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Curtin D, Taylor EM, Bellgrove MA, Chong TTJ, Coxon JP. Dopamine D2 Receptor Modulates Exercise Related Effect on Cortical Excitation/Inhibition and Motor Skill Acquisition. J Neurosci 2024; 44:e2028232024. [PMID: 38553046 PMCID: PMC11079968 DOI: 10.1523/jneurosci.2028-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 05/12/2024] Open
Abstract
Exercise is known to benefit motor skill learning in health and neurological disease. Evidence from brain stimulation, genotyping, and Parkinson's disease studies converge to suggest that the dopamine D2 receptor, and shifts in the cortical excitation and inhibition (E:I) balance, are prime candidates for the drivers of exercise-enhanced motor learning. However, causal evidence using experimental pharmacological challenge is lacking. We hypothesized that the modulatory effect of the dopamine D2 receptor on exercise-induced changes in the E:I balance would determine the magnitude of motor skill acquisition. To test this, we measured exercise-induced changes in excitation and inhibition using paired-pulse transcranial magnetic stimulation (TMS) in 22 healthy female and male humans, and then had participants learn a novel motor skill-the sequential visual isometric pinch task (SVIPT). We examined the effect of D2 receptor blockade (800 mg sulpiride) on these measures within a randomized, double-blind, placebo-controlled design. Our key result was that motor skill acquisition was driven by an interaction between the D2 receptor and E:I balance. Specifically, poorer skill learning was related to an attenuated shift in the E:I balance in the sulpiride condition, whereas this interaction was not evident in placebo. Our results demonstrate that exercise-primed motor skill acquisition is causally influenced by D2 receptor activity on motor cortical circuits.
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Affiliation(s)
- Dylan Curtin
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3800, Australia
| | - Eleanor M Taylor
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3800, Australia
| | - Mark A Bellgrove
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3800, Australia
| | - Trevor T-J Chong
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3800, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria 3004, Australia
- Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria 3065, Australia
| | - James P Coxon
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria 3800, Australia
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Tucak C, Chih H, Mastaglia F, Rodrigues J. The 'PD Warrior' exercise programme improves motor outcomes and quality of life in patients with early Parkinson disease: results of a pilot study. Intern Med J 2024; 54:823-832. [PMID: 38100122 DOI: 10.1111/imj.16301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/19/2023] [Indexed: 05/18/2024]
Abstract
BACKGROUND 'PD Warrior' (PDW) is a popular exercise programme for Parkinson disease; however, there are no published studies on the outcomes of the programme. AIMS To investigate short-term functional and quality of life (QoL) outcomes after the PDW 10-week programme in a pilot study of individuals with early Parkinson Disease (PD). METHODS Twenty individuals with PD (Hoehn & Yahr 1-3) attending a hospital outpatient clinic were recruited into the PDW 10-week programme, comprising a weekly 1-h supervised class complemented by an individualised daily home exercise programme. Participants had the following assessments at baseline and after completion of the programme: Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part III, timed up-and-go (TUG), 10-m walk test (10mWT), 6-min walking test (6MWT), balance tests, fine motor skills, 7-day Parkinson KinetiGraph (PKG) and PDQ-39 QoL scale. RESULTS Seventeen individuals completed the programme. Significant improvements were observed in MDS-UPDRS motor score (P = 0.019, d = 0.68, MCID 7); 6MWT distance (P < 0.001, d = 1.16); walking time during motor or cognitive dual tasking (P = 0.006, d = 0.77; P = 0.005, d = 0.79, respectively); and the PDQ-39 emotional well-being subdomain (P = 0.009; MCID 4.2); as well as improvements trending to significance in bradykinesia (P = 0.025, d = 0.73), 10mWT walking time (P = 0.023, d = 0.61) and borderline improvement in balance (P = 0.056, d = 0.50). CONCLUSIONS The outcomes of this study support the efficacy of the PDW programme in individuals with early PD and provide justification for future trials and investigation of its effects.
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Affiliation(s)
- Claire Tucak
- Physiotherapy Department, Hollywood Private Hospital, Nedlands, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - HuiJun Chih
- Curtin School of Population Health, Clinical Trials Enabling Platform, Curtin University, Perth, Western Australia, Australia
| | - Frank Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
- Queen Elizabeth II Medical Centre, Perth, Western Australia, Australia
| | - Julian Rodrigues
- Perth Neurology Clinic, Hollywood Private Hospital, Nedlands, Western Australia, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Neurosciences Queensland, Spring Hill, Queensland, Australia
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Gao X, Zhang H, Fu X, Yang Y, Dou J. The effect of home-based exercise on motor and non-motor symptoms with Parkinson's disease patients: A systematic review and network meta-analysis. J Clin Nurs 2024. [PMID: 38661119 DOI: 10.1111/jocn.17136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/23/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the effects of home-based exercise in Parkinson's disease (PD) patients. DESIGN A network meta-analysis of randomized controlled trials. METHODS This study systematically searched PubMed, MEDLINE, Embase, Cochrane library and Web of Science. The quality of the literature was assessed using the Cochrane Risk of Bias 2.0 criteria. The data were pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS Thirty studies involving 2264 PD patients were included. Meta-analysis results showed that home-based exercise had a small effect in relieving overall motor symptoms in PD patients (SMD: -.28, 95% Crl [-.43; -.14]), improving quality of life (SMD = .15 [.03, .26]), walking speed (SMD = .30 [.04, .56]), balance ability (SMD = .18 [.04, .33]; p < .0001) and finger dexterity (SMD = .28 [.10, .46]). Mixed exercise (Mix) had better effects on improving motor symptoms and quality of life. In addition, the results of dose analysis showed that only mixed exercise exceeding 850 METs-min per week and more than 18 weeks can significantly alleviate the overall motor symptoms of PD patients. CONCLUSION Home-based exercise was an effective form of therapy for alleviating motor symptoms. In addition, Mix appeared to be more suitable for PD patients engaging in home-based exercise. Existing evidence suggested that significant therapeutic effects were achieved with a Mix, with a weekly exercise volume exceeding 850 METs and a duration of more than 18 weeks. RELEVANCE TO CLINICAL PRACTICE Home-based exercise had a small effect in relieving overall motor symptoms in PD patients, improving quality of life, walking speed, balance ability and finger dexterity. In terms of exercise dosage, we recommend the exercise period is no less than 18 weeks and the dose per is no less than 850 METs-min. No Patient or Public Contribution.
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Affiliation(s)
- Xianqi Gao
- Department of Nursing Sciences, School of Medicine, Lishui University, Lishui, Zhejiang, China
| | - Haoyang Zhang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Xueying Fu
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, China
| | - Jiejie Dou
- Faculty of Teacher Education, Lishui University, Lishui, Zhejiang, China
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Maher S, Donlon E, Mullane G, Walsh R, Lynch T, Fearon C. Treatment of Apathy in Parkinson's Disease and Implications for Underlying Pathophysiology. J Clin Med 2024; 13:2216. [PMID: 38673489 PMCID: PMC11051068 DOI: 10.3390/jcm13082216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Apathy is a prevalent and highly debilitating non-motor symptom of Parkinson's disease (PD) that is often overlooked in clinical practice due to its subtle nature. This review aims to provide a comprehensive overview of the current evidence for the treatment of apathy in PD, highlighting recent advancements and emerging therapeutic avenues. In this review, we analyse a diverse array of treatment strategies for apathy in PD, including pharmacological interventions, non-pharmacological approaches, and emerging neuromodulation techniques. We evaluate the efficacy, safety, and limitations of established pharmacotherapies, such as dopaminergic agents, antidepressants, and cognitive enhancers. Additionally, we examine the promising role of non-pharmacological interventions, encompassing psychotherapies and behavioural interventions, in ameliorating apathetic symptoms. Furthermore, this review explores the effects of neuromodulation techniques on apathy, including the modulation of apathy via deep brain stimulation and emerging data on the potential influence of transcranial magnetic stimulation (TMS) on apathy in PD. Ultimately, a deeper understanding of effective treatment strategies for apathy has the potential to significantly improve the quality of life and overall well-being of individuals living with PD.
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Affiliation(s)
- Senan Maher
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Eoghan Donlon
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Gerard Mullane
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Richard Walsh
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Tim Lynch
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Conor Fearon
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
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van Wegen EEH, van Balkom TD, Hirsch MA, Rutten S, van den Heuvel OA. Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230228. [PMID: 38607762 DOI: 10.3233/jpd-230228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Affiliation(s)
- Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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| | - Tim D van Balkom
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Mark A Hirsch
- Carolinas Medical Center, Atrium Health Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, NC, USA
- Wake Forest School of Medicine, Department of Orthopedic Surgery and Rehabilitation, Winston-Salem, NC, USA
| | - Sonja Rutten
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
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Leem YH, Park JS, Park JE, Kim DY, Kim HS. Creatine supplementation with exercise reduces α-synuclein oligomerization and necroptosis in Parkinson's disease mouse model. J Nutr Biochem 2024; 126:109586. [PMID: 38262563 DOI: 10.1016/j.jnutbio.2024.109586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/04/2024] [Accepted: 01/17/2024] [Indexed: 01/25/2024]
Abstract
Parkinson's disease (PD) is an incurable neurological disorder that causes typical motor deficits. In this study, we investigated the effects of creatine supplementation and exercise in the subacute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. We found that 2% creatine supplementation and/or exercise intervention for 4 weeks elicited neurobehavioral recovery and neuroprotective effects regarding dopaminergic cell loss in MPTP-treated mice; this effect implies functional preservation of dopaminergic cells in the substantia nigra, as reflected by tyrosine hydroxylase expression recovery. Creatine and exercise reduced necroptotic activity in dopaminergic cells by lowering mixed lineage kinase domain-like protein (MLKL) modification to active phenotypes (phosphorylation at Ser345 and oligomerization) and phosphorylated receptor-interacting protein kinase 1 (RIPK1) (Ser166-p) and RIPK3 (Ser232-p) levels. In addition, creatine and exercise reduced the MPTP-induced increase in pathogenic α-synuclein forms, such as Ser129 phosphorylation and oligomerization. Furthermore, creatine and exercise had anti-inflammatory and antioxidative effects in MPTP mice, as evidenced by a decrease in microglia activation, NF-κB-dependent pro-inflammatory molecule expression, and increase in antioxidant enzyme expression. These phenotypic changes were associated with the exercise/creatine-induced AMP-activated protein kinase (AMPK)/nuclear factor erythroid 2-related factor 2 (Nrf2) and sirtuin 3 (SIRT3)/forkhead box O3 (FoxO3a) signaling pathways. In all experiments, combining creatine with exercise resulted in considerable improvement over either treatment alone. Consequently, these findings suggest that creatine supplementation with exercise has anti-inflammatory, antioxidative, and anti-α-synucleinopathy effects, thereby reducing necroptotic cell death in a PD mouse model.
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Affiliation(s)
- Yea-Hyun Leem
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jin-Sun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jung-Eun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Do-Yeon Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hee-Sun Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea; Department of Brain & Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
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Costa V, Prati JM, de Oliveira Barreto Suassuna A, Souza Silva Brito T, Frigo da Rocha T, Gianlorenço AC. Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis. J Geriatr Psychiatry Neurol 2024:8919887241237223. [PMID: 38445606 DOI: 10.1177/08919887241237223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD. METHODS Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate. RESULTS Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety. CONCLUSION Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.
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Affiliation(s)
- Valton Costa
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - José Mario Prati
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Alice de Oliveira Barreto Suassuna
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Federal University of Uberlandia, Uberlandia, Brazil
| | - Thanielle Souza Silva Brito
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Thalita Frigo da Rocha
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Anna Carolyna Gianlorenço
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
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Ceci C, Lacal PM, Barbaccia ML, Mercuri NB, Graziani G, Ledonne A. The VEGFs/VEGFRs system in Alzheimer's and Parkinson's diseases: Pathophysiological roles and therapeutic implications. Pharmacol Res 2024; 201:107101. [PMID: 38336311 DOI: 10.1016/j.phrs.2024.107101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
The vascular endothelial growth factors (VEGFs) and their cognate receptors (VEGFRs), besides their well-known involvement in physiological angiogenesis/lymphangiogenesis and in diseases associated to pathological vessel formation, play multifaceted functions in the central nervous system (CNS). In addition to shaping brain development, by controlling cerebral vasculogenesis and regulating neurogenesis as well as astrocyte differentiation, the VEGFs/VEGFRs axis exerts essential functions in the adult brain both in physiological and pathological contexts. In this article, after describing the physiological VEGFs/VEGFRs functions in the CNS, we focus on the VEGFs/VEGFRs involvement in neurodegenerative diseases by reviewing the current literature on the rather complex VEGFs/VEGFRs contribution to the pathogenic mechanisms of Alzheimer's (AD) and Parkinson's (PD) diseases. Thereafter, based on the outcome of VEGFs/VEGFRs targeting in animal models of AD and PD, we discuss the factual relevance of pharmacological VEGFs/VEGFRs modulation as a novel and potential disease-modifying approach for these neurodegenerative pathologies. Specific VEGFRs targeting, aimed at selective VEGFR-1 inhibition, while preserving VEGFR-2 signal transduction, appears as a promising strategy to hit the molecular mechanisms underlying AD pathology. Moreover, therapeutic VEGFs-based approaches can be proposed for PD treatment, with the aim of fine-tuning their brain levels to amplify neurotrophic/neuroprotective effects while limiting an excessive impact on vascular permeability.
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Affiliation(s)
- Claudia Ceci
- Pharmacology Section, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Maria Luisa Barbaccia
- Pharmacology Section, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Section, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; IRCCS Santa Lucia Foundation, Department of Experimental Neuroscience, Rome, Italy; Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
| | - Grazia Graziani
- Pharmacology Section, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Ada Ledonne
- Pharmacology Section, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; IRCCS Santa Lucia Foundation, Department of Experimental Neuroscience, Rome, Italy; Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
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Mai AS, Lee YS, Yong JH, Teo DCYJ, Wan YM, Tan EK. Treatment of apathy in Parkinson's disease: A bayesian network meta-analysis of randomised controlled trials. Heliyon 2024; 10:e26107. [PMID: 38440294 PMCID: PMC10909723 DOI: 10.1016/j.heliyon.2024.e26107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 01/12/2024] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Background Apathy is an important but unrecognised aspect of Parkinson's disease (PD). The optimal therapeutic options for apathy remain unclear. Early recognition and treatment of apathy can reduce the significant burden of disease for patients and their caregivers. Here we conducted a meta-analysis to evaluate the comparative efficacy of different treatment modalities of apathy in PD (CRD42021292099). Methods We screened Medline, Embase, and PsycINFO databases for articles on therapies for apathy in PD. The outcome of interest is the reduction in apathy scores post-intervention and is measured by standardised mean differences (SMD) with 95% credible intervals (CrI). We included only randomised controlled trials examining interventions targeted at reducing apathy. Results Nineteen studies involving 2372 patients were included in the quantitative analysis. The network meta-analysis found pharmacotherapy to be the most efficacious treatment, significantly better than brain stimulation (SMD -0.43, 95% CrI -0.78 to -0.07), exercise-based interventions (SMD -0.66, 95% CrI -1.25 to -0.08), supplements (SMD -0.33, 95% CrI -0.67 to 0), and placebo (SMD -0.38, 95% CrI -0.56 to -0.23). Subgroup analysis of pharmacotherapy versus placebo found similar efficacy of dopamine agonists (SMD -0.36, 95% CI -0.59 to -0.12, P = 0.003) and alternative medications (SMD -0.42, 95% CI -0.61 to -0.23, P < 0.001). The remaining comparisons and subgroup analyses did not demonstrate any significant treatment effects. Conclusion Our meta-analysis of randomised controlled trials showed that pharmacotherapy is the most efficacious treatment option, with dopamine agonists having similar efficacy as other medications. Further research is needed to determine the optimal management strategy.
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Affiliation(s)
- Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi Siang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jung Hahn Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Yi-Min Wan
- Department of Psychiatry, Ng Teng Fong General Hospital, Singapore
| | - Eng-King Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
- Neuroscience and Behavioural Programme, Duke-NUS Medical School, Singapore
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Antoniotti P, Biscaro V, Mancini F, Caprino M, Tropea P, Corbo M. Rehabilitation activities with tablet (REACT) in Parkinson's disease. Neurol Sci 2024:10.1007/s10072-024-07414-x. [PMID: 38388895 DOI: 10.1007/s10072-024-07414-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION There is evidence to demonstrate that plasticity is "use-dependent" and that intensive practice may be necessary to modify neural organization. PURPOSE The main aim of this work is to investigate the REACT usability, an innovative app, to assist People with Parkinson Disease (PwPD) at home. METHODS A pilot study has been conducted enrolling 20 consecutive PwPD. Before home rehabilitation activities started, each patient received training on the REACT app and how to use the device and the services in daily practice. Motor and cognitive evaluations were administered to assign personalized exercises, tailored to patients' needs and potential. PwPD carried out REACT home program for 1 month, four times a week. The app included motor exercise and tutorial of activities of daily living (ADL) and functional cognitive stimulation. REACT-app usability was evaluated with the System Usability Scale (SUS). RESULTS The results from SUS questionnaire were, on average, above the threshold of "good usability" (SUS score > 68), as reported in the literature. The 47% of PwPD that used the app rated the usability of the solution as "excellent." Almost all SUS items reached the reference benchmark (except items 4, 5, and 7). No adverse events occurred. CONCLUSIONS REACT can be considered a useful and safe tool to support the continuity of care and treatment at home, in PwPD. Larger-scale trials are needed to validate the good acceptance and efficacy of home rehabilitation through technology applications.
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Affiliation(s)
- Paola Antoniotti
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Via Dezza, 48, 20144, Milan, Italy.
| | | | - Francesca Mancini
- Fondazione Need Institute, Milan, Italy
- Clinica Polispecialistica San Carlo, Paderno Dugnano, MI, Italy
| | - Massimo Caprino
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Via Dezza, 48, 20144, Milan, Italy
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Via Dezza, 48, 20144, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Di Cura Igea, Via Dezza, 48, 20144, Milan, Italy
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Tang R, Gong S, Li J, Hu W, Liu J, Liao C. Efficacy of non-pharmacological interventions for sleep quality in Parkinson's disease: a systematic review and network meta-analysis. Front Neurosci 2024; 18:1337616. [PMID: 38449730 PMCID: PMC10914945 DOI: 10.3389/fnins.2024.1337616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
Background Sleep disorders are one of the most common non-motor symptoms in PD. It can cause a notable decrease in quality of life and functioning in PD patients, as well as place a huge burden on both patients and caregivers. Currently, there are numerous non-pharmacological interventions available to improve sleep quality in PD, with disagreement as to which intervention is most effective. This network meta-analysis was performed to compare and rank non-pharmacological interventions to explore their efficacy in improving sleep quality in PD and to select the best interventions, with a view to providing references and bases for the development of clinical treatments and care programs. Methods The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched from inception to December 6, 2023. Two authors independently screened all studies, extracted the data, and evaluated risk of bias of included studies. STATA software version 17.0 was used to conduct the network meta-analysis. Results Our network meta-analysis included 29 studies involving 1,477 participants and 16 non-pharmacological interventions. Although most nonpharmacological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values indicated that the best non-pharmacological intervention for sleep disorders was massage therapy (97.3%), followed by music therapy (94.2%), and Treadmill training (85.7%). Conclusion Massage therapy can be considered as an effective therapy for improving sleep quality in patients with PD. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the conclusions of this network meta-analysis. Systematic review registration identifier CRD42023429339, PROSPERO (york.ac.uk).
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Affiliation(s)
| | | | | | | | - Jihong Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunlian Liao
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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12
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Hodgson P, Jordan A, Sinani C, Charura D, Orange ST. The relationship between physical function and psychological symptoms in Parkinson's disease: A systematic review and meta-regression analysis. CNS Neurosci Ther 2024; 30:e14562. [PMID: 38334239 PMCID: PMC10853949 DOI: 10.1111/cns.14562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/21/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024] Open
Abstract
AIMS This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any relationships exist between these measures in individuals with Parkinson's disease. METHODS MEDLINE, CINAHL, AMED, and APA PsychInfo databases were systematically searched. Screening, quality assessment, and data extraction were completed alongside meta-regression analysis. RESULTS Of 1175 studies retrieved, 40 were selected for analysis with only one study assessing the relationship between physical and psychological outcomes within their cohort. A total of 27 studies were also eligible for meta-regression analysis-a total sample of 1211 participants. Meta-regressions of five combinations of paired physical and psychological outcomes showed a significant moderating effect of symptoms of depression (Beck Depression Inventory) on mobility (Timed-Up-and-Go test; coefficient = 0.37, 95% CI 0.09 to 0.65, p = 0.012) and balance (Berg Balance Score) scores (coefficient = -1.25, 95% CI -1.77 to -0.73, p < 0.001). CONCLUSION Although physical and psychological outcomes of interest were used in all included studies, only one examined their relationship. Our analysis suggests that symptoms of depression may influence measures of mobility and balance. Specifically, as the severity of symptoms of depression increases, performance on measures of mobility and balance worsens.
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Affiliation(s)
- Philip Hodgson
- Tees, Esk and Wear Valleys NHS Foundation TrustYork St John UniversityYorkUK
- York St John UniversityYorkUK
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13
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Chmiel J, Rybakowski F, Leszek J. Effect of Transcranial Direct Current Stimulation (tDCS) on Depression in Parkinson's Disease-A Narrative Review. J Clin Med 2024; 13:699. [PMID: 38337395 PMCID: PMC10856764 DOI: 10.3390/jcm13030699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Depression is the most prevalent comorbid neuropsychiatric condition in individuals with Parkinson's disease (PD), and its underlying mechanisms are not yet fully understood. Current treatment methods are characterised by moderate effectiveness and possible side effects, prompting the search for new non-invasive and safe treatment methods. METHODS This narrative review explores the use of transcranial direct current stimulation (tDCS) in the treatment of depression in PD, based on neuropsychological measures. Searches were conducted in the PubMed/Medline, Research Gate, and Cochrane databases. RESULTS Nine relevant studies were identified, where depression scores served as either primary or secondary outcomes. Stimulation protocols displayed heterogeneity, especially concerning choice of stimulation site. Patient samples were also heterogeneous. The majority of the studies incorporated anodal stimulation targeting the left dorsolateral prefrontal cortex (DLPFC). The results revealed a reduction in depression scores among PD patients following tDCS. Potential mechanisms through which tDCS may alleviate depression in PD were discussed and recommendations for future research were made. CONCLUSIONS Preliminary evidence suggests that tDCS applied anodally to the left DLPFC reduces depression scores in people with PD; however, due to the heterogeneity of the studies analysed, the use of tDCS in this field should be approached with caution and warrants further validation and confirmation.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Filip Rybakowski
- Department and Clinic of Psychiatry, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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14
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Brauer SG, Lamont RM, O'Sullivan JD. A physiotherapy group exercise and self-management approach to improve physical activity in people with mild-moderate Parkinson's disease: a randomized controlled trial. Trials 2024; 25:76. [PMID: 38254229 PMCID: PMC10801959 DOI: 10.1186/s13063-023-07870-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Physical activity levels are low in people with Parkinson's disease (PD) and have proved difficult to increase with exercise programs alone. Intervention approaches that address both the capacity to engage in physical activity and self-management strategies to change and maintain exercise behaviours are needed to address this intractable issue. METHODS This will be an assessor-blinded, randomized controlled trial performed in Brisbane, Australia. Ninety-two people with mild-moderate PD will be randomly allocated to two groups: usual care, and a physiotherapy-led group exercise program combined with self-management strategies. In the intervention group, twelve, 80-min sessions will be conducted over 4 weeks in groups of up to 4 participants. The intervention will consist of circuit training including treadmill walking to target aerobic fitness, and activities targeting strength, balance, and gait performance. In addition, each session will also incorporate strategies focusing on self-management and behaviour change, augmented by the provision of a fitness activity tracker. Outcome measures will be collected at baseline (T1), immediately post intervention (T2) and at 6 months follow-up (T3). The primary outcome measure is free-living physical activity (average daily step count over 7 days) at pre (T1) and post (T2) intervention measured using an activPAL™ device. Secondary outcome measures captured at all time points include time spent walking, sedentary and in moderate intensity exercise over 7 days; spatiotemporal gait performance (step length, gait speed, endurance); health-related quality of life; and outcome expectations and self-efficacy for exercise. DISCUSSION Sustainability of gains in physical activity following exercise interventions is a challenge for most populations. Our incorporation of a chronic disease self-management approach into the exercise program including fitness tracking extends previous trials and has potential to significantly improve free-living physical activity in people with PD. TRIAL REGISTRATION This study has been prospectively registered in Australian and New Zealand Clinical Trial Registry (ACTRN12617001057370), registered on 19/07/2017. Available from www.anzctr.org.au/ACTRN12617001057370.aspx .
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Affiliation(s)
- Sandra G Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Qld, St Lucia, Australia.
| | - Robyn M Lamont
- School of Health and Rehabilitation Sciences, The University of Queensland, Qld, St Lucia, Australia
| | - John D O'Sullivan
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Department of Neurology, Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
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15
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Li C, Hui D, Wu F, Xia Y, Shi F, Yang M, Zhang J, Peng C, Feng J, Li C. Automatic diagnosis of Parkinson's disease using artificial intelligence base on routine T1-weighted MRI. Front Med (Lausanne) 2024; 10:1303501. [PMID: 38249966 PMCID: PMC10797132 DOI: 10.3389/fmed.2023.1303501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024] Open
Abstract
Background Parkinson's disease (PD) is the second most common neurodegenerative disease. An objective diagnosis method is urgently needed in clinical practice. In this study, deep learning and radiomics techniques were studied to automatically diagnose PD from healthy controls (HCs). Methods 155 PD patients and 154 HCs were randomly divided into a training set (246 patients) and a testing set (63 patients). The brain subregions identification and segmentation were automatically performed with a VB-net, and radiomics features of billateral thalamus, caudatum, putamen and pallidum were extracted. Five independent machine learning classifiers [Support Vector Machine (SVM), Stochastic gradient descent (SGD), random forest (RF), quadratic discriminant analysis (QDA) and decision tree (DT)] were trained on the training set, and validated on the testing. Delong test was used to compare the performance of different models. Results Our VB-net could automatically identify and segment the brain into 109 regions. 2,264 radiomics features were automatically extracted from the billateral thalamus, caudatum, putamen or pallidum of each patient. After four step of features dimensionality reduction, Delong tests showed that the SVM model based on combined features had the best performance, with AUCs of 0.988 (95% CI: 0.979 ~ 0.998, specificity = 91.1%, sensitivity =100%, accuracy = 89.4% and precision = 88.2%) and 0.976 (95% CI: 0.942 ~ 1.000, specificity = 100%, sensitivity = 87.1%, accuracy = 93.5% and precision = 88.6%) in the training set and testing set, respectively. Decision curve analysis showed that the clinical benefit of the line graph model was high. Conclusion The SVM model based on combined features could be used to diagnose PD with high accuracy. Our fully automatic model could rapidly process the MRI data and distinguish PD and HCs in one minute. It greatly improved the diagnostic efficiency and has a great potential value in clinical practice to help the early diagnosis of PD.
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Affiliation(s)
- Chang Li
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
| | - Dongming Hui
- Department of Radiology, Chongqing Western Hospital, Chongqing, China
| | - Faqi Wu
- Department of Medical Service, Yanzhuang Central Hospital of Gangcheng District, Chongqing, China
| | - Yuwei Xia
- Department of Research and Development, Shanghai United Imaging Intelligence, Co., Ltd. Shanghai, China
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence, Co., Ltd. Shanghai, China
| | - Mingguang Yang
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
| | - Jinrui Zhang
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
| | - Chao Peng
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
| | - Junbang Feng
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
| | - Chuanming Li
- Bioengineering College of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), Chongqing, China
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16
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Paola Caminiti S, Gallo S, Menegon F, Naldi A, Comi C, Tondo G. Lifestyle Modulators of Neuroplasticity in Parkinson's Disease: Evidence in Human Neuroimaging Studies. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:602-613. [PMID: 37326116 DOI: 10.2174/1871527322666230616121213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease characterized by both motor and non-motor symptoms. A progressive neuronal loss and the consequent clinical impairment lead to deleterious effects on daily living and quality of life. Despite effective symptomatic therapeutic approaches, no disease-modifying therapies are currently available. Emerging evidence suggests that adopting a healthy lifestyle can improve the quality of life of PD patients. In addition, modulating lifestyle factors can positively affect the microstructural and macrostructural brain levels, corresponding to clinical improvement. Neuroimaging studies may help to identify the mechanisms through which physical exercise, dietary changes, cognitive enrichment, and exposure to substances modulate neuroprotection. All these factors have been associated with a modified risk of developing PD, with attenuation or exacerbation of motor and non-motor symptomatology, and possibly with structural and molecular changes. In the present work, we review the current knowledge on how lifestyle factors influence PD development and progression and the neuroimaging evidence for the brain structural, functional, and molecular changes induced by the adoption of positive or negative lifestyle behaviours.
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Affiliation(s)
| | - Silvia Gallo
- Neurology Unit, Department of Translational Medicine, Movement Disorders Centre, University of Piemonte Orientale, 28100 Novara, Italy
| | - Federico Menegon
- Neurology Unit, Department of Translational Medicine, Movement Disorders Centre, University of Piemonte Orientale, 28100 Novara, Italy
| | - Andrea Naldi
- Neurology Unit, San Giovanni Bosco Hospital, 10154 Turin, Italy
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy
| | - Giacomo Tondo
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy
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17
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Burtscher J, Moraud EM, Malatesta D, Millet GP, Bally JF, Patoz A. Exercise and gait/movement analyses in treatment and diagnosis of Parkinson's Disease. Ageing Res Rev 2024; 93:102147. [PMID: 38036102 DOI: 10.1016/j.arr.2023.102147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
Cardinal motor symptoms in Parkinson's disease (PD) include bradykinesia, rest tremor and/or rigidity. This symptomatology can additionally encompass abnormal gait, balance and postural patterns at advanced stages of the disease. Besides pharmacological and surgical therapies, physical exercise represents an important strategy for the management of these advanced impairments. Traditionally, diagnosis and classification of such abnormalities have relied on partially subjective evaluations performed by neurologists during short and temporally scattered hospital appointments. Emerging sports medical methods, including wearable sensor-based movement assessment and computational-statistical analysis, are paving the way for more objective and systematic diagnoses in everyday life conditions. These approaches hold promise to facilitate customizing clinical trials to specific PD groups, as well as personalizing neuromodulation therapies and exercise prescriptions for each individual, remotely and regularly, according to disease progression or specific motor symptoms. We aim to summarize exercise benefits for PD with a specific emphasis on gait and balance deficits, and to provide an overview of recent advances in movement analysis approaches, notably from the sports science community, with value for diagnosis and prognosis. Although such techniques are becoming increasingly available, their standardization and optimization for clinical purposes is critically missing, especially in their translation to complex neurodegenerative disorders such as PD. We highlight the importance of integrating state-of-the-art gait and movement analysis approaches, in combination with other motor, electrophysiological or neural biomarkers, to improve the understanding of the diversity of PD phenotypes, their response to therapies and the dynamics of their disease progression.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Eduardo Martin Moraud
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland; Defitech Centre for Interventional Neurotherapies (NeuroRestore), UNIL-CHUV and Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Davide Malatesta
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Julien F Bally
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Aurélien Patoz
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland
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18
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Balasubramanian S, Mehmood KT, Al-Baldawi S, Zúñiga Salazar G, Zúñiga D. Behind the Mask: Parkinson's Disease and Depression. Cureus 2024; 16:e52663. [PMID: 38380213 PMCID: PMC10877222 DOI: 10.7759/cureus.52663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
Parkinson's disease (PD) is a common, prevalent neurodegenerative disease. It is mainly characterized by motor symptoms such as rigidity, tremors, and bradykinesia, but it can also manifest with non-motor symptoms, of which depression is the most frequent. The latter can impair the quality of life, yet it gets overlooked and goes untreated because of the significant overlap in their clinical features, hence making the diagnosis difficult. Furthermore, there is limited data on the availability of appropriate criteria for making the diagnosis of depression in PD patients, as it can occur with varying expressions throughout the course of PD or it can also precede it. This review article has included a brief discussion on the diagnosis of depression in PD patients and their overlapped clinical manifestations. Understanding the mechanisms underlying the disease processes of PD and depression and the pathways interconnecting them gives better knowledge on devising treatment options for the patients. Only studies from Pubmed were included and all other databases were excluded. Studies from the last 50 years were included. Suitable references included in these studies were also extracted. Thus, depression in PD and PD in depression, along with their pharmacological and non-pharmacological treatment options, have been discussed.
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Affiliation(s)
| | | | | | | | - Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
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19
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Zhao A, Cui E, Leroux A, Lindquist MA, Crainiceanu CM. Evaluating the prediction performance of objective physical activity measures for incident Parkinson's disease in the UK Biobank. J Neurol 2023; 270:5913-5923. [PMID: 37612539 DOI: 10.1007/s00415-023-11939-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is the fastest-growing neurological condition with over 10 million cases worldwide. While age and sex are known predictors of incident PD, there is a need to identify other predictors. This study compares the prediction performance of accelerometry-derived physical activity (PA) measures and traditional risk factors for incident PD in the UK Biobank. METHODS The study population consisted of 92,352 UK Biobank participants without PD at baseline (43.8% male, median age 63 years with interquartile range 43-69). 245 participants were diagnosed with PD by April 1, 2021 (586,604 person-years of follow-up). The incident PD prediction performances of 10 traditional predictors and 8 objective PA measures were compared using single- and multi-variable Cox models. Prediction performance was assessed using a novel, stable statistic: the repeated cross-validated concordance (rcvC). Sensitivity analyses were conducted where PD cases diagnosed within the first six months, one year, and two years were deleted. RESULTS Single-predictor Cox regression models indicated that all PA measures were statistically significant (p-values < 0.0001). The highest-performing individual predictors were total acceleration (TA) (rcvC = 0.813) among PA measures, and age (rcvC = 0.757) among traditional predictors. The two-step forward-selection process produced a model containing age, sex, and TA (rcvC = 0.851). Adding TA to the model increased the rcvC by 9.8% (p-value < 0.0001). Results were largely unchanged in sensitivity analyses. CONCLUSIONS Objective PA summaries have better single-predictor model performance than known risk factors and increase the prediction performance substantially when added to models with age and sex.
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Affiliation(s)
- Angela Zhao
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA.
| | - Erjia Cui
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
- Division of Biostatistics, University of Minnesota Twin Cities, Minneapolis, USA
| | - Andrew Leroux
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - Martin A Lindquist
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
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20
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Kola S, Subramanian I. Updates in Parkinson's Disease Integrative Therapies: an Evidence-Based Review. Curr Neurol Neurosci Rep 2023; 23:717-726. [PMID: 37921943 DOI: 10.1007/s11910-023-01312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence-based integrative therapies for Parkinson's disease (PD) that may improve motor and non-motor symptoms, enhance quality of life, and alter disease progression. RECENT FINDINGS Imaging studies have demonstrated that aerobic exercise changes brain structure and function, while strength training improves posture and balance. Loneliness is associated with worsening PD severity, but social prescribing and cognitive behavioral therapy may effectively foster connections. Ayurvedic and traditional Chinese medicine practices including yoga, meditation, tai chi, and acupuncture may help improve mobility, mood, sleep, and quality of life. Art therapy enhances visuospatial skills, whereas music and dance therapy can alleviate freezing of gait. Several studies demonstrate successful use of these integrative strategies virtually, thereby improving patient accessibility and participation. PD management has broadened to include integrative approaches combining conventional and complementary therapies. Potential benefits of movement, nutrition, sleep, socialization, and mind-body practices have been confirmed with several recent randomized controlled trials.
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Affiliation(s)
- Sushma Kola
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Indu Subramanian
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- SW PADRECC, Veterans Affairs, Los Angeles, CA, USA
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21
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Miró-Padilla A, Adrián-Ventura J, Cherednichenko A, Monzonís-Carda I, Beltran-Valls MR, MolinerUrdiales D, Ávila C. Relevance of the anterior cingulate cortex volume and personality in motivated physical activity behaviors. Commun Biol 2023; 6:1106. [PMID: 37907751 PMCID: PMC10618534 DOI: 10.1038/s42003-023-05423-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023] Open
Abstract
Some recent theories about the origins and maintenance of regular physical activity focus on the rewards of the properties of practicing this activity. Animal and human studies have demonstrated that mesolimbic dopamine plays a crucial role in the involvement in voluntary physical activity. Here, we test this possible role in a sample of 66 right-handed healthy young adults by studying the influence of personality and the volume of reward-related brain areas on individual differences in voluntary physical activity, objectively measured by accelerometer and subjectively self-reported by questionnaire. Our results show that a smaller volume of the right anterior cingulate cortex and lower scores on reward sensitivity contributed to explaining low levels of daily physical activity. Moreover, the volume of the right anterior cingulate cortex correlates positively with self-reported total physical activity. Results are discussed by highlighting the need to use objective measures of daily physical activity, as well as the important role of the anterior cingulate cortex and personality in promoting effortful and invigorating actions to obtain rewards.
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Affiliation(s)
- Anna Miró-Padilla
- Neuropsychology and Functional Neuroimaging Group, Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain.
| | - Jesús Adrián-Ventura
- Neuropsychology and Functional Neuroimaging Group, Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- Department of Psychology and Sociology, University of Zaragoza, 44003, Teruel, Spain
| | - Anastasia Cherednichenko
- Neuropsychology and Functional Neuroimaging Group, Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Irene Monzonís-Carda
- LIFE Research Group, Department of Education, Universitat Jaume I, 12071, Castellon, Spain
| | | | - Diego MolinerUrdiales
- LIFE Research Group, Department of Education, Universitat Jaume I, 12071, Castellon, Spain
| | - César Ávila
- Neuropsychology and Functional Neuroimaging Group, Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
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22
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Li Q, Guo Z, Hu F, Xiao M, Zhang Q, Wen J, Ying T, Zheng D, Wang Y, Yang S, Hou H. Tourism experiences reduce the risk of cognitive impairment in the Chinese older adult: a prospective cohort study. Front Public Health 2023; 11:1271319. [PMID: 37942247 PMCID: PMC10629014 DOI: 10.3389/fpubh.2023.1271319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Background Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism's potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults. Method From a nationwide community-based cohort, 6,717 individuals aged ≥60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively followed up until 2018. The association between tourism and cognitive impairment was examined by the Cox proportional hazards regression model. The adjusted hazard ratio (aHR) and its 95% confidence interval (CI) were calculated to evaluate the effect of tourism experience on cognitive impairment and dementia. Results A total of 1,416 individuals were newly diagnosed with cognitive impairment and 139 individuals with dementia onset during follow-up. The incidence of cognitive impairment was significantly lower among participants with tourism experiences (316.94 per 10,000 person-years) than those without such experiences (552.38 per 10,000 person-years). Cox regression showed that tourism decreased the risk of cognitive impairment (aHR = 0.69, 95% CI: 0.41-0.62) when adjusted for behavioral covariates and characteristics. Compared with participants without tourism experiences, those with 1, 2, and ≥3 tourism experiences had a lower risk of cognitive impairment with the aHRs of 0.72 (95% CI: 0.52-0.99), 0.65 (0.42-1.01), and 0.68 (0.44-0.98), respectively. Tourism experiences also reduced participants' risk of dementia (aHR = 0.41, 95% CI: 0.19-0.89). Conclusion Our findings demonstrated associations between tourism and reduced risks of cognitive impairment and dementia in older Chinese adults. Thus, tourism could serve as a novel approach to dementia prevention.
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Affiliation(s)
- Qian Li
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zheng Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Fangli Hu
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
| | - Mengfei Xiao
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Qiang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jun Wen
- School of Business and Law, Edith Cowan University, Joondalup, WA, Australia
| | - Tianyu Ying
- Department of Tourism and Hotel Management, Zhejiang University, Hangzhou, China
| | - Danni Zheng
- Department of Tourism, Fudan University, Shanghai, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Song Yang
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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23
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Corcos DM. Beneficial effects of activity level on striatal binding: Careful replication is required. Parkinsonism Relat Disord 2023; 115:105856. [PMID: 37770321 DOI: 10.1016/j.parkreldis.2023.105856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Affiliation(s)
- Daniel M Corcos
- Northwestern University, Department of Physical Therapy and Human Movement Sciences, Chicago, IL, USA.
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Li Y, Zhao Z, Tan YY, Wang X. Dynamical analysis of the effects of circadian clock on the neurotransmitter dopamine. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:16663-16677. [PMID: 37920028 DOI: 10.3934/mbe.2023742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
The circadian clock is an autonomous timing system that regulates the physiological and behavioral activities of organisms. Dopamine (DA) is an important neurotransmitter that is associated with many biological activities such as mood and movement. Experimental studies have shown that the circadian clock influences the DA system and disorders in the circadian clock lead to DA-related diseases. However, the regulatory mechanism of the circadian clock on DA is far from clear. In this paper, we apply an existing circadian-dopamine mathematical model to explore the effects of the circadian clock on DA. Based on numerical simulations, we find the disturbance of the circadian clock, including clock gene mutations, jet lag and light pulses, leads to abnormal DA levels. The effects of mutations in some clock genes on the mood and behavior of mice are closely related to DA disruptions. By sensitivity analysis of DA levels to parameter perturbation, we identify key reactions that affect DA levels, which provides insights into modulating DA disorders. Sudden changes in external light influence the circadian clock, bringing about effects on the DA system. Jet lag causes transient DA rhythm desynchronization with the environment and the influence of jet lag in different directions on DA level and phase varies. Light pulses affect the amplitude and phase shift of DA, which provides a promising method for treating DA disorders through light exposure. This study helps to better understand the impact of the circadian clock on the DA system and provides theoretical support for the treatment of DA disorders.
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Affiliation(s)
- Ying Li
- College of Information Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Zhao Zhao
- College of Information Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Yuan-Yuan Tan
- College of Information Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Xue Wang
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 203306, China
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25
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Angelopoulou E, Stanitsa E, Karpodini CC, Bougea A, Kontaxopoulou D, Fragkiadaki S, Koros C, Georgakopoulou VE, Fotakopoulos G, Koutedakis Y, Piperi C, Papageorgiou SG. Pharmacological and Non-Pharmacological Treatments for Depression in Parkinson's Disease: An Updated Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1454. [PMID: 37629744 PMCID: PMC10456434 DOI: 10.3390/medicina59081454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Depression represents one of the most common non-motor disorders in Parkinson's disease (PD) and it has been related to worse life quality, higher levels of disability, and cognitive impairment, thereby majorly affecting not only the patients but also their caregivers. Available pharmacological therapeutic options for depression in PD mainly include selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants; meanwhile, agents acting on dopaminergic pathways used for motor symptoms, such as levodopa, dopaminergic agonists, and monoamine oxidase B (MAO-B) inhibitors, may also provide beneficial antidepressant effects. Recently, there is a growing interest in non-pharmacological interventions, including cognitive behavioral therapy; physical exercise, including dance and mind-body exercises, such as yoga, tai chi, and qigong; acupuncture; therapeutic massage; music therapy; active therapy; repetitive transcranial magnetic stimulation (rTMS); and electroconvulsive therapy (ECT) for refractory cases. However, the optimal treatment approach for PD depression is uncertain, its management may be challenging, and definite guidelines are also lacking. It is still unclear which of these interventions is the most appropriate and for which PD stage under which circumstances. Herein, we aim to provide an updated comprehensive review of both pharmacological and non-pharmacological treatments for depression in PD, focusing on recent clinical trials, systematic reviews, and meta-analyses. Finally, we discuss the pharmacological agents that are currently under investigation at a clinical level, as well as future approaches based on the pathophysiological mechanisms underlying the onset of depression in PD.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Evangelia Stanitsa
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Anastasia Bougea
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | - Christos Koros
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
| | | | - George Fotakopoulos
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece;
| | - Yiannis Koutedakis
- Functional Architecture of Mammals in Their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 38221 Volos, Greece;
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece; (E.A.); (E.S.); (A.B.); (D.K.); (S.F.); (C.K.)
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26
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Marino G, Campanelli F, Natale G, De Carluccio M, Servillo F, Ferrari E, Gardoni F, Caristo ME, Picconi B, Cardinale A, Loffredo V, Crupi F, De Leonibus E, Viscomi MT, Ghiglieri V, Calabresi P. Intensive exercise ameliorates motor and cognitive symptoms in experimental Parkinson's disease restoring striatal synaptic plasticity. SCIENCE ADVANCES 2023; 9:eadh1403. [PMID: 37450585 PMCID: PMC10348672 DOI: 10.1126/sciadv.adh1403] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
Intensive physical activity improves motor functions in patients with Parkinson's disease (PD) at early stages. However, the mechanisms underlying the beneficial effects of exercise on PD-associated neuronal alterations have not been fully clarified yet. Here, we tested the hypothesis that an intensive treadmill training program rescues alterations in striatal plasticity and early motor and cognitive deficits in rats receiving an intrastriatal injection of alpha-synuclein (α-syn) preformed fibrils. Improved motor control and visuospatial learning in active animals were associated with a recovery of dendritic spine density alterations and a lasting rescue of a physiological corticostriatal long-term potentiation (LTP). Pharmacological analyses of LTP show that modulations of N-methyl-d-aspartate receptors bearing GluN2B subunits and tropomyosin receptor kinase B, the main brain-derived neurotrophic factor receptor, are involved in these beneficial effects. We demonstrate that intensive exercise training has effects on the early plastic alterations induced by α-syn aggregates and reduces the spread of toxic α-syn species to other vulnerable brain areas.
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Affiliation(s)
- Gioia Marino
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Campanelli
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppina Natale
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria De Carluccio
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Neurosciences and Neurorehabilitation IRCCS S.Raffaele-Roma, Rome, Italy
| | - Federica Servillo
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elena Ferrari
- Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy
| | - Fabrizio Gardoni
- Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy
| | | | - Barbara Picconi
- Department of Human Sciences and Quality of Life Promotion, Università Telematica San Raffaele, Rome, Italy
- IRCCS San Raffaele Roma, Lab. Neurofisiologia Sperimentale, Roma, Italy
| | - Antonella Cardinale
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
- IRCCS San Raffaele Roma, Lab. Neurofisiologia Sperimentale, Roma, Italy
| | - Vittorio Loffredo
- Institute of Biochemistry and Cell Biology, National Research Council, Monterotondo (Rome), Italy
| | - Francesco Crupi
- Institute of Biochemistry and Cell Biology, National Research Council, Monterotondo (Rome), Italy
| | - Elvira De Leonibus
- Institute of Biochemistry and Cell Biology, National Research Council, Monterotondo (Rome), Italy
- Telethon Institute of Genetics and Medicine, Telethon Foundation, Pozzuoli (NA), Italy
| | - Maria Teresa Viscomi
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Veronica Ghiglieri
- Department of Human Sciences and Quality of Life Promotion, Università Telematica San Raffaele, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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27
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Kasanga EA, Soto I, Centner A, McManus R, Shifflet MK, Navarrete W, Han Y, Lisk J, Wheeler K, Mhatre-Winters I, Richardson JR, Bishop C, Nejtek VA, Salvatore MF. Moderate intensity aerobic exercise in 6-OHDA-lesioned rats alleviates established motor deficits and reduces neurofilament light and glial fibrillary acidic protein serum levels without increased striatal dopamine or tyrosine hydroxylase protein. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.11.548638. [PMID: 37502851 PMCID: PMC10369940 DOI: 10.1101/2023.07.11.548638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Alleviation of motor impairment by aerobic exercise (AE) in Parkinson's disease (PD) points to a CNS response that could be targeted by therapeutic approaches, but recovery of striatal dopamine (DA) or tyrosine hydroxylase (TH) has been inconsistent in rodent studies. Objective To increase translation of AE, 3 components were implemented into AE design to determine if recovery of established motor impairment, concomitant with >80% striatal DA and TH loss, was possible. We also evaluated if serum levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP), blood-based biomarkers of disease severity in human PD, were affected. Methods We used a 6-OHDA hemiparkinson rat model featuring progressive nigrostriatal neuron loss over 28 days, with impaired forelimb use 7 days post-lesion, and hypokinesia onset 21 days post-lesion. After establishing forelimb use deficits, moderate intensity AE began 1-3 days later, 3x per week, for 40 min/session. Motor assessments were conducted weekly for 3 wks, followed by determination of striatal DA, TH protein and mRNA, and NfL and GFAP serum levels. Results Seven days after 6-OHDA lesion, recovery of depolarization-stimulated extracellular DA and DA tissue content was <10%, representing severity of DA loss in human PD, concomitant with 50% reduction in forelimb use. Despite severe DA loss, recovery of forelimb use deficits and alleviation of hypokinesia progression began after 2 weeks of AE and was maintained. Increased NfLand GFAP levels from lesion were reduced by AE. Despite these AE-driven changes, striatal DA tissue and TH protein levels were unaffected. Conclusions This proof-of-concept study shows AE, using exercise parameters within the capabilities most PD patients, promotes recovery of established motor deficits in a rodent PD model, concomitant with reduced levels of blood-based biomarkers associated with PD severity, without commensurate increase in striatal DA or TH protein.
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28
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Curtin D, Taylor EM, Bellgrove MA, Chong TTJ, Coxon JP. D2 receptor blockade eliminates exercise-induced changes in cortical inhibition and excitation. Brain Stimul 2023; 16:727-733. [PMID: 37100200 DOI: 10.1016/j.brs.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Although cardiorespiratory exercise is known to affect cortical excitatory and inhibitory activity, the neurochemical mechanisms driving this effect are poorly understood. Animal models of Parkinson's disease identify dopamine D2 receptor expression as a candidate mechanism, but the link between the D2 receptor and exercise-induced changes in cortical activity in humans is unknown. OBJECTIVE Here, we examined the effect of a selective dopamine D2 receptor antagonist, sulpiride, on exercise-induced changes in cortical activity. METHODS We acquired measures of excitatory and inhibitory activity of the primary motor cortex using transcranial magnetic stimulation (TMS) from 23 healthy adults, both before and after a 20-min bout of high-intensity interval cycling exercise. We examined the effect of D2 receptor blockade (800 mg sulpiride) on these measures within a randomised, double-blind, placebo-controlled crossover design. RESULTS Sulpiride abolished exercise-induced modulation of the cortical excitation:inhibition balance relative to placebo (P < 0.001, Cohen's d = 1.76). Sulpiride blocked both the increase in glutamatergic excitation and reduction in gamma-aminobutyric acid (GABA) inhibition that was observed following exercise in the placebo condition. CONCLUSION Our results provide causal evidence that D2 receptor blockade eliminates exercise-induced changes in excitatory and inhibitory cortical networks, and have implications for how exercise should be prescribed in diseases of dopaminergic dysfunction.
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Affiliation(s)
- Dylan Curtin
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Eleanor M Taylor
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Mark A Bellgrove
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Trevor T-J Chong
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia; Department of Neurology, Alfred Health, Melbourne, Victoria, 3004, Australia; Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
| | - James P Coxon
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia.
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29
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Leem YH, Park JS, Park JE, Kim DY, Kim HS. Suppression of neuroinflammation and α-synuclein oligomerization by rotarod walking exercise in subacute MPTP model of Parkinson's disease. Neurochem Int 2023; 165:105519. [PMID: 36931345 DOI: 10.1016/j.neuint.2023.105519] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/27/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023]
Abstract
Parkinson's disease (PD) belongs to an α-synucleinopathy and manifests motor dysfunction attributed to nigrostriatal dopaminergic degeneration. In clinical practice, the beneficial role of physical therapy such as motor skill learning training has been recognized in PD-linked motor defects. Nevertheless, the disease-modifying effects of motor skill learning training on PD-related pathology remain unclear. Here, we investigated the disease-modifying effects of rotarod walking exercise (RWE), a modality of motor skill learning training, in a subacute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. In motor function and dopaminergic degeneration, RWE improved MPTP-induced deficits. In addition, RWE enhanced the expression of neurotrophic factors BDNF/GDNF, PGC1-α, Nurr1, and p-AMPK, thereby recovering dopaminergic neuronal cell death. Moreover, RWE inhibited microglial activation and the expression of pro-inflammatory markers, such as p-IκBα, iNOS, IL-1β, TNF-α, and cathepsin D, while elevating anti-inflammatory IL-10 and TGF-β. RWE also decreased oxidative stress markers in the substantia nigra, such as 4-HNE and 8-OHdG-positive cells, while increasing Nrf2-controlled antioxidant enzymes. Regarding the effect of RWE on α-synuclein, it reduced the monomer/oligomer forms of α-synuclein and phosphorylation at serine 129. Further mechanistic studies revealed that RWE suppressed the expression of matrix metalloproteinase-3 and p-GSK3β (Y216), which play key roles in α-synuclein aggregation. These data collectively suggest that inhibition of neuroinflammation and α-synuclein oligomerization by RWE may contribute to the improvement of PD pathology.
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Affiliation(s)
- Yea-Hyun Leem
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Jin-Sun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Jung-Eun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Do-Youn Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Hee-Sun Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea; Department of Brain & Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
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30
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Avgerinos KI, Liu J, Dalamaga M. Could exercise hormone irisin be a therapeutic agent against Parkinson's and other neurodegenerative diseases? Metabol Open 2023; 17:100233. [PMID: 36785617 PMCID: PMC9918419 DOI: 10.1016/j.metop.2023.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease (AD). The pathologic hallmarks of the disease are the loss of dopaminergic neurons of substantia nigra pars compacta and the presence of intraneuronal alpha synuclein (a-syn) aggregates. Clinical features of PD include motor symptoms such as bradykinesia, rigidity, tremors, postural instability, and gait impairment, and non-motor symptoms such as constipation, orthostatic hypotension, REM sleep disorder, depression and dementia. Currently, there is no disease-modifying therapy for PD. Several human studies have shown that exercise reduces progression of motor symptoms, improves performance on cognitive tasks, and slows functional deterioration. However, regular exercise may not always be feasible in PD patients. Irisin is an exercise-induced myokine involved in metabolism modulation and body fat reduction, but it also crosses the blood-brain barrier and may mediate some of the benefits of exercise in brain function. Recent evidence has shown that irisin could be therapeutically promising in PD as an "exercise-mimicking" intervention. Exogenous irisin administration decreases brain a-syn pathology and loss of dopaminergic neurons, while it improves motor outcomes in preclinical models. Several other neurodegenerative disorders such as AD share common underlying pathogenetic mechanisms with PD such as protein misfolding and aggregation, neuroinflammation, brain metabolic abnormalities, and neuronal loss. Therefore, investigation of irisin as a disease-modifying therapy could be promising for PD and other neurodegenerative disorders including AD.
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31
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de la Garanderie MP, Courtay A, Féral-Basin C, Rainville P, Gaveau J, Pageaux B. Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks. Front Psychol 2023; 13:974172. [PMID: 36760904 PMCID: PMC9904170 DOI: 10.3389/fpsyg.2022.974172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023] Open
Abstract
Purpose The perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks. The present study examines the validity of PE to prescribe and monitor exercise during upper-limb motor tasks under various loads and speed requirements. Methods Forty participants volunteered in two experiments. In experiment 1, we used four PE intensities to prescribe exercise on a modified version of the box and block test (BBT) and a pointing task. We investigated the possibility of monitoring the exercise intensity by tracking changes in PE rating in response to three different tempos or additional weights. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of additional weights on performance and PE during the standardized version of the BBT. Muscle activation, heart rate, and respiratory frequencies were recorded. Results In experiment 1, increasing the PE intensity to prescribe exercise induced an increased performance between each intensity. Increasing task difficulty with faster movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, participants maintained performance at the cost of a higher PE. In both experiments, changes in PE were associated with changes in muscle activation. Conclusion Our results suggest that PE is a valid tool to prescribe and monitor exercise during upper-limb motor tasks.
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Affiliation(s)
- Marie Payen de la Garanderie
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
| | - Aymeric Courtay
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
| | - Camille Féral-Basin
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
| | - Pierre Rainville
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- Département de Stomatologie, Faculté de Médecine Dentaire, Université de Montréal, Montreal, QC, Canada
| | - Jérémie Gaveau
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
- Espace d’Etude du Mouvement—Etienne Jules MAREY, Université Bourgogne Franche-Comte, UFR des Sciences du Sport, Dijon, France
| | - Benjamin Pageaux
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- Centre Interdisciplinaire de Recherche sur le Cerveau et l’Apprentissage (CIRCA), Montreal, QC, Canada
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Kim R, Lee TL, Lee H, Ko DK, Jeon B, Kang N. Effects of Exercise on Depressive Symptoms in Patients With Parkinson Disease: A Meta-analysis. Neurology 2023; 100:e377-e387. [PMID: 36220597 DOI: 10.1212/wnl.0000000000201453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to provide clear evidence in support of the use of exercise to improve depressive symptoms in patients with Parkinson disease (PD) and to investigate whether this effect differs by exercise type and intensity. METHODS Three independent reviewers searched for randomized controlled trials (RCTs) that applied exercise interventions with depressive symptoms as an outcome measure for patients with PD on PubMed and Web of Science up to February 28, 2022. Random-effects meta-analyses were performed, in which standardized mean differences (SMDs) between the effects of exercise and control interventions on depressive symptoms with 95% CIs were calculated. RESULTS A total of 19 RCTs including 1,302 patients with PD were eligible for meta-analysis, and we obtained 23 comparisons from the included studies for data synthesis. Physical exercise interventions showed significant effects on the reduction in depressive symptoms in patients with PD (SMD = 0.829; 95% CI = 0.516-1.142; p < 0.001). Moderator analyses on exercise type revealed significant positive effects for combined exercise interventions (SMD = 1.111; 95% CI = 0.635-1.587; p < 0.001), whereas aerobic training alone failed to show significant effects (SMD = 0.202; 95% CI = -0.045 to 0.449; p = 0.108). Both light-to-moderate intensity exercises (SMD = 0.971; 95% CI = 0.521-1.421; p < 0.001) and moderate-to-vigorous intensity exercises (SMD = 0.779; 95% CI = 0.407-1.152; p < 0.001) significantly improved depressive symptoms with a small difference between the exercise intensities. DISCUSSION Our results suggest that physical exercise has significant antidepressant effects in patients with PD. These effects seemed to be more closely associated with exercise type than intensity. Different types of exercise interventions may result in greater benefit and require further investigation.
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Affiliation(s)
- Ryul Kim
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea
| | - Tae Lee Lee
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea
| | - Hanall Lee
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea
| | - Do Kyung Ko
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea
| | - Beomseok Jeon
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea
| | - Nyeonju Kang
- From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
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da Costa RO, Gadelha-Filho CVJ, de Aquino PEA, Lima LAR, de Lucena JD, Ribeiro WLC, Lima FAV, Neves KRT, de Barros Viana GS. Vitamin D (VD3) Intensifies the Effects of Exercise and Prevents Alterations of Behavior, Brain Oxidative Stress, and Neuroinflammation, in Hemiparkinsonian Rats. Neurochem Res 2023; 48:142-160. [PMID: 36028736 DOI: 10.1007/s11064-022-03728-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/31/2022] [Accepted: 08/15/2022] [Indexed: 01/11/2023]
Abstract
In the present study, we investigated the effects of physical exercise in the presence of Vitamin D3 (VD3), on 6-hydroxydopamine (6-OHDA)-lesioned hemiparkinsonian rats. The animals were divided into sham-operated (SO), 6-OHDA-lesioned, and 6-OHDA-lesioned plus VD3 (1 µg/kg, 21 days), in the absence (no exercise, NE) and presence (with exercise, WE) of physical exercise on a treadmill (30 min, speed of 20 cm/s, once a day/21 days). This procedure started, 24 h after the stereotaxic surgery (injections of 6-OHDA into the right striatum). The animals were then subjected to behavioral (rotarod, open field, and apomorphine tests) and their brain areas were dissected for neurochemical, dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC) determinations, and immunohistochemical studies for tyrosine hydroxylase (TH), dopamine transporter (DAT), and vitamin D receptor (VD3R). The effects on the brain oxidative stress: nitrite/nitrate, glutathione (GSH), and malondialdehyde (MDA) measurements were also evaluated. Behavioral changes of the 6-OHDA lesioned group were improved by exercise plus VD3. Similar results were observed in dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) concentrations increased by exercise and VD3, compared with SO groups. Additionally, tyrosine hydroxylase (TH) and dopamine transporter (DAT) immunoexpressions were decreased in the 6-OHDA-lesioned groups, with values normalized after exercise and VD3. The VD3 receptor immunoexpression decreased in the 6-OHDA (NE) group, and this was attenuated by exercise, especially after VD3. While 6-OHDA lesions increased, VD3 supplementation decreased the oxidative stress, which was intensified by exercise. VD3 showed neuroprotective properties that were intensified by physical exercise. These VD3 actions on hemiparkinsonian rats are possibly related to its antioxidant and anti-inflammatory effects.
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Affiliation(s)
- Roberta Oliveira da Costa
- Graduate Program of Morphofunctional Sciences, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Ludmila Araújo Rodrigues Lima
- Graduate Program of Morphofunctional Sciences, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil
| | - Jalles Dantas de Lucena
- Graduate Program of Morphofunctional Sciences, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Kelly Rose Tavares Neves
- Graduate Program of Pharmacology, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil
| | - Glauce Socorro de Barros Viana
- Graduate Program of Morphofunctional Sciences, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil. .,Graduate Program of Pharmacology, Faculty of Medicine of the Federal University of Ceará, Fortaleza, Brazil.
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34
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Chen H, Dong G, Li K. Overview on brain function enhancement of Internet addicts through exercise intervention: Based on reward-execution-decision cycle. Front Psychiatry 2023; 14:1094583. [PMID: 36816421 PMCID: PMC9933907 DOI: 10.3389/fpsyt.2023.1094583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
Internet addiction (IA) has become an impulse control disorder included in the category of psychiatric disorders. The IA trend significantly increased after the outbreak of the new crown epidemic. IA damages some brain functions in humans. Emerging evidence suggests that exercise exerts beneficial effects on the brain function and cognitive level damaged by IA. This work reviews the neurobiological mechanisms of IA and describes the brain function impairment by IA from three systems: reward, execution, and decision-making. Furthermore, we sort out the research related to exercise intervention on IA and its effect on improving brain function. The internal and external factors that produce IA must be considered when summarizing movement interventions from a behavioral perspective. We can design exercise prescriptions based on exercise interests and achieve the goal of quitting IA. This work explores the possible mechanisms of exercise to improve IA through systematic analysis. Furthermore, this work provides research directions for the future targeted design of exercise prescriptions.
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Affiliation(s)
- Hao Chen
- Department of Sports, Quzhou University, Quzhou, China.,Department of Graduate School of Education, Shandong Sport University, Jinan, China
| | - Guijun Dong
- Department of Sports, Quzhou University, Quzhou, China.,Department of Graduate School of Education, Shandong Sport University, Jinan, China
| | - Kefeng Li
- Department of Medicine, Quzhou College of Technology, Quzhou, China
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35
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Obeso JA, Monje MHG, Matarazzo M. Major advances in Parkinson's disease over the past two decades and future research directions. Lancet Neurol 2022; 21:1076-1079. [DOI: 10.1016/s1474-4422(22)00448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022]
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36
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Gallou-Guyot M, Nuic D, Mandigout S, Compagnat M, Welter ML, Daviet JC, Perrochon A. Effectiveness of home-based rehabilitation using active video games on quality of life, cognitive and motor functions in people with Parkinson's disease: a systematic review. Disabil Rehabil 2022; 44:8222-8233. [PMID: 34982599 DOI: 10.1080/09638288.2021.2022780] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE We summarized the effectiveness of home-based active video game interventions on physical and cognitive functions, as well as quality of life in adults with Parkinson's disease. We also assessed the feasibility, safety, adherence, and retention of benefits of these interventions. METHOD We searched studies in eight databases from 1st March to 30th November 2020. Two authors independently performed the selection, data extraction and risk of bias evaluation (PROSPERO ID: CRD42020178138). RESULTS Nine studies were included in this systematic review (412 participants). All in all, home-based active video games were found effective in improving gait and balance functions in people with Parkinson's disease, equivalent to usual care and conventional therapy. No conclusion can be drawn on cognition and quality of life. Home-based active video games seemed feasible, safe, and were enjoyed by people with Parkinson's disease. The optimal dose, the need for supervision and the retention of benefits of these interventions are still to be determined. These results should be interpreted carefully, considering the limited number of included studies and their small sample sizes, the widespread heterogeneity of included studies and their medium average methodological quality. CONCLUSION Future research should focus on the effects of home-based active video games on impairments specific to Parkinson's disease, such as falls, freezing of gait and attention, as well as the dose, need for supervision and retention of the benefits of these interventions.IMPLICATIONS FOR REHABILITATIONHome-based active video games are effective in improving motor functions in people with PD.No conclusion can be drawn regarding cognition in people with PD.No conclusion can be drawn regarding quality of life in people with PD.Home-based active video games seem feasible and safe, and are enjoyed by people with PD.The dose, need for control and retention of the benefits still need to be determined.
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Affiliation(s)
- M Gallou-Guyot
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - D Nuic
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Mandigout
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - M Compagnat
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - M L Welter
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France.,Département de Neurophysiologie, CHU Rouen, Rouen, France
| | - J C Daviet
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - A Perrochon
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
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37
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Wang Y, Sun X, Li F, Li Q, Jin Y. Efficacy of non-pharmacological interventions for depression in individuals with Parkinson's disease: A systematic review and network meta-analysis. Front Aging Neurosci 2022; 14:1050715. [PMID: 36438007 PMCID: PMC9691406 DOI: 10.3389/fnagi.2022.1050715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/26/2022] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Depression in Parkinson's disease (PD) is a major health concern worldwide. Recently, an increasing number of non-pharmacological interventions have been used in PD to alleviate depressive symptoms. However, it is uncertain which intervention is the best, and related evidence is limited. This network meta-analysis was performed to compare and rank non-pharmacological interventions for PD and analyze their effects on depression to provide evidence for clinicians to choose appropriate non-pharmacological management options. METHODS The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched from inception to April 7, 2022. Two authors screened all studies, extracted the data, and evaluated the methodological quality. STATA software version 16.0 was used to conduct the network meta-analysis. RESULTS Our network meta-analysis included 62 studies involving 3,050 participants and 35 non-pharmacological interventions. Although most non-pharmacological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values indicated that the best non-pharmacological intervention for depression was dance (82.3%), followed by LSVT-BIG therapy (77.4%), and CBT (73.6%). CONCLUSION Dance can be considered as an effective therapy for improving depression in patients with PD. In the future, more strictly designed trials are needed to verify the conclusions of this network meta-analysis.
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Affiliation(s)
- Yuxin Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue Sun
- Nursing Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fei Li
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Qi Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yi Jin
- Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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Zhen K, Zhang S, Tao X, Li G, Lv Y, Yu L. A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson's disease. NPJ Parkinsons Dis 2022; 8:146. [PMID: 36316416 PMCID: PMC9622812 DOI: 10.1038/s41531-022-00418-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Previous studies have shown that aerobic exercise is an effective way to improve symptoms of Parkinson's disease (PD). The aim of this study [PROSPERO CRD42022340730] was to explore the effects of aerobic exercises on balance, gait, motor function, and quality of life in PD patients. Searches were performed in PubMed, Web of Science, and EBSCO electronic databases. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1287 search records initially identified, 20 studies were considered eligible for systematic review and meta-analysis. There was a significant effect of aerobic exercise on improving timed up and go test [standardized mean difference (SMD), -0.41 (95% CI, -0.61 to -0.22), p < 0.00001], Berg Balance Scale [0.99 (95% CI, 0.76 to 1.23), p < 0.00001], stride/step length [0.32 (95% CI, 0.03 to 0.61), p = 0.03], gait velocity [0.49 (95% CI, 0.20 to 0.78), p = 0.0009], Unified Parkinson's Disease Rating Scale Part-III [-0.40 (95% CI, -0.55 to -0.24), p < 0.00001], and 6-minute walking test [0.35 (95% CI, 0.13 to 0.56), p = 0.002] in people with PD, but not in step cadence [-0.08 (95% CI, -0.43 to 0.27), p = 0.65] and Parkinson's Disease Questionnaire-39 [-0.113 (95% CI, -0.39 to 0.13), p = 0.32]. Aerobic exercise had beneficial effects in improving balance, gait (velocity and stride/step length), and motor function in PD patients. However, aerobic exercise had no significant associations with the step cadence and quality of life in PD patients.
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Affiliation(s)
- Kai Zhen
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Gen Li
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
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Scarfò G, Piccarducci R, Daniele S, Franzoni F, Martini C. Exploring the Role of Lipid-Binding Proteins and Oxidative Stress in Neurodegenerative Disorders: A Focus on the Neuroprotective Effects of Nutraceutical Supplementation and Physical Exercise. Antioxidants (Basel) 2022; 11:2116. [PMID: 36358488 PMCID: PMC9686611 DOI: 10.3390/antiox11112116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 07/29/2023] Open
Abstract
The human brain is primarily composed of lipids, and their homeostasis is crucial to carry on normal neuronal functions. In order to provide an adequate amount of lipid transport in and out of the central nervous system, organisms need a set of proteins able to bind them. Therefore, alterations in the structure or function of lipid-binding proteins negatively affect brain homeostasis, as well as increase inflammation and oxidative stress with the consequent risk of neurodegeneration. In this regard, lifestyle changes seem to be protective against neurodegenerative processes. Nutraceutical supplementation with antioxidant molecules has proven to be useful in proving cognitive functions. Additionally, regular physical activity seems to protect neuronal vitality and increases antioxidant defenses. The aim of the present review was to investigate mechanisms that link lipid-binding protein dysfunction and oxidative stress to cognitive decline, also underlining the neuroprotective effects of diet and exercise.
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Affiliation(s)
- Giorgia Scarfò
- Department of Clinical and Experimental Medicine, Division of General Medicine, University of Pisa, 56126 Pisa, Italy
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, 56126 Pisa, Italy
| | | | - Simona Daniele
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, Division of General Medicine, University of Pisa, 56126 Pisa, Italy
- Center for Rehabilitative Medicine “Sport and Anatomy”, University of Pisa, 56126 Pisa, Italy
| | - Claudia Martini
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
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40
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Weintraub D, Aarsland D, Biundo R, Dobkin R, Goldman J, Lewis S. Management of psychiatric and cognitive complications in Parkinson's disease. BMJ 2022; 379:e068718. [PMID: 36280256 DOI: 10.1136/bmj-2021-068718] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson's disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Roberta Biundo
- Department of General Psychology, University of Padua, Padua, Italy
- Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer Goldman
- Shirley Ryan AbilityLab, Parkinson's Disease and Movement Disorders, Chicago, IL
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
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Patterson CG, Joslin E, Gil AB, Spigle W, Nemet T, Chahine L, Christiansen CL, Melanson E, Kohrt WM, Mancini M, Josbeno D, Balfany K, Griffith G, Dunlap MK, Lamotte G, Suttman E, Larson D, Branson C, McKee KE, Goelz L, Poon C, Tilley B, Kang UJ, Tansey MG, Luthra N, Tanner CM, Haus JM, Fantuzzi G, McFarland NR, Gonzalez-Latapi P, Foroud T, Motl R, Schwarzschild MA, Simuni T, Marek K, Naito A, Lungu C, Corcos DM. Study in Parkinson's disease of exercise phase 3 (SPARX3): study protocol for a randomized controlled trial. Trials 2022; 23:855. [PMID: 36203214 PMCID: PMC9535216 DOI: 10.1186/s13063-022-06703-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To date, no medication has slowed the progression of Parkinson's disease (PD). Preclinical, epidemiological, and experimental data on humans all support many benefits of endurance exercise among persons with PD. The key question is whether there is a definitive additional benefit of exercising at high intensity, in terms of slowing disease progression, beyond the well-documented benefit of endurance training on a treadmill for fitness, gait, and functional mobility. This study will determine the efficacy of high-intensity endurance exercise as first-line therapy for persons diagnosed with PD within 3 years, and untreated with symptomatic therapy at baseline. METHODS This is a multicenter, randomized, evaluator-blinded study of endurance exercise training. The exercise intervention will be delivered by treadmill at 2 doses over 18 months: moderate intensity (4 days/week for 30 min per session at 60-65% maximum heart rate) and high intensity (4 days/week for 30 min per session at 80-85% maximum heart rate). We will randomize 370 participants and follow them at multiple time points for 24 months. The primary outcome is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score (Part III) with the primary analysis assessing the change in MDS-UPDRS motor score (Part III) over 12 months, or until initiation of symptomatic antiparkinsonian treatment if before 12 months. Secondary outcomes are striatal dopamine transporter binding, 6-min walk distance, number of daily steps, cognitive function, physical fitness, quality of life, time to initiate dopaminergic medication, circulating levels of C-reactive protein (CRP), and brain-derived neurotrophic factor (BDNF). Tertiary outcomes are walking stride length and turning velocity. DISCUSSION SPARX3 is a Phase 3 clinical trial designed to determine the efficacy of high-intensity, endurance treadmill exercise to slow the progression of PD as measured by the MDS-UPDRS motor score. Establishing whether high-intensity endurance treadmill exercise can slow the progression of PD would mark a significant breakthrough in treating PD. It would have a meaningful impact on the quality of life of people with PD, their caregivers and public health. TRIAL REGISTRATION ClinicalTrials.gov NCT04284436 . Registered on February 25, 2020.
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Affiliation(s)
- Charity G. Patterson
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Elizabeth Joslin
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
| | - Alexandra B. Gil
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Wendy Spigle
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Todd Nemet
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Lana Chahine
- Department of Neurology, University of Pittsburgh, School of Medicine, 3471 Fifth Avenue, Pittsburgh, PA 15213 USA
| | - Cory L. Christiansen
- Department of Physical Medicine & Rehabilitation, University of Colorado, School of Medicine, Aurora, CO 80217 USA
| | - Ed Melanson
- Division of Endocrinology, Metabolism and Diabetes, and Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado VA Health Care System, Geriatric Research Education and Clinical Center (GRECC), Denver, CO USA
| | - Wendy M. Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VAMC, Aurora, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Road, Portland, OR 97219 USA
| | - Deborah Josbeno
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Katherine Balfany
- Department of Physical Medicine & Rehabilitation, University of Colorado, School of Medicine, Aurora, CO 80217 USA
| | - Garett Griffith
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
| | - Mac Kenzie Dunlap
- Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 USA
| | - Guillaume Lamotte
- Movement Disorders Division, Department of Neurology, University of Utah, 175 Medical Dr N, Salt Lake City, UT 84132 USA
| | - Erin Suttman
- Department of Physical Therapy & Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 84115 USA
| | - Danielle Larson
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Chantale Branson
- Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310 USA
| | - Kathleen E. McKee
- Neurosciences Clinical Program, Intermountain Healthcare, 5171 S Cottonwood Street, Suite 810, Murray, UT 84107 USA
| | - Li Goelz
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Cynthia Poon
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Barbara Tilley
- Department of Biostatistics and Data Science, University of Texas Health Science Center School of Public Health, 1200 Pressler Street E835, Houston, TX 77030 USA
| | - Un Jung Kang
- NYU Langone Health, NYU Grossman School of Medicine, 435 E 30th Street, Science Building 1305, New York, NY 10016 USA
| | - Malú Gámez Tansey
- Department of Neuroscience and Neurology, Normal Fixel Institute for Neurological Diseases and College of Medicine, University of Florida, 4911 Newell Road, Gainesville, FL 32610 USA
| | - Nijee Luthra
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, 1651 4th Street, San Francisco, CA 94158 USA
| | - Caroline M. Tanner
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, 1651 4th Street, San Francisco, CA 94158 USA
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, 830 N. University Ave, Ann Arbor, MI 48109 USA
| | - Giamila Fantuzzi
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Nikolaus R. McFarland
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, College of Medicine, University of Florida, Gainesville, FL 32608 USA
| | - Paulina Gonzalez-Latapi
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN 46220 USA
| | - Robert Motl
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Michael A. Schwarzschild
- Mass General Institute for Neurodegenerative Disease, Massachusetts General Hospital, Rm 3002, 114 16th Street, Boston, MA 02129 USA
| | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, 60 Temple St, New Haven, CT 06510 USA
| | - Anna Naito
- Parkinson’s Foundation 200 SE 1st Street Suite 800, Miami, FL 33131 USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke, NIH, 6001 Executive Blvd, #2188, Rockville, MD 20852 USA
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
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Imaging the Limbic System in Parkinson's Disease-A Review of Limbic Pathology and Clinical Symptoms. Brain Sci 2022; 12:brainsci12091248. [PMID: 36138984 PMCID: PMC9496800 DOI: 10.3390/brainsci12091248] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023] Open
Abstract
The limbic system describes a complex of brain structures central for memory, learning, as well as goal directed and emotional behavior. In addition to pathological studies, recent findings using in vivo structural and functional imaging of the brain pinpoint the vulnerability of limbic structures to neurodegeneration in Parkinson's disease (PD) throughout the disease course. Accordingly, dysfunction of the limbic system is critically related to the symptom complex which characterizes PD, including neuropsychiatric, vegetative, and motor symptoms, and their heterogeneity in patients with PD. The aim of this systematic review was to put the spotlight on neuroimaging of the limbic system in PD and to give an overview of the most important structures affected by the disease, their function, disease related alterations, and corresponding clinical manifestations. PubMed was searched in order to identify the most recent studies that investigate the limbic system in PD with the help of neuroimaging methods. First, PD related neuropathological changes and corresponding clinical symptoms of each limbic system region are reviewed, and, finally, a network integration of the limbic system within the complex of PD pathology is discussed.
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Prange S, Theis H, Banwinkler M, van Eimeren T. Molecular Imaging in Parkinsonian Disorders—What’s New and Hot? Brain Sci 2022; 12:brainsci12091146. [PMID: 36138882 PMCID: PMC9496752 DOI: 10.3390/brainsci12091146] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
Highlights Abstract Neurodegenerative parkinsonian disorders are characterized by a great diversity of clinical symptoms and underlying neuropathology, yet differential diagnosis during lifetime remains probabilistic. Molecular imaging is a powerful method to detect pathological changes in vivo on a cellular and molecular level with high specificity. Thereby, molecular imaging enables to investigate functional changes and pathological hallmarks in neurodegenerative disorders, thus allowing to better differentiate between different forms of degenerative parkinsonism, improve the accuracy of the clinical diagnosis and disentangle the pathophysiology of disease-related symptoms. The past decade led to significant progress in the field of molecular imaging, including the development of multiple new and promising radioactive tracers for single photon emission computed tomography (SPECT) and positron emission tomography (PET) as well as novel analytical methods. Here, we review the most recent advances in molecular imaging for the diagnosis, prognosis, and mechanistic understanding of parkinsonian disorders. First, advances in imaging of neurotransmission abnormalities, metabolism, synaptic density, inflammation, and pathological protein aggregation are reviewed, highlighting our renewed understanding regarding the multiplicity of neurodegenerative processes involved in parkinsonian disorders. Consequently, we review the role of molecular imaging in the context of disease-modifying interventions to follow neurodegeneration, ensure stratification, and target engagement in clinical trials.
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Affiliation(s)
- Stéphane Prange
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Université de Lyon, 69675 Bron, France
- Correspondence: (S.P.); (T.v.E.); Tel.: +49-221-47882843 (T.v.E.)
| | - Hendrik Theis
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Department of Neurology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
| | - Magdalena Banwinkler
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Department of Neurology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Correspondence: (S.P.); (T.v.E.); Tel.: +49-221-47882843 (T.v.E.)
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Hortobágyi T, Vetrovsky T, Balbim GM, Sorte Silva NCB, Manca A, Deriu F, Kolmos M, Kruuse C, Liu-Ambrose T, Radák Z, Váczi M, Johansson H, Dos Santos PCR, Franzén E, Granacher U. The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease. Ageing Res Rev 2022; 80:101698. [PMID: 35853549 DOI: 10.1016/j.arr.2022.101698] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. DESIGN Systematic review and robust variance estimation meta-analysis with meta-regression. DATA SOURCES Systematic search of MEDLINE, Web of Science, and CINAHL databases. RESULTS Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. CONCLUSION Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.
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Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary; Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany; Hungarian University of Sports Science, Department of Kinesiology, Budapest, Hungary.
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Guilherme Moraes Balbim
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
| | - Mia Kolmos
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christina Kruuse
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Zsolt Radák
- Research Center of Molecular Exercise Science, Hungarian University of Sport Science, Budapest, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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Thrue C, Hvid LG, Gamborg M, Dawes H, Dalgas U, Langeskov-Christensen M. Aerobic capacity in persons with Parkinson’s disease: a systematic review. Disabil Rehabil 2022:1-13. [DOI: 10.1080/09638288.2022.2094480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Cecilie Thrue
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Lars G. Hvid
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Mads Gamborg
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Helen Dawes
- Faculty of Health and Life Sciences, Centre for Movement and Occupational Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ulrik Dalgas
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
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Wu M, Tang Q, Wang L, Zhang M, Song W, Teng L, Zhu L. Efficacy of Traditional Chinese Exercise in Improving Gait and Balance in Cases of Parkinson's Disease: A Systematic Review and Meta-analysis. Front Aging Neurosci 2022; 14:927315. [PMID: 35847669 PMCID: PMC9285003 DOI: 10.3389/fnagi.2022.927315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of motor function in patients with Parkinson's disease (PD) is controversial. The present study aimed to assess the effects of TCE on balance and gait outcomes, as well as motor symptoms in individuals with PD, and evaluate potential discrete moderators such as TCE dosage-related variables. Method PubMed, Embase, Cochrane's Library, Web of Science, Medline, and Scopus were systematically searched from their dates of inception to February 2022. All studies were randomized controlled trials (RCTs) of TCE-based interventions for PD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges' g). The Physiotherapy Evidence Database was used to evaluate the methodological quality of the study. Result Fifteen studies involving a total of 873 participants were included in the final analysis. The meta-analytic findings revealed significant improvements in balance outcomes [Berg Balance Scales (BBS) (g = 0.83, 95% CI = 0.37–1.29, p = 0.000, I2 = 84%), time up and go (TUG) (g = −0.80, 95% CI = −1.13– −0.47, p = 0.000, I2 = 81%), and the one legged blind balance test (g = 0.49, 95% CI = 0.13–0.86, p = 0.01, I2 = 10%)], as well as gait outcomes [gait velocity (g = 0.28, 95% CI = 0.02–0.54, p = 0.04, I2 = 64%), 6-min walking test (6MWT) (g = 0.32, 95% CI 0.01–0.62, p = 0.04, I2= 15%), stride length (g = 0.25, 95% CI = 0.08–0.41, p = 0.003, I2 = 42%)], and motor symptoms [Unified Parkinson's Disease Rating Scale part III (UPDRS-III) (g = −0.77, 95% CI = −1.06– −0.48, p = 0.000, I2 = 76%)]. However, cadence (g = −0.03) and step length (g = 0.02) did not differ significantly. The moderator shows that the effects of TCE on BBS and gait velocity were moderated by Pedro score, exercise type, control group type, and number of sessions. Meta-regression found that TCE (exercise duration, number of sessions, and session duration) was significantly associated with improved UPDRS-III and BBS scores. Conclusion These findings provide evidence for the therapeutic benefits of TCE as an adjunct therapy for patients with PD. TEC dosage (high-intensity long sessions) may moderate some favorable effects. Systematic Review Registration PROSPERO, identifier CRD42022314686.
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Affiliation(s)
- Minmin Wu
- Department of Rehabilitation Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qiang Tang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Linjing Wang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mei Zhang
- Department of Rehabilitation Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wenjing Song
- Department of Rehabilitation Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lili Teng
- Department of Rehabilitation Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
- *Correspondence: Luwen Zhu
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Neurogenic effects of rotarod walking exercise in subventricular zone, subgranular zone, and substantia nigra in MPTP-induced Parkinson's disease mice. Sci Rep 2022; 12:10544. [PMID: 35732806 PMCID: PMC9217938 DOI: 10.1038/s41598-022-14823-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/13/2022] [Indexed: 01/19/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease, and its incidence is predicted to increase worldwide. Striatal dopamine depletion caused by substantia nigra (SN) degeneration is a pathological hallmark of PD and is strongly associated with cardinal motor and non-motor symptoms. Previous studies have reported that exercise increases neuroplasticity and promotes neurorestoration by increasing neurotrophic factors and synaptic strength and stimulating neurogenesis in PD. In the present study, we found that rotarod walking exercise, a modality of motor skill learning training, improved locomotor disturbances and reduced nigrostriatal degeneration in the subacute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. In addition, our exercise regimen improved MPTP-induced perturbation of adult neurogenesis in some areas of the brain, including the subventricular zone, subgranular zone, SN, and striatum. Moreover, rotarod walking activated the phosphorylation of adenosine monophosphate-activated protein kinase (AMPK) and induced brain-derived neurotrophic factor (BDNF) expression in these regions. The results suggest that motor skill learning training using rotarod walking improves adult neurogenesis and restores motor performance by modulating the AMPK/BDNF pathway. Therefore, our findings provide evidence for neuroprotective effects and improved neuroplasticity in PD through motor skill learning training.
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Licen T, Rakusa M, Bohnen NI, Manganotti P, Marusic U. Brain Dynamics Underlying Preserved Cycling Ability in Patients With Parkinson's Disease and Freezing of Gait. Front Psychol 2022; 13:847703. [PMID: 35783714 PMCID: PMC9244145 DOI: 10.3389/fpsyg.2022.847703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022] Open
Abstract
Parkinson's disease (PD) is generally associated with abnormally increased beta band oscillations in the cortico-basal ganglia loop during walking. PD patients with freezing of gait (FOG) exhibit a more distinct, prolonged narrow band of beta oscillations that are locked to the initiation of movement at ∼18 Hz. Upon initiation of cycling movements, this oscillation has been reported to be weaker and rather brief in duration. Due to the suppression of the overall beta band power during cycling and its continuous nature of the movement, cycling is considered to be less demanding for cortical networks compared to walking, including reduced need for sensorimotor processing, and thus unimpaired continuous cycling motion. Furthermore, cycling has been considered one of the most efficient non-pharmacological therapies with an influence on the subthalamic nucleus (STN) beta rhythms implicative of the deep brain stimulation effects. In the current review, we provide an overview of the currently available studies and discuss the underlying mechanism of preserved cycling ability in relation to the FOG in PD patients. The mechanisms are presented in detail using a graphical scheme comparing cortical oscillations during walking and cycling in PD.
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Affiliation(s)
- Teja Licen
- Faculty of Medicine, Institute of Sports Medicine Maribor, University of Maribor, Maribor, Slovenia
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Martin Rakusa
- Division of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Nicolaas I. Bohnen
- Functional Neuroimaging, Cognitive and Mobility Laboratory, Department of Radiology, University of Michigan, Ann Arbor, MI, United States
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, United States
- Geriatric Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Neurology, University of Michigan, Ann Arbor, MI, United States
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Uros Marusic
- Faculty of Medicine, Institute of Sports Medicine Maribor, University of Maribor, Maribor, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, Maribor, Slovenia
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Prange S, Klinger H, Laurencin C, Danaila T, Thobois S. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging 2022; 39:417-439. [PMID: 35705848 PMCID: PMC9200562 DOI: 10.1007/s40266-022-00942-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 12/11/2022]
Abstract
Depression is one of the most frequent and burdensome non-motor symptoms in Parkinson’s disease (PD), across all stages. Even when its severity is mild, PD depression has a great impact on quality of life for these patients and their caregivers. Accordingly, accurate diagnosis, supported by validated scales, identification of risk factors, and recognition of motor and non-motor symptoms comorbid to depression are critical to understanding the neurobiology of depression, which in turn determines the effectiveness of dopaminergic drugs, antidepressants and non-pharmacological interventions. Recent advances using in vivo functional and structural imaging demonstrate that PD depression is underpinned by dysfunction of limbic networks and monoaminergic systems, depending on the stage of PD and its associated symptoms, including apathy, anxiety, rapid eye movement sleep behavior disorder (RBD), cognitive impairment and dementia. In particular, the evolution of serotonergic, noradrenergic, and dopaminergic dysfunction and abnormalities of limbic circuits across time, involving the anterior cingulate and orbitofrontal cortices, amygdala, thalamus and ventral striatum, help to delineate the variable expression of depression in patients with prodromal, early and advanced PD. Evidence is accumulating to support the use of dual serotonin and noradrenaline reuptake inhibitors (desipramine, nortriptyline, venlafaxine) in patients with PD and moderate to severe depression, while selective serotonin reuptake inhibitors, repetitive transcranial magnetic stimulation and cognitive behavioral therapy may also be considered. In all patients, recent findings advocate that optimization of dopamine replacement therapy and evaluation of deep brain stimulation of the subthalamic nucleus to improve motor symptoms represents an important first step, in addition to physical activity. Overall, this review indicates that increasing understanding of neurobiological changes help to implement a roadmap of tailored interventions for patients with PD and depression, depending on the stage and comorbid symptoms underlying PD subtypes and their prognosis.
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Affiliation(s)
- Stéphane Prange
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France
| | - Chloé Laurencin
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Teodor Danaila
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Stéphane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France.
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Effects of Ten Different Exercise Interventions on Motor Function in Parkinson’s Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials. Brain Sci 2022; 12:brainsci12060698. [PMID: 35741584 PMCID: PMC9221238 DOI: 10.3390/brainsci12060698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this study was to evaluate ten exercise interventions (YOGA: yoga training, RT: resistance training, AQU: aquatic training, TAI: Taiji Qigong training, TRD: treadmill training, VR: virtual reality training, DANCE: musical dance training, WKT: walking training, CYC: cycling training, BDJ: Baduanjin Qigong training) on motor function in Parkinson’s disease (PD) patients. Design: Through searching PubMed, Embase, Cochrane Library, Web of Science, and CNKI, only randomized controlled trials (RCTs) were collected to study the effects of the ten exercise interventions on motor function in patients with Parkinson’s disease. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool. Results: The RCTs were collected between the earliest available date and April 2022. Sixty RCTs were included and the total sample size used in the study was 2859. The results of the network meta-analysis showed that DANCE can significantly improve patients’ Berg Balance Scale (BBS) (SUCRA = 78.4%); DANCE can significantly decline patients’ Unified Parkinson’s Disease Rating Scale score (UPDRS) (SUCRA = 72.3%) and YOGA can significantly decline patients’ Timed-Up-and-Go score (TUGT) (SUCRA = 78.0%). Conclusion: Based on the network meta-analysis and SUCRA ranking, we can state that dance, yoga, virtual reality training and resistance training offers better advantages than other exercise interventions for patients’ motor function.
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