Pilot trial of gamification to treat apathy in Parkinson’s disease

Principal Investigators: Nabila Dahodwala, MD, MS and Mitesh Patel, MD, MBA, MS

Impaired goal-directed behavior results in the common, disabling and costly syndrome of apathy seen across neuropsychiatric conditions including Parkinson’s disease (PD). Our preliminary work demonstrates that impairments in motivation, planning and initiation drive diminished goal-directed behavior, and thus apathy, in PD. Unfortunately, we still lack effective therapies to treat apathy.

This project will study if behavioral economic approaches can improve motivation and increase goal achievement. Specifically, we will test the feasibility and preliminary effectiveness of a gamification intervention that enhances supportive social incentives to increase physical activity levels. Furthermore, we propose to determine if behavioral phenotyping will predict responsiveness to the gamification intervention.

We hypothesize that: 1) Social incentives that include collaboration, accountability and peer support will improve physical activity levels compared to a standard of care educational session; and 2) Individuals with greater impairments in motivation compared to initiation and/or planning will have greater improvement in physical activity compared to individuals with relatively greater impairments in initiation and/or planning.

We propose to recruit 40 individuals with PD from Penn’s Parkinson’s Disease Center. Using a previously validated, computerized tool we will assess motivation, planning and initiation behaviors. We will then utilize the Way to Health platform to randomize and deliver the gamification intervention. Control subjects will receive a one-time educational session on the importance of exercise. This application will enhance our understanding of the feasibility and potential efficacy of behavioral economic interventions to treat apathy, and if we can tailor therapy based on specific behavioral phenotypes.