Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 21:11:100277.
doi: 10.1016/j.prdoa.2024.100277. eCollection 2024.

Coupling neurologic music therapy with immersive virtual reality to improve executive functions in individuals with Parkinson's disease: A Quasi-Randomized Clinical Trial

Federica Impellizzeri  1 , Maria Grazia Maggio  1 , Paolo De Pasquale  1 , Mirjam Bonanno  1 , Lilla Bonanno  1 , Rosaria De Luca  1 , Giuseppe Paladina  1 , Angela Alibrandi  2 , Demetrio Milardi  3 , Michael Thaut  4 , Corene Hurt  4 , Angelo Quartarone  1 , Rocco Salvatore Calabrò  1
Affiliations

Coupling neurologic music therapy with immersive virtual reality to improve executive functions in individuals with Parkinson's disease: A Quasi-Randomized Clinical Trial

Federica Impellizzeri et al. Clin Park Relat Disord. .

Abstract

Introduction: Parkinson's disease (PD) is one the most common neurodegenerative movement disorder, leading to motor and non-motor symptoms, including deficits in executive functions (EF), memory, visuospatial abilities, and psychomotor speed. Current treatments are primarily symptomatic, involving pharmacological, surgical strategies. Neurologic Music Therapy (NMT) has gained recognition for its effectiveness in neurorehabilitation of PD patients and improving motor and cognitive domains, such as EF. This study combines NMT with the virtual reality (VR) platform Computer-Assisted Rehabilitation Environment (CAREN), offering customizable environments for rhythmic cue practice to provide an innovative approach to Parkinson's rehabilitation.

Methods: In our single-blind quasi-randomized controlled trial, forty patients were assigned to either an experimental group (EG = 20) or a control group (CG = 20). Both groups underwent two months of training with CAREN scenarios (three times a week for 24 sessions). The experimental group additionally received NMT applied to the selected scenarios. Participants were evaluated by a neuropsychologist at baseline and immediately after training.

Results: Intra-group analysis showed significant improvements in the EG for MOCA (p = 0.007), FAB (p = 0.008), Stroop Error (p = 0.003), Stroop Time (p < 0.001), and Visual Search (p < 0.001). The CG showed a significant difference only in Stroop Error (p = 0.02).

Conclusions: This pilot study is the first to combine NMT with CAREN in PD patients. Our findings suggest that NMT, within an immersive VR environment, effectively improves cognitive and EF in PD. Music structured within NMT techniques, coupled with advanced audio-visual feedback from VR, offers an innovative and potentially more effective approach for managing cognitive and executive deficits associated with PD.

Keywords: Computer-Assisted Rehabilitation Environment (CAREN); Executive Functions (EF); Neurologic Music Therapy (NMT); Parkinson’s disease (PD).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest regarding the research, authorship, or publication of this article.

Figures

Fig. 1
Fig. 1
Flow diagram.
See this image and copyright information in PMC

References

    1. Riccò M., Vezzosi L., Balzarini F., Gualerzi G., Ranzieri S., Signorelli C., et al. Prevalence of Parkinson disease in Italy: a systematic review and meta-analysis. Acta Biomed. 2020;91(3):e2020088. - PMC - PubMed
    1. Schapira A.H.V., Chaudhuri K.R., Jenner P. Non-motor features of Parkinson disease. Nat. Rev. Neurosci. [Internet] 2017;18(7):435–450. doi: 10.1038/nrn.2017.62. - DOI - PubMed
    1. Baschi R., Nicoletti A., Restivo V., Recca D., Zappia M., Monastero R. Frequency and correlates of subjective memory complaints in Parkinson’s disease with and without mild cognitive impairment: data from the Parkinson’s disease cognitive impairment study. J. Alzheimer’s Dis. 2018;63(3):1015–1024. - PubMed
    1. Monastero R., Cicero C.E., Baschi R., Davì M., Luca A., Restivo V., et al. Mild cognitive impairment in Parkinson’s disease: the Parkinson’s disease cognitive study (PACOS) J. Neurol. 2018;265(5):1050–1058. - PubMed
    1. Barone P., Antonini A., Colosimo C., Marconi R., Morgante L., Avarello T.P., et al. The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov. Disord. 2009;24(11):1641–1649. - PubMed

LinkOut - more resources