Investigator:
Bonnie Wong, PhD
Name of Institution:
Boston University, Boston, MA
Project Title:
Alleviating depression and cognitive impairment in Parkinson’s disease through telehealth psychotherapy
Investigator Bio:
Dr. Wong is a Clinical Associate Professor in the Department of Psychological and Brain Sciences at Boston University, and directs the Interventional Neuropsychology Group at the Center for Anxiety and Related Disorders. She received her PhD from Boston University. She is a board-certified clinical neuropsychologist experienced in assessing and treating disorders of cognition and mood in neurologic and neuropsychiatric populations. She created and directed a cognitive rehabilitation center in the Cognitive Neurology Unit of the Department of Neurology at Beth Israel Deaconess Medical Center, where she developed programs to train attention and memory in individuals with neurologic disorders.
Objective:
This project will evaluate the feasibility, acceptability, and preliminary efficacy of live videoconference cognitive behavioral therapy (CBT) for the treatment of depression in PD. It will also examine CBT’s effect on cognition, predicting that the alleviation of depression will improve cognition.
Background:
Depression and cognitive impairment are both common non-motor symptoms of PD and often co-occur, compromising everyday function and strongly predicting a decreased quality of life. CBT has been shown to be an effective treatment for depression in PD, but motor disability, work schedule, transportation issues, caregiver burden, and lack of available health care providers, may cause difficulty in attending weekly face-to-face therapy sessions. A promising avenue in the delivery of CBT is telehealth, or the distribution of health services electronically and through telecommunication technologies.
Methods/Design:
We plan to enroll 12 participants with idiopathic PD with depression and mild subjective and objective cognitive impairment. Age, education, functional status, disease duration, medication dosages (levodopa equivalent dose), and data on apathy and sleep, will be collected. Participants will be treated in 12 weekly psychotherapy sessions via secure live videoconferencing, with each session lasting 50-60 minutes. Six participants will receive three assessments: baseline, immediately post-treatment and 6 weeks after treatment. The other six will start by serving as controls for the first six, undergoing an assessment before the start of treatment. They will then proceed to undergo treatment themselves. The advantage of this waitlist control design is that all participants receive CBT treatment and all of the assessments. In addition, it allows us to examine the “standard of care,” or no-active-treatment.
Relevance to Diagnosis/Treatment of Parkinson’s disease:
Depression and cognitive impairment are prevalent non-motor symptoms of PD and are not treated adequately due to substantial barriers to care. CBT has been shown to be an effective treatment for depression in PD, and through its alleviation of depression, may also improve cognition. If CBT administered via live videoconference technology is effective, then many more people with PD will be able to be treated appropriately.