A strategic executive treatment for executive dysfunction in patients with Parkinson’s disease

INTERVENTION: Patients are blindly allocated to the following two groups by drawing lots. In order to balance the allocation of patients to both treatment conditions, lots are drawn per 4 patients (i.e. 2 experimental and 2 control lots). A co‐worker who is not actively involved in the study is responsible for drawing lots. 1. Experimental treatment ‐ ReSET: strategic executive training for dysfunctions in executive functions. ReSET contains three modules: information and awareness; goal setting and planning; and initiative and regulation. Patients are taught several strategies that can be applied to a broad range of daily life situations. 2. Control treatment ‐ Cogniplus: computerized cognitive training for aspects of attention. Cogniplus aims at training several aspects of attention (e.g. selective, sustained attention) by repeated practice of several tasks. Both treatment programs are individually administered to patients and consist of 14 one‐hour sessions. Before, at maximum 2 weeks post‐treatment and at 3‐5 months follow‐up an extensive neuropsychological assessment focused on executive functions (including tests and questionnaires) is administered. CONDITION: Parkinson's disease ; Nervous System Diseases ; Parkinson disease PRIMARY OUTCOME: Patients’ level of participation in different societal domains (i.e. work, social relations, leisure activities and mobility), measured using the Role Resumption list (RRL) at baseline, two weeks post‐treatment and at 3‐5 months follow‐up SECONDARY OUTCOME: Measured at baseline, 2 weeks post‐treatment and at 3‐5 months follow‐up:; 1. Attainment of three individual executive goals set by patients during the third session of ReSET or Cogniplus, measured using the Treatment Goal Attainment scale ; 2. Problems in executive functioning in daily life, measured using the Dysexecutive Questionnaire, completed by participants and someone who had a good insight into the patients’ functioning in daily life; 3. Quality of life, measured using the Parkinson's Disease Questionnaire (PDQ‐39); 4. Behavioural functioning, measured using executive subscales of the Brock Adaptive Functioning Questionnaire (BAFQ) (participant and significant other ratings); 5. Caregiver burden, measured using the Zarit Burden Interview; 6. Executive functions (planning skills, inhibition, abstract reasoning, problem solving and estimation of time), measured using the Behavioural Assessment of the Dysexecutive Syndrome (BADS); 7. Selective attention and attentional switching or cognitive flexibility, measured using the Test of Everyday Attention (TEA) INCLUSION CRITERIA: 1. Patients diagnosed with idiopathic Parkinson's disease according to the UK Parkinson’s Disease Brain Bank Criteria, with disease severity = Hoehn & Yahr (H&Y) stage 3 2. Age range 18‐80 years 3. Patients had to be motivated for treatment 4. Patients had to report problems with EF in daily life that were experienced as burdensome (based on semi‐structured interview and/or a total score of =18 on the Dysexecutive Questionnaire (DEX) and/or showed impairments on objective neuropsychological tests of executive function (EF): 4.1. A standard score of =2 on the subtests Zoo Map Test or Six Elements Test of the Behavioural Assessment of the Dysexecutive Syndrome (BADS) and/or 4.2. A standard age total score on the BADS categorized as “low average” or lower and/or 4.3. A discrepancy of 15 points between standard age score and premorbid IQ as measured with the short version of the Dutch Groninger Intelligence Test 5. Patients had to speak and understa