Effects of virtual reality cognitive training on executive function and prospective memory in Parkinson's disease and...

Neurocognitive disturbances in Parkinson's disease (PD) are common and can impact several aspects of daily functioning and quality of life. This multicenter study evaluated the efficacy of a novel immersive virtual reality (iVR) cognitive training (CT) targeting executive functions (EF)-planning, shifting, and updating abilities-to improve prospective memory (PM) in PD patients with mild cognitive impairment (PD-MCI). Potential transfer effects were also examined in healthy older adults (HC).

In this double-blind randomized controlled trial, 30 PD-MCI were randomized into a 4-week EF-training (PD-CT) or active placebo (PD-AP), delivered at home through a combined approach of telemedicine and iVR. Similarly, 30 age- and education-matched HC were assigned to the EF-training (HC-CT) or active placebo (HC-AP).

The PD-CT group exhibited significant improvements in PM (in time-based and verbal-response tasks) and in EF, particularly in inhibition abilities (in the Stroop test), with effects sustained at 2-month follow-up. These gains were absent in the PD-AP group. Regression analyses revealed that PM enhancements were primarily driven by improved inhibition and shifting abilities. The EF-training was effective also in the older adults, the HC-CT group showed improvements in planning abilities (in the Zoo Map test) at post-intervention and 2-month follow-up, while no cognitive gains were observed in the HC-AP group.

This innovative iVR-based EF-training effectively enhances PM and inhibition in PD-MCI, and planning abilities in healthy older adults, demonstrating its potential for improving cognition in both populations. These findings support the use of iVR and telemedicine for accessible, personalized non-pharmacological cognitive interventions.