Periodic Reporting for period 2 - Motivageing (Motivation–cognition interaction in healthy ageing and Parkinson’s disease)
Período documentado: 2020-02-01 hasta 2021-01-31
Europe is greying: this is the metaphor representing the increase in the life expectancy of people living in the European Union (EU). By 2025 more than 20% of Europeans will be 65 or over, with a particularly rapid increase in numbers of over-80s.
Healthy ageing is invariably associated with a progressive decline in cognitive functioning. This decline affects not only low-level stages of processing like hearing or vision, but also higher-level stages such as attention, memory, reasoning, and therefore decision-making.
With the increase of older adult’s population in the EU society, a better understanding of how age ultimately affects decision-making processes is therefore crucial.
Furthermore, a decline of cognitive efficiency is predictive of the transition from mild cognitive impairment, namely, a clinical condition in which the cognitive decline exceeds that of normal aging, but does not impair daily living, to a diagnosable state of dementia. Hence, research efforts aimed to improve cognition in old age and prevent dementia are extremely important for our society.
Advancing age is the single greatest risk factor for the development of neurodegenerative disorders, such as Parkinson’s disease (PD).
PD is deteriorating neurological disorder that starts with motor deficits, and as it progresses, mental processes (cognitive) and mood disorder can develop also. The staging in which the motor, then cognitive symptoms present is due to the progressive loss of dopamine first from the movement circuits of the brain, before the cognitive circuits. Research evidence suggests that the dopamine replacement medication prescribed to ameliorate the motor symptoms also impacts cognition in Parkinson’s. Specifically, cognitive deficits in PD patients mostly occur in high level cognitive functions like attention, impulse inhibition capacity, and consequently decision-making. However, it is not clear yet how different dopamine replacement medications specifically affect these processes. Hence new evidence is needed to better understand this phenomenon, and therefore reducing the impact of PD, and PD-related medication, on quality of life of both patients and caregivers.
Currently, more than 10 million people worldwide are living with PD. In Europe, PD affects 1.2 million EU citizens, a number expected to rise to 2.5 million in the next 15 years. This has important societal consequences. The EU currently spends €1.39 billion annually in direct and indirect PD-related costs, including healthcare services, the loss of productivity, and carer burden. Directly as a result of European greying, these numbers are projected to double by 2030, at enormous economic and social cost.
The present research project is therefore focused on the study of cognitive functions in both healthy ageing and Parkinson’s disease. More specifically, the two main overall objective of the current project are 1) understanding age-related cognitive changes and developing new cognitive stimulation techniques for healthy older adults, in order to improve their cognitive functions and quality of life and 2) defining the effects of dopaminergic medications on cognitive functions and well being in people with PD.
Healthy ageing is invariably associated with a progressive decline in cognitive functioning. This decline affects not only low-level stages of processing like hearing or vision, but also higher-level stages such as attention, memory, reasoning, and therefore decision-making.
With the increase of older adult’s population in the EU society, a better understanding of how age ultimately affects decision-making processes is therefore crucial.
Furthermore, a decline of cognitive efficiency is predictive of the transition from mild cognitive impairment, namely, a clinical condition in which the cognitive decline exceeds that of normal aging, but does not impair daily living, to a diagnosable state of dementia. Hence, research efforts aimed to improve cognition in old age and prevent dementia are extremely important for our society.
Advancing age is the single greatest risk factor for the development of neurodegenerative disorders, such as Parkinson’s disease (PD).
PD is deteriorating neurological disorder that starts with motor deficits, and as it progresses, mental processes (cognitive) and mood disorder can develop also. The staging in which the motor, then cognitive symptoms present is due to the progressive loss of dopamine first from the movement circuits of the brain, before the cognitive circuits. Research evidence suggests that the dopamine replacement medication prescribed to ameliorate the motor symptoms also impacts cognition in Parkinson’s. Specifically, cognitive deficits in PD patients mostly occur in high level cognitive functions like attention, impulse inhibition capacity, and consequently decision-making. However, it is not clear yet how different dopamine replacement medications specifically affect these processes. Hence new evidence is needed to better understand this phenomenon, and therefore reducing the impact of PD, and PD-related medication, on quality of life of both patients and caregivers.
Currently, more than 10 million people worldwide are living with PD. In Europe, PD affects 1.2 million EU citizens, a number expected to rise to 2.5 million in the next 15 years. This has important societal consequences. The EU currently spends €1.39 billion annually in direct and indirect PD-related costs, including healthcare services, the loss of productivity, and carer burden. Directly as a result of European greying, these numbers are projected to double by 2030, at enormous economic and social cost.
The present research project is therefore focused on the study of cognitive functions in both healthy ageing and Parkinson’s disease. More specifically, the two main overall objective of the current project are 1) understanding age-related cognitive changes and developing new cognitive stimulation techniques for healthy older adults, in order to improve their cognitive functions and quality of life and 2) defining the effects of dopaminergic medications on cognitive functions and well being in people with PD.
The MOTIVAGEING project was carried out in three prestigious host institutions, such as the Department of Psychological and Brain Sciences of Washington University in St. Louis (US),the Department of General Psychology, University of Padova (Italy) and at the School of Psychology, Keele University (UK).
The work performed in these three institutions respectively consisted in: 1) a substantial theoretical and practical training on the use of functional neuroimaging procedures (such as fMRI and PET), which was followed by a productive data collection and analysis phase; 2) a systematic review and meta-analysis of the studies where non-invasive brain stimulation has been employed to modulate cognitive performance in both healthy and pathological conditions; 3) the analysis of data collected in different cohorts of Parkinson's disease patients, using advanced imaging, biologic sampling and clinical and behavioural measures.
Results of these three main studies have been object of already scientific publications (already published and/or currently in preparation), and of communication at international scientific conferences and meetings.
The work performed in these three institutions respectively consisted in: 1) a substantial theoretical and practical training on the use of functional neuroimaging procedures (such as fMRI and PET), which was followed by a productive data collection and analysis phase; 2) a systematic review and meta-analysis of the studies where non-invasive brain stimulation has been employed to modulate cognitive performance in both healthy and pathological conditions; 3) the analysis of data collected in different cohorts of Parkinson's disease patients, using advanced imaging, biologic sampling and clinical and behavioural measures.
Results of these three main studies have been object of already scientific publications (already published and/or currently in preparation), and of communication at international scientific conferences and meetings.
The results obtained represent an important progress beyond the state of the art in the research field of motivation-cognition interaction.
One of them is represented by the development, validation and implementation of several new experimental paradigms aimed to assess and study behavioural and neural correlates of motivation-cognition interaction in both young and older adults. These paradigms have been developed with the aim to overcome an important scientific limitation in this research field, such as the lack of reliable paradigms to test specific constructs like the delay of gratification capacity, especially in older adults (see publications listed above). Moreover, these paradigms are all open source and can therefore be easily used from many different laboratories in the world, allowing a much greater impact on the scientific community of our work.
Results will also represent an important progress beyond the state of the art in cognitive and clinical neuropsychology. Specifically, results of the meta-analysis will allow to better understand the interaction between motivation and cognition, and moreover will allow to better understand the effect of non-invasive brain stimulation on cognitive functions, in both healthy young and older adults, as well as in several different clinical conditions.Importantly results will have an impact from both a theoretical point of view and from a clinical one, providing who employs non-invasive brain stimulation for cognitive rehabilitation an important and updated summary of the state of the art, and updated guidelines for a more effective clinical and research practice.
Finally, results will allow to obtain significant progresses in the understanding of cognitive and behavioural deficits in patients with Parkinson's disease. Our findings will inform about the prevalence, the evolution and the predictors of impulse control disorder’s symptoms in patients with Parkinson’s disease (PD), and will therefore add new crucial knowledge in this research field, informing also the clinicians who work with PD patients about the most updated scientific knowledge, which are currently urgently needed in order to prevent the development/treat and manage the presence of these important cognitive and behavioural disorders.
Taken together, our results represent new informative and innovative empirical evidence, which will be shared through open access publication, conferences and public seminars, and which will allow the MOTIVAGEING project to have a significant scientific and societal impact, contributing to the development of new strategic plans for our aging society and to the advanced understanding of one of the most common neurodegenerative disorders, such as Parkinson’s disease.
One of them is represented by the development, validation and implementation of several new experimental paradigms aimed to assess and study behavioural and neural correlates of motivation-cognition interaction in both young and older adults. These paradigms have been developed with the aim to overcome an important scientific limitation in this research field, such as the lack of reliable paradigms to test specific constructs like the delay of gratification capacity, especially in older adults (see publications listed above). Moreover, these paradigms are all open source and can therefore be easily used from many different laboratories in the world, allowing a much greater impact on the scientific community of our work.
Results will also represent an important progress beyond the state of the art in cognitive and clinical neuropsychology. Specifically, results of the meta-analysis will allow to better understand the interaction between motivation and cognition, and moreover will allow to better understand the effect of non-invasive brain stimulation on cognitive functions, in both healthy young and older adults, as well as in several different clinical conditions.Importantly results will have an impact from both a theoretical point of view and from a clinical one, providing who employs non-invasive brain stimulation for cognitive rehabilitation an important and updated summary of the state of the art, and updated guidelines for a more effective clinical and research practice.
Finally, results will allow to obtain significant progresses in the understanding of cognitive and behavioural deficits in patients with Parkinson's disease. Our findings will inform about the prevalence, the evolution and the predictors of impulse control disorder’s symptoms in patients with Parkinson’s disease (PD), and will therefore add new crucial knowledge in this research field, informing also the clinicians who work with PD patients about the most updated scientific knowledge, which are currently urgently needed in order to prevent the development/treat and manage the presence of these important cognitive and behavioural disorders.
Taken together, our results represent new informative and innovative empirical evidence, which will be shared through open access publication, conferences and public seminars, and which will allow the MOTIVAGEING project to have a significant scientific and societal impact, contributing to the development of new strategic plans for our aging society and to the advanced understanding of one of the most common neurodegenerative disorders, such as Parkinson’s disease.