance in this
                      cohort could potentially be achieved via working memory
                      training. However, the specific neural mechanisms underlying
                      different working memory processes such as maintenance as
                      opposed to manipulation are largely under-investigated in
                      Parkinson’s disease. Moreover, the plasticity of these
                      correlates as a function of working memory training is
                      currently unknown in this population. Thus, the working
                      memory subprocesses of maintenance and manipulation were
                      assessed in 41 cognitively healthy patients with
                      Parkinson’s disease using a newly developed working memory
                      paradigm and functional MRI. Nineteen patients were
                      randomized to a 5-week home-based digital working memory
                      training intervention while the remaining patients entered a
                      control, wait list condition. Working memory task-related
                      activation patterns and context-dependent functional
                      connectivity, as well as the change of these neural
                      correlates as a function of training, were assessed. While
                      both working memory processes activated an extended
                      frontoparietal–cerebellar network, only the manipulation
                      of items within working memory also recruited the anterior
                      striatum. The intervention effect on the neural correlates
                      was small, but decreased activation in areas relevant for
                      working memory could be observed, with activation changes
                      correlating with behavioural change. Moreover, training
                      seemed to result in decreased functional connectivity when
                      pure maintenance was required, and in a reorganization of
                      functional connectivity when items had to be manipulated. In
                      accordance with the neural efficacy hypothesis, training
                      resulted in overall reduced activation and reorganized
                      functional connectivity, with a differential effect on the
                      different working memory processes under investigation. Now,
                      larger trials including follow-up examinations are needed to
                      further explore the long-term effects of such interventions
                      on a neural level and to estimate the clinical relevance to
                      potentially delay cognitive decline in cognitively healthy
                      patients with Parkinson’s disease.Keywords: idiopathic
                      Parkinson’s disease, home-based working memory training,
                      functional magnetic resonance imaging, blood oxygen level
                      dependent signal, functional connectivity},
      cin          = {INM-2},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-2-20090406},
      pnm          = {89573 - Neuroimaging (POF2-89573)},
      pid          = {G:(DE-HGF)POF2-89573},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {32954349},
      UT           = {WOS:000639431800056},
      doi          = {10.1093/braincomms/fcaa115},
      url          = {https://juser.fz-juelich.de/record/889195},
}