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Bange M, Herz DM, Ciolac D, Gonzalez-Escamilla G, Groppa S. Modifying the progression of Parkinson's disease through movement interventions: multimodal quantification of underlying mechanisms. Neural Regen Res 2024; 19:1651-1652. [PMID: 38103225 PMCID: PMC10960283 DOI: 10.4103/1673-5374.389633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Manuel Bange
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Damian Marc Herz
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dumitru Ciolac
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Gabriel Gonzalez-Escamilla
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Wang Y, Wei L, Tan M, Yang Z, Gao B, Li J, Liu Y, Zikereya T, Shi K, Chen W. Aerobic exercise improves motor dysfunction in Parkinson's model mice via differential regulation of striatal medium spiny neuron. Sci Rep 2024; 14:12132. [PMID: 38802497 PMCID: PMC11130133 DOI: 10.1038/s41598-024-63045-4] [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: 02/04/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
The striatum plays a crucial role in providing input to the basal ganglia circuit and is implicated in the pathological process of Parkinson's disease (PD). Disruption of the dynamic equilibrium in the basal ganglia loop can be attributed to the abnormal functioning of the medium spiny neurons (MSNs) within the striatum, potentially acting as a trigger for PD. Exercise has been shown to mitigate striatal neuronal dysfunction through neuroprotective and neurorestorative effects and to improve behavioral deficits in PD model mice. In addition, this effect is offset by the activation of MSNs expressing dopamine D2 receptors (D2-MSNs). In the current study, we investigated the underlying neurobiological mechanisms of this effect. Our findings indicated that exercise reduces the power spectral density of the beta-band in the striatum and decreases the overall firing frequency of MSNs, particularly in the case of striatal D2-MSNs. These observations were consistent with the results of molecular biology experiments, which revealed that aerobic training specifically enhanced the expression of striatal dopamine D2 receptors (D2R). Taken together, our results suggest that aerobic training aimed at upregulating striatal D2R expression to inhibit the functional activity of D2-MSNs represents a potential therapeutic strategy for the amelioration of motor dysfunction in PD.
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Affiliation(s)
- Yinhao Wang
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Longwei Wei
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Mingli Tan
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Zizheng Yang
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Bo Gao
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Juan Li
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Yang Liu
- School of Physical Education, Hebei Normal University, Shijiazhuang, China
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China
| | - Talifu Zikereya
- Department of Physical Education, China University of Geoscience, Beijing, China
| | - Kaixuan Shi
- Department of Physical Education, China University of Geoscience, Beijing, China.
| | - Wei Chen
- School of Physical Education, Hebei Normal University, Shijiazhuang, China.
- Key Laboratory of Measurement and Evaluation in Exercise Bioinformation of Hebei Province, Shijiazhuang, China.
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Brandín-de la Cruz N, Jiménez-Sánchez C, Herrero P, Córdova-Alegre P, Buesa-Estéllez A, Calvo S. Experiences of patients with Parkinson's disease belonging to an association. A qualitative approach. ENFERMERIA CLINICA (ENGLISH EDITION) 2024:S2445-1479(24)00040-7. [PMID: 38796106 DOI: 10.1016/j.enfcle.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 03/13/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Parkinson's disease (PD) affects the physical, cognitive, emotional, and social domains of people who suffer it. A good strategy for patients is to belong to an Association, using the services they offer. OBJECTIVE The aim of this study was to explore the experiences and perceptions of patients with PD in a Parkinson's Association. METHODS A sample of participants with PD who met the inclusion criteria was selected through purpose and theoretical sampling. Semi-structured qualitative interviews were used to collect the data, which was analyzed by thematic phenomenological analysis. Different strategies such as triangulation between researchers were used to ensure methodological rigor. RESULTS The data analyzed from 10 participants led to two themes: the context of the Association, where the importance of interdisciplinary treatments and the relationship with other patients is collected; and how they see their future, which describes the future perspectives that patients with PD have. DISCUSSION Patients agree on the importance of belonging to the Association, feeling part of a group, while benefiting from receiving therapies from the interdisciplinary team. The Association plays a relevant role in the evolution of the disease, as it influences how patients imagine their future. Developing strategies based on a good therapeutic alliance with professionals at the service of patients promotes the empowerment, adherence and continuity of treatments at home, which results in improving the quality of life of patients with PD.
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Affiliation(s)
- Natalia Brandín-de la Cruz
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad San Jorge, Campus Universitario Villanueva de Gállego, Villanueva de Gállego, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
| | - Carolina Jiménez-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad San Jorge, Campus Universitario Villanueva de Gállego, Villanueva de Gállego, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
| | - Pablo Herrero
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Paula Córdova-Alegre
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad San Jorge, Campus Universitario Villanueva de Gállego, Villanueva de Gállego, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain
| | - Almudena Buesa-Estéllez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad San Jorge, Campus Universitario Villanueva de Gállego, Villanueva de Gállego, Zaragoza, Spain.
| | - Sandra Calvo
- Instituto de Investigación Sanitaria de Aragón, IIS Aragón, Zaragoza, Spain; Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
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Chrysagis N, Trompouki G, Petropaulis D, Koumantakis GA, Krekoukias G, Theotokatos G, Skordilis E, Sakellari V. Effect of Boxing Exercises on the Functional Ability and Quality of Life of Individuals with Parkinson's Disease: A Systematic Review. Eur J Investig Health Psychol Educ 2024; 14:1295-1310. [PMID: 38785583 PMCID: PMC11119617 DOI: 10.3390/ejihpe14050085] [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: 03/11/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Parkinson's disease (PD) is a neurological disorder caused by the loss of dopamine-producing cells in the substantia nigra and characterized by motor and non-motor symptoms. Boxing is a type of complementary therapy to improve symptoms in PD. The purpose of the present study was to examine the effect of boxing training on the functionality and quality of life of patients with PD. The literature search was performed on PubMed, Scopus, PEDro, Cochrane Library, and Google Scholar search engines. The PEDro scale was used to assess the methodological quality of the studies. This systematic review included three studies that examined disease severity, mobility, physical activity, balance, and quality of life. According to the PEDro scale criteria, the three articles included were of high methodological quality. Statistically significant improvements after the implementation of boxing training was shown for balance and quality of life in contrast to the other variables. Boxing training intervention programs had a positive effect on balance and quality of life in patients with PD; however, the results are conflicting regarding certain functionality variables. Therefore, it is necessary to conduct further research to examine the effectiveness of boxing training on the functionality and quality of life of patients with Parkinson's disease.
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Affiliation(s)
- Nikolaos Chrysagis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgia Trompouki
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
| | - Dimitris Petropaulis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
| | - George A. Koumantakis
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgios Krekoukias
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
| | - Georgios Theotokatos
- School of Physical Education and Sport Science, National and Kapodestrian University of Athens, Ethniki Antistaseos 41, 17237 Dapne, Greece; (G.T.); (E.S.)
| | - Emmanouil Skordilis
- School of Physical Education and Sport Science, National and Kapodestrian University of Athens, Ethniki Antistaseos 41, 17237 Dapne, Greece; (G.T.); (E.S.)
| | - Vasiliki Sakellari
- Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece; (G.T.); (D.P.); (G.A.K.); (G.K.)
- Laboratory of Advanced Physiotherapy, Physiotherapy Department, School of Health & Care Sciences, University of West Attica, Agiou Spiridonos 28, 12243 Egaleo, Greece
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Gu R, Pan J, Awan MUN, Sun X, Yan F, Bai L, Bai J. The major histocompatibility complex participates in Parkinson's disease. Pharmacol Res 2024; 203:107168. [PMID: 38583689 DOI: 10.1016/j.phrs.2024.107168] [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: 11/25/2023] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease characterized by progressive loss of dopaminergic neurons in the substantia nigra and the aggregation of alpha-synuclein (α-syn). The central nervous system (CNS) has previously been considered as an immune-privileged area. However, studies have shown that the immune responses are involved in PD. The major histocompatibility complex (MHC) presents antigens from antigen-presenting cells (APCs) to T lymphocytes, immune responses will be induced. MHCs are expressed in microglia, astrocytes, and dopaminergic neurons. Single nucleotide polymorphisms in MHC are related to the risk of PD. The aggregated α-syn triggers the expression of MHCs by activating glia cells. CD4+ and CD8+ T lymphocytes responses and microglia activation are detected in brains of PD patients. In addiction immune responses further increase blood-brain barrier (BBB) permeability and T cell infiltration in PD. Thus, MHCs are involved in PD through participating in immune and inflammatory responses.
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Affiliation(s)
- Rou Gu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China; Medical School, Kunming University of Science and Technology, Kunming 650500, China
| | - Jianyu Pan
- Medical School, Kunming University of Science and Technology, Kunming 650500, China
| | - Maher Un Nisa Awan
- Medical School, Kunming University of Science and Technology, Kunming 650500, China; Department of Neurology, The Affiliated Hospital of Yunnan University, Kunming 650500, China
| | - Xiaowei Sun
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China; Medical School, Kunming University of Science and Technology, Kunming 650500, China
| | - Fang Yan
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China; Medical School, Kunming University of Science and Technology, Kunming 650500, China
| | - Liping Bai
- Medical School, Kunming University of Science and Technology, Kunming 650500, China
| | - Jie Bai
- Medical School, Kunming University of Science and Technology, Kunming 650500, China.
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Zhang Z, Wu Z, Hu S, He M. Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease. Medicine (Baltimore) 2024; 103:e37470. [PMID: 38552099 PMCID: PMC10977540 DOI: 10.1097/md.0000000000037470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/12/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Long-term physical exercise has been shown to benefit patients with Parkinson disease (PD), but there is a lack of evidence regarding the underlying mechanism. A better understanding of how such benefits are induced by exercise might contribute to the development of therapeutic targets for improving the motor function in individuals with PD. The purpose of this study was therefore to investigate the possible association between exercise-induced motor improvements and the changes in serum microRNA (miRNA) levels of PD patients through small RNA sequencing for the first time. METHODS Thirteen PD patients completed our 3-month home-and-community-based exercise program, while 6 patients were assigned to the control group. Motor functions were measured, and small RNA sequencing with data analysis was performed on serum miRNAs both before and after the program. The results were further validated by quantitative real-time polymerase chain reaction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were then conducted to determine the role of differentially expressed miRNAs. RESULTS The 3-month home-and-community-based exercise program induced significant motor improvements in PD patients in terms of Unified Parkinson's Disease Rating Scale activities of daily living and Motor Subscale (P < .05), comfortable walking speed (P = .003), fast walking speed (P = .028), Six-Minute Walk Test (P = .004), Berg Balance Scale (P = .039), and Timed Up and Go (P = .002). A total of 11 miRNAs (10 upregulated and one downregulated) were identified to be remarkably differentially expressed after intervention in the exercise group, but not in the control group. The results of miRNA sequencing were further validated by quantitative real-time polymerase chain reaction. It was found that the targets of altered miRNAs were mostly enriched in the mitogen-activated protein kinase, Wnt, and Hippo signaling pathways and the GO annotations mainly included binding, catalytic activity, and transcription regulator activity. CONCLUSION The exercise-induced motor improvements were possibly associated with changes in circulating miRNA levels in PD patients. These miRNAs, as well as the most enriched pathways and GO terms, may play a critical role in the mechanism of exercise-induced benefits in PD and serve as novel treatment targets for the disease, although further investigations are needed.
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Affiliation(s)
- Ziyi Zhang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziwei Wu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shenglan Hu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Miao He
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Xie X, Zhang X, Li S, Du W. Involvement of Fgf2-mediated tau protein phosphorylation in cognitive deficits induced by sevoflurane in aged rats. Mol Med 2024; 30:39. [PMID: 38493090 PMCID: PMC10943822 DOI: 10.1186/s10020-024-00784-0] [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: 10/30/2023] [Accepted: 01/11/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE Anesthetics have been linked to cognitive alterations, particularly in the elderly. The current research delineates how Fibroblast Growth Factor 2 (Fgf2) modulates tau protein phosphorylation, contributing to cognitive impairments in aged rats upon sevoflurane administration. METHODS Rats aged 3, 12, and 18 months were subjected to a 2.5% sevoflurane exposure to form a neurotoxicity model. Cognitive performance was gauged, and the GEO database was employed to identify differentially expressed genes (DEGs) in the 18-month-old cohort post sevoflurane exposure. Bioinformatics tools, inclusive of STRING and GeneCards, facilitated detailed analysis. Experimental validations, both in vivo and in vitro, examined Fgf2's effect on tau phosphorylation. RESULTS Sevoflurane notably altered cognitive behavior in older rats. Out of 128 DEGs discerned, Fgf2 stood out as instrumental in regulating tau protein phosphorylation. Sevoflurane exposure spiked Fgf2 expression in cortical neurons, intensifying tau phosphorylation via the PI3K/AKT/Gsk3b trajectory. Diminishing Fgf2 expression correspondingly curtailed tau phosphorylation, neurofibrillary tangles, and enhanced cognitive capacities in aged rats. CONCLUSION Sevoflurane elicits a surge in Fgf2 expression in aging rats, directing tau protein phosphorylation through the PI3K/AKT/Gsk3b route, instigating cognitive aberrations.
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Affiliation(s)
- Xin Xie
- Department of Anesthesiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dandong District, Liaoning Province, Shenyang, 110042, P. R. China
| | - Xiaomin Zhang
- Department of Anesthesiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dandong District, Liaoning Province, Shenyang, 110042, P. R. China
| | - Songze Li
- Department of Anesthesiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dandong District, Liaoning Province, Shenyang, 110042, P. R. China
| | - Wei Du
- Department of Anesthesiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dandong District, Liaoning Province, Shenyang, 110042, P. R. China.
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Langeskov-Christensen M, Franzén E, Grøndahl Hvid L, Dalgas U. Exercise as medicine in Parkinson's disease. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-332974. [PMID: 38418216 DOI: 10.1136/jnnp-2023-332974] [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] [Received: 11/09/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
Parkinson's disease (PD) is an incurable and progressive neurological disorder leading to deleterious motor and non-motor consequences. Presently, no pharmacological agents can prevent PD evolution or progression, while pharmacological symptomatic treatments have limited effects in certain domains and cause side effects. Identification of interventions that prevent, slow, halt or mitigate the disease is therefore pivotal. Exercise is safe and represents a cornerstone in PD rehabilitation, but exercise may have even more fundamental benefits that could change clinical practice. In PD, the existing knowledge base supports exercise as (1) a protective lifestyle factor preventing the disease (ie, primary prevention), (2) a potential disease-modifying therapy (ie, secondary prevention) and (3) an effective symptomatic treatment (ie, tertiary prevention). Based on current evidence, a paradigm shift is proposed, stating that exercise should be individually prescribed as medicine to persons with PD at an early disease stage, alongside conventional medical treatment.
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Affiliation(s)
- Martin Langeskov-Christensen
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurology, Viborg Regional Hospital, Viborg, Denmark
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Grøndahl Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
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Zheng Q, Liu H, Gao Y, Cao G, Wang Y, Li Z. Ameliorating Mitochondrial Dysfunction for the Therapy of Parkinson's Disease. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2311571. [PMID: 38385823 DOI: 10.1002/smll.202311571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/27/2024] [Indexed: 02/23/2024]
Abstract
Parkinson's disease (PD) is currently the second most incurable central neurodegenerative disease resulting from various pathogenesis. As the "energy factory" of cells, mitochondria play an extremely important role in supporting neuronal signal transmission and other physiological activities. Mitochondrial dysfunction can cause and accelerate the occurrence and progression of PD. How to effectively prevent and suppress mitochondrial disorders is a key strategy for the treatment of PD from the root. Therefore, the emerging mitochondria-targeted therapy has attracted considerable interest. Herein, the relationship between mitochondrial dysfunction and PD, the causes and results of mitochondrial dysfunction, and major strategies for ameliorating mitochondrial dysfunction to treat PD are systematically reviewed. The study also prospects the main challenges for the treatment of PD.
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Affiliation(s)
- Qing Zheng
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
| | - Hanghang Liu
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
- Hubei Key Laboratory of Natural Products Research and Development and College of Biological and Pharmaceutical Science, China Three Gorges University, Yichang, 443002, China
| | - Yifan Gao
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
| | - Guozhi Cao
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
| | - Yusong Wang
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
| | - Zhen Li
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Suzhou Medical College, Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, 215123, China
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Toloraia K, Gschwandtner U, Fuhr P. High-frequency multimodal training with a focus on Tai Chi in people with Parkinson's disease: a pilot study. Front Aging Neurosci 2024; 16:1335951. [PMID: 38425785 PMCID: PMC10902121 DOI: 10.3389/fnagi.2024.1335951] [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: 11/09/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Background and objectives Cognitive decline is an important and common complication in patients with Parkinson's disease (PD) since it significantly reduces the quality of life. A breakthrough in treating and preventing cognitive decline in PD remains to be achieved. This study aimed to evaluate the effectiveness of high-frequency and intensive multimodal training in improving motor and cognitive function. Methods Twenty-eight patients diagnosed with idiopathic PD completed a comprehensive neuropsychological test battery and were neurologically examined. The patients of the intervention group (n = 15) underwent 2 weekly sessions of Tai Chi therapy over 4 weeks and participated in an individually tailored training program consisting of two modules (smartphone-based speech training and cognitive training). A matched control group consisted of n = 13 patients with PD who received computer-assisted cognitive training. The data were analyzed with repeated-measures ANOVA. Results Four weeks of high-frequency training showed significant effects on verbal and figural episodic memory and visuospatial function in the intervention group. Compared to the control group, the cognitive performance of the intervention group improved significantly in visuospatial function and figural episodic memory. A significant improvement was also shown in the intervention group in the Tinetti Mobility Test and the Epworth Sleepiness Scale. The significant effects in the Tinetti mobility test remained after the 6 months follow-up. After the intervention, the patients reported high motivation and satisfaction with the multimodal training. Conclusion In patients with PD, a multimodal training program not only improves gait and stability but may also contribute to improving cognition. Clinical trial registration ClinicalTrials.gov Identifier: NCT04103255; https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=1&cx=-jg9qo4.
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Affiliation(s)
- Ketevan Toloraia
- Department of Clinical Research and Neurology, University Hospital Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Ute Gschwandtner
- Department of Clinical Research and Neurology, University Hospital Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Peter Fuhr
- Department of Clinical Research and Neurology, University Hospital Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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Yi M, Zhang W, Zhao B, Wang Z. The Effects of Mindfulness-Based Interventions in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. Clin Gerontol 2024:1-19. [PMID: 38324289 DOI: 10.1080/07317115.2024.2314192] [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: 02/08/2024]
Abstract
OBJECTIVES To examine the effectiveness of mindfulness-based interventions (MBIs) on psychological symptoms, motor symptoms, and quality of life in patients with Parkinson's disease (PD). METHODS Published studies in Chinese and English languages, conducted from inception to March 2023, were identified by searching PubMed, Web of Science, Cochrane Library, CINAHL, PsycINFO, and two Chinese electronic databases. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. RESULTS Twelve studies were selected for quantitative syntheses. The impact of MBIs on reducing depression and anxiety, and improving mindfulness and quality of life in PD patients was statistically significant compared to the control group. However, no statistically significant effect on motor symptoms was observed. Subgroup analysis indicated that participants from Asia, those who received face-to-face sessions, and those whose sessions lasted 1.5 hours showed a more positive effect than other subgroups. CONCLUSIONS Patients with PD may benefit from MBIs to improve psychological symptoms and quality of life. MBIs represent a pivotal non-pharmacological therapeutic approach in clinical practice. CLINICAL IMPLICATIONS MBIs confer positive improvements in psychological well-being and quality of life in PD patients. However, it remains challenging to conclusively determine their efficacy in addressing motor symptoms.
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Affiliation(s)
- Mo Yi
- School of Nursing, Peking University, Beijing, China
| | - Wenmin Zhang
- School of Nursing, Peking University, Beijing, China
| | - Baosheng Zhao
- Department of Emergency, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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12
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Shafiq MA, Singh J, Khan ZA, Neary JP, Bardutz HA. Effect of exercise on sleep quality in Parkinson's disease: a mini review. BMC Neurol 2024; 24:49. [PMID: 38291381 PMCID: PMC10826022 DOI: 10.1186/s12883-024-03548-9] [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: 11/09/2023] [Accepted: 01/24/2024] [Indexed: 02/01/2024] Open
Abstract
The growing incidence of Parkinson's Disease (PD) is a major burden on the healthcare system. PD is caused by the degeneration of dopaminergic neurons and is known for its effects on motor function and sleep. Sleep is vital for maintaining proper homeostasis and clearing the brain of metabolic waste. Adequate time spent in each sleep stage can help maintain homeostatic function; however, patients with PD appear to exhibit sleep impairments. Although medications enhance the function of remaining dopaminergic neurons and reduce motor symptoms, their potential to improve sleep is still under question. Recently, research has shifted towards exercise protocols to help improve sleep in patients with PD. This review aims to provide an overview of how sleep is impaired in patients with PD, such as experiencing a reduction in time spent in slow-wave sleep, and how exercise can help restore normal sleep function. A PubMed search summarized the relevant research on the effects of aerobic and resistance exercise on sleep in patients with PD. Both high and low-intensity aerobic and resistance exercises, along with exercises related to balance and coordination, have been shown to improve some aspects of sleep. Neurochemically, sleeping leads to an increase in toxin clearance, including α-synuclein. Furthermore, exercise appears to enhance the concentration of brain-derived neurotrophic factors, which has preliminary evidence to suggest correlations to time spent in slow-wave sleep. More research is needed to further elucidate the physiological mechanism pertaining to sleep and exercise in patients with PD.
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Affiliation(s)
- M Abdullah Shafiq
- College of Medicine, University of Saskatchewan Regina Campus, 1440 14 Ave, Regina, SK, S4P 0W5, Canada
| | - Jyotpal Singh
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK, S4S 0A2, Canada
| | - Zain A Khan
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK, S4S 0A2, Canada
| | - J Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK, S4S 0A2, Canada
| | - Holly A Bardutz
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK, S4S 0A2, Canada.
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13
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Jiang X, Zhou J, Chen Q, Xu Q, Wang S, Yuan L, Zhang D, Bi H, Li H. Effect of robot-assisted gait training on motor dysfunction in Parkinson's patients:A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2024; 37:253-268. [PMID: 37955075 DOI: 10.3233/bmr-220395] [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] [Indexed: 11/14/2023]
Abstract
BACKGROUND Robot-assisted gait training (RAGT) has been reported to treat motor dysfunction in patients with Parkinson's disease (PD) in the last few years. However, the benefits of RAGT for treating motor dysfunction in PD are still unclear. OBJECTIVES To investigate the efficacy of RAGT for motor dysfunction in PD patients. METHODS We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, Chinese Biomedical Literature Database (CBM), and Chinese VIP Database for randomized controlled trials investigating RAGT to improve motor dysfunction in PD from the databases' inception dates until September 1, 2022. The following outcome indexes were employed to evaluate motor dysfunction: the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), 10-Meter Walk Test gait speed (10-MWT), gait speed, stride length, cadence Unified Parkinson Disease Rating Scale Part III (UPDRS III), 6-Minute Walk Test (6MWT), and the Timed Up and Go test (TUG). The meta-analysis was performed using the proper randomeffect model or fixed-effect model to evaluate the difference in efficacy between the RAGT and the control groups. The Cochrane Risk of Bias Tool was used for the included studies and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of the results. RESULTS The results consisted of 17 studies comprising a total of 670 participants. Six hundred and seven PD patients with motor dysfunction were included: 335 in the RAGT group and 335 in the control group. This meta-analysis results established that when compared with the control group, robot-assisted gait training improved the BBS results of PD patients (MD: 2.80, 95%CI: 2.11-3.49, P< 0.00001), ABC score (MD: 7.30, 95%CI: 5.08-9.52, P< 0.00001), 10-MWT (MD: 0.06, 95%CI: 0.03-0.10, P= 0.0009), gait speed (MD: 3.67, 95%CI: 2.58-4.76, P< 0.00001), stride length (MD: 5.53, 95%CI: 3.64-7.42, P< 0.00001), cadence (MD: 4.52, 95%CI: 0.94-8.10, P= 0.01), UPDRS III (MD: -2.16, 95%CI: -2.48--1.83, P< 0.00001), 6MWT (MD: 13.87, 95%CI: 11.92-15.82, P< 0.00001). However, RAGT did not significantly improve the TUG test result of patients with PD (MD =-0.56, 95% CI: -1.12-0.00, P= 0.05). No safety concerns or adverse reactions among robot-assisted gait training patients were observed. CONCLUSION Even though RAGT can improve balance function, walking function, and gait performance and has demonstrated positive results in several studies, there is currently insufficient compelling evidence to suggest that it can improve all aspects of lower motor function.
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Affiliation(s)
- Xiaoyu Jiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jianpeng Zhou
- Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
| | - Qiang Chen
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qiling Xu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shuting Wang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lin Yuan
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Deqi Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Hongyan Bi
- Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, Shandong, China
| | - Haixia Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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14
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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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15
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Liu X, Zhang B, Tian J, Han Y. Plasma metabolomics reveals the intervention mechanism of different types of exercise on chronic unpredictable mild stress-induced depression rat model. Metab Brain Dis 2024; 39:1-13. [PMID: 37999885 DOI: 10.1007/s11011-023-01310-7] [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] [Accepted: 10/08/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To study the effects of different types of exercise on the plasma metabolomics of chronic unpredictable mild stress (CUMS)-induced depressed rats based on 1H-NMR metabolomics techniques, and to explore the potential mechanisms of exercise for the treatment of depression. Rats were randomly divided into blank control group (C), CUMS control group (D), pre-exercise with CUMS group (P), CUMS with aerobic exercise group, CUMS with resistance exercise group (R), and CUMS with aerobic + resistance exercise group (E). The corresponding protocol intervention was applied to each group of rats. Body weight, sucrose preference and open field tests were performed weekly during the experiment to evaluate the extent of depression in rats. Plasma samples from each group of rats were collected at the end of the experiment, and then the plasma was analyzed by 1H-NMR metabolomics combined with multivariate statistical analysis methods to identify differential metabolites and perform metabolic pathway analysis. (1) Compared with the group D, the body weight, sucrose preference rate, and the number of crossings and standings in the different types of exercise groups were significantly improved (p < 0.05 or p < 0.01). (2) Compared to group C, a total of 15 differential metabolites associated with depression were screened in the plasma of rats in group D, involving 6 metabolic pathways. Group P can regulate the levels of 6 metabolites: valine, lactate, inositol, glucose, phosphocreatine, acetoacetic acid. Group A can regulate the levels of 6 metabolites: N-acetylglycoprotein, leucine, lactate, low density lipoprotein, glucose and acetoacetic acid. Group R can regulate the levels of 6 metabolites: choline, lactate, inositol, glucose, phosphocreatine and acetoacetic acid. Group E can regulate the levels of 5 metabolites: choline, citric acid, glucose, acetone and acetoacetic acid. The different types of exercise groups can improve the depressive symptoms in CUMS rats, and there are common metabolites and metabolic pathways for their mechanism of effects. This study provides a powerful analytical tool to study the mechanism of the antidepressant effect of exercise, and provides an important method and basis for the early diagnosis, prevention and treatment of depression.
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Affiliation(s)
- Xiangyu Liu
- School of Physical Education, Huainan Normal University, Huainan, China.
| | - Bo Zhang
- Changji Vocational and Technical College, Xinjiang, China
| | - Junsheng Tian
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Yumei Han
- School of Physical Education, Shanxi University, Taiyuan, China
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16
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Corcos DM, Lamotte G, Luthra NS, McKee KE. Advice to People with Parkinson's in My Clinic: Exercise. JOURNAL OF PARKINSON'S DISEASE 2024; 14:609-617. [PMID: 38189710 PMCID: PMC11091645 DOI: 10.3233/jpd-230277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
There is compelling evidence that exercise must be part of main line therapy for people with Parkinson's disease. In this viewpoint, we outline the four key components of exercise: aerobic exercise, resistance exercise, flexibility exercise, and neuromotor exercises (posture, gait, balance, and agility) that can improve both motor and non-motor symptoms of the disease and, in the case of aerobic exercise, may delay the disease. We outline guidelines on how to change and optimize the exercise prescription at different stages of the disease.
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Affiliation(s)
- Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Guillaume Lamotte
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Nijee S. Luthra
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Kathleen E. McKee
- Neurosciences Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
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17
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Yang Y, Fu X, Zhang H, Ouyang G, Lin SC. The effect of home-based exercise on motor symptoms, quality of life and functional performance in Parkinson's disease: a systematic review and meta-analysis. BMC Geriatr 2023; 23:873. [PMID: 38114897 PMCID: PMC10731835 DOI: 10.1186/s12877-023-04595-6] [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: 06/13/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Faced with the lack of physical activity caused by mandatory home isolation during special periods and patients' inconvenience in carrying out professionally supervised exercise, many home-based exercise programs have been developed. This systematic review and meta-analysis aimed to examine the effects of home-based exercise on measures of motor symptoms, quality of life and functional performance in Parkinson's disease (PD) patients. METHODS We performed a systematic review and meta-analysis, and searched PubMed, MEDLINE, Embase, Cochrane library, and Web of Science from their inception date to April 1, 2023. The quality of the literature was assessed using PEDro's quality scale. The data was pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS A total of 20 studies involving 1885 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 = -0.29 [-0.45, -0.13]; P < 0.0001), improving quality of life (SMD = 0.20 [0.08, 0.32]; P < 0.0001), walking speed (SMD = 0.26 [0.05, 0.48]; P = 0.005), balance ability (SMD = 0.23 [0.10, 0.36]; P < 0.0001), finger dexterity (SMD = 0.28 [0.10, 0.46]; P = 0.003) and decreasing fear of falling (SMD = -0.29 [-0.49, -0.08]; P = 0.001). However, home-based exercise did not significantly relieve the overall motor symptoms of PD patients when the training period was less than 8 weeks and the total number of sessions was less than 30. CONCLUSION During times of limited physical activity due to pandemics such as COVID-19, home-based exercise is an alternative to maintain and improve motor symptoms in PD patients. In addition, for the minimum dose of home-based exercise, we recommend that the exercise period is no less than 8 weeks and the total number of sessions is no less than 30 times. TRIAL REGISTRATION PROSPERO registration number: CRD42022329780.
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Affiliation(s)
- Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, 238000, China
| | - Xueying Fu
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, 475001, China
| | - Haoyang Zhang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, 475001, China
| | | | - Shu-Cheng Lin
- Department of Sport, Leisure and Health Management, Tainan University of Technology, Tainan City, 710302, Taiwan.
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18
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Song YT, Liu YB, Xiang HB, Manyande A, He ZG. The Application of Deep Brain Stimulation for Parkinson's Disease on the Motor Pathway: A Bibliometric Analysis across 10 Years. Curr Med Sci 2023; 43:1247-1257. [PMID: 38153631 DOI: 10.1007/s11596-023-2811-9] [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: 08/08/2023] [Accepted: 09/27/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Since its initial report by James Parkinson in 1817, Parkinson's disease (PD) has remained a central subject of research and clinical advancement. The disease is estimated to affect approximately 1% of adults aged 60 and above. Deep brain stimulation, emerging as an alternative therapy for end-stage cases, has offered a lifeline to numerous patients. This review aimed to analyze publications pertaining to the impact of deep brain stimulation on the motor pathway in patients with PD over the last decade. METHODS Data were obtained from the Web of Science Core Collection through the library of Huazhong University of Science and Technology (China). The search strategy encompassed the following keywords: "deep brain stimulation", "Parkinson's disease", "motor pathway", and "human", from January 1, 2012, to December 1, 2022. Additionally, this review visualized the findings using the Citespace software. RESULTS The results indicated that the United States, the United Kingdom, Germany, and China were the primary contributors to this research field. University College London, Capital Medical University, and Maastricht University were the top 3 research institutions in the research area. Tom Foltynie ranked first with 6 publications, and the journals of Brain and Brain Stimulation published the greatest number of relevant articles. The prevailing research focal points in this domain, as determined by keywords "burst analysis", "encompassed neuronal activity", "nucleus", "hyper direct pathway", etc. CONCLUSION: This study has provided a new perspective through bibliometric analysis of the deep brain stimulation therapy for treating patients with PD, which can shed light on future research to advance our comprehension of this particular field of study.
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Affiliation(s)
- Yong-Tang Song
- Medical Association of Hubei Province, Wuhan, 430060, China
| | - Yan-Bo Liu
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hong-Bing Xiang
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, London, 0044, UK
| | - Zhi-Gang He
- Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Wang X, Hu W, Qu L, Wang J, Wu A, Lo HH, Ng JPL, Tang Y, Yun X, Wu J, Wong VKW, Chung SK, Wang L, Luo W, Ji X, Law BYK. Tricin promoted ATG-7 dependent autophagic degradation of α-synuclein and dopamine release for improving cognitive and motor deficits in Parkinson's disease. Pharmacol Res 2023; 196:106874. [PMID: 37586619 DOI: 10.1016/j.phrs.2023.106874] [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] [Received: 06/06/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Abstract
Tricin, a natural nontoxic flavonoid distributed in grasses and euphorbia plants, has been reported to scavenge free radicals, possess anti-inflammatory and antioxidative effects. However, its autophagic effect on Parkinson's disease (PD) has not been elucidated. By adopting cellular and C. elegans models of PD, the autophagic effect of tricin was identified based on the level of autophagy markers (LC3-II and p62). Besides, the pharmacological effects on neurotransmitters (dopamine), inflammatory cytokines (IFN γ, TNFα, MCP-1, IL-10, IL-6 and IL-17A), histology (hematoxylin & eosin and Nissl staining) and behavioural pathology (open-field test, hindlimb clasping, Y-maze, Morris water-maze and nest building test) were also confirmed in the A53T-α-synuclein transgenic PD mouse model. Further experiments demonstrated that tricin induced autophagic flux and lowered the level of α-synuclein through AMPK-p70s6K- and ATG7-dependent mechanism. Compared to the existing clinical PD drugs, tricin mitigated pathogenesis and symptoms of PD with no observable side effects. In summary, tricin is proposed as a potential adjuvant remedy or nutraceutical for the prevention and treatment of PD.
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Affiliation(s)
- Xingxia Wang
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China; Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wei Hu
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Liqun Qu
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China; Marine Traditional Chinese Medicine Research Center, Key Laboratory of Marine Traditional Chinese Medicine in Shandong Universities, Shandong Engineering and Technology Research Center on Omics of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Jian Wang
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Anguo Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Drug ability Evaluation, Luzhou Key Laboratory of Activity Screening and Draggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Hang Hong Lo
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Jerome P L Ng
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Yong Tang
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China; Sichuan Key Medical Laboratory of New Drug Discovery and Drug ability Evaluation, Luzhou Key Laboratory of Activity Screening and Draggability Evaluation for Chinese Materia Medica, Key Laboratory of Medical Electrophysiology of Ministry of Education, School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Xiaoyun Yun
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Jianhui Wu
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Vincent Kam Wai Wong
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Sookja Kim Chung
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China; Faculty of Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Linna Wang
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Weidan Luo
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Xiang Ji
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China
| | - Betty Yuen Kwan Law
- Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau Special Administrative Region of China.
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20
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Rafie F, Rajizadeh MA, Shahbazi M, Pourranjbar M, Nekouei AH, Sheibani V, Peterson D. Effects of voluntary, and forced exercises on neurotrophic factors and cognitive function in animal models of Parkinson's disease. Neuropeptides 2023; 101:102357. [PMID: 37393777 DOI: 10.1016/j.npep.2023.102357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/04/2023] [Accepted: 06/25/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the elderly. Cognitive dysfunction represents a common and challenging non-motor symptom for people with Parkinson's disease. The number of neurotrophic proteins in the brain is critical in neurodegenerative diseases such as Parkinson's. This research aims to compare the effects of two types of exercise, forced and voluntary, on spatial memory and learning and neurochemical factors (CDNF and BDNF). METHODS In this research, 60 male rats were randomly divided into six groups (n = 10): the control (CTL) group without exercise, the Parkinson's groups without and with forced (FE) and voluntary (VE) exercises, and the sham groups (with voluntary and forced exercise). The animals in the forced exercise group were placed on the treadmill for four weeks (five days a week). At the same time, voluntary exercise training groups were placed in a special cage equipped with a rotating wheel. At the end of 4 weeks, learning and spatial memory were evaluated with the Morris water maze test. BDNF and CDNF protein levels in the hippocampus were measured by the ELISA method. RESULTS The results showed that although the PD group without exercise was at a significantly lower level than other groups in terms of cognitive function and neurochemical factors, both types of exercise, could improve these problems. CONCLUSION According to our results, 4 weeks of voluntary and forced exercises were all found to reverse the cognitive impairments of PD rats.
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Affiliation(s)
- Forouzan Rafie
- Health Solutions, College of (CHS), Arizona State University, Phoenix, AZ, USA; Neuroscience Research Centre, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohammad Amin Rajizadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Shahbazi
- Department of Physical Education & Exercise Science, Tehran University, Tehran, Iran
| | - Mohammad Pourranjbar
- Neuroscience Research Centre, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Amir H Nekouei
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Sheibani
- Neuroscience Research Centre, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Daniel Peterson
- Health Solutions, College of (CHS), Arizona State University, Phoenix, AZ, USA; Pheonix VA Medical Center. Phoenix, AZ, USA
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21
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Duarte GP, Ferraz DD, Trippo KV, Novais MCM, Sales M, Ribeiro NMDS, Oliveira Filho J. Effects of three physical exercise modalities on respiratory function of older adults with Parkinson's disease: A randomized clinical trial. J Bodyw Mov Ther 2023; 36:425-431. [PMID: 37949595 DOI: 10.1016/j.jbmt.2023.05.014] [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: 12/26/2022] [Revised: 04/17/2023] [Accepted: 05/30/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Deficits in respiratory function of patients with Parkinson's disease contribute to aspiration pneumonia, one of the main causes of mortality in this population. The aim of this study was to evaluate the effects of functional training, bicycle exercise, and exergaming on respiratory function of elderly with Parkinson's disease. METHODS A randomized clinical trial with single blinding was conducted in a public reference outpatient clinic for the elderly. The participants were randomly assigned to three groups. Group 1 was submitted to functional training (n = 18); group 2 performed bicycle exercise (n = 20), and group 3 trained with Kinect Adventures exergames (n = 20). The sessions performed lasted 8 weeks with a frequency of three 50-min sessions per week. The primary outcome was the forced expiratory volume in the first second; and the secondary outcomes were forced vital capacity, peak expiratory flow, and maximum inspiratory and expiratory pressures. RESULTS The interventions performed did not improve the forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow. However, group 2 improved (p = 0.03) maximum expiratory pressure (from 65.5cmH2O to 73.1cmH2O) (effect size 0.47), and group 3 increased (p = 0.03) maximum inspiratory pressure (from -61.3cmH2O to -71.6cmH2O) (effect size 0.53). CONCLUSIONS No effect was found on lung volume, forced respiratory flow and capacity of the participants with Parkinson's disease submitted to three different modalities of motor training. However, bicycle exercise and exergaming have improved expiratory and inspiratory muscle strength, respectively. NCT02622737.
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Affiliation(s)
| | | | | | | | - Matheus Sales
- Grupo de Pesquisa em Atenção Integral a Pessoas Com Doenças Raras e Doenças Crônicas, Complexo Hospitalar Universitário Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Nildo Manoel da Silva Ribeiro
- Department of Physical Therapy, Federal University of Bahia, Salvador, Brazil; Grupo de Pesquisa em Atenção Integral a Pessoas Com Doenças Raras e Doenças Crônicas, Complexo Hospitalar Universitário Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
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22
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Yang Y, Wang Y, Gao T, Reyila A, Liu J, Liu J, Han H. Effect of Physiotherapy Interventions on Motor Symptoms in People With Parkinson's Disease: A Systematic Review and Meta-Analysis. Biol Res Nurs 2023; 25:586-605. [PMID: 37070664 DOI: 10.1177/10998004231171587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of different types of physiotherapy interventions in people with Parkinson's disease (PD). DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS Five databases (PubMed, Embase, Cochrane Library, CINAHL and Web of Science Core Collection) were searched for relevant RCTs published from database inception to July 14, 2022. Reviewers independently screened the literature, extracted data, and assessed the literature quality according to the Cochrane Collaboration Risk of Bias Tool and PEDro Scale. This meta-analysis was conducted using RevMan 5.4.1 and reported in compliance with the PRISMA statement. RESULTS Forty-two RCTs with 2,530 participants were included. Across all types of physiotherapy, strength training, mind-body exercise, aerobic exercise, and non-invasive brain stimulation (NiBS) were effective in improving motor symptoms as measured by the (Movement Disorders Society-) Unified PD Scale, whereas balance and gait training (BGT) and acupuncture were not. The pooled results showed that the change in mind-body exercise (MD = -5.36, 95% CI [-7.97 to -2.74], p < .01, I2 = 68%) and NiBS (MD = -4.59, 95% CI [-8.59 to -0.59], p = .02, I2 = 78%) reached clinical threshold, indicating clinically meaningful improvements. Considering the effectiveness of the interventions on motor symptoms, balance, gait and functional mobility, mind-body exercise was recommended the most. CONCLUSIONS Exercise appears to be a better form of physiotherapy than NiBS and acupuncture for improving motor function. Mind-body exercise showed beneficial effects on motor symptoms, balance, gait and functional mobility in people with PD, and is worthy of being promoted.
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Affiliation(s)
- Yajie Yang
- School of Nursing, Peking University, Beijing 100191, China
| | - Yang Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - Tianzi Gao
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | | | - Jiaxin Liu
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Jiajia Liu
- School of Nursing, Peking University, Beijing 100191, China
| | - Hongbin Han
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
- Department of Radiology, Peking University Third Hospital, Beijing 100191, China
- NMPA Key Laboratory for Evaluation of Medical Imaging Equipment and Technique, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging Technology, Beijing 100191, China
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23
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Goh L, Canning CG, Song J, Clemson L, Allen NE. The effect of rehabilitation interventions on freezing of gait in people with Parkinson's disease is unclear: a systematic review and meta-analyses. Disabil Rehabil 2023; 45:3199-3218. [PMID: 36106644 DOI: 10.1080/09638288.2022.2120099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To summarize the effects of rehabilitation interventions to reduce freezing of gait (FOG) in people with Parkinson's disease. METHODS A systematic review with meta-analyses of randomized trials of rehabilitation interventions that reported a FOG outcome was conducted. Quality of included studies and certainty of FOG outcome were assessed using the PEDro scale and GRADE framework. RESULTS Sixty-five studies were eligible, with 62 trialing physical therapy/exercise, and five trialing cognitive and/or behavioral therapies. All meta-analyses produced very low-certainty evidence. Physical therapy/exercise had a small effect on reducing FOG post-intervention compared to control (Hedges' g= -0.26, 95% CI= -0.38 to -0.14, 95% prediction interval (PI)= -0.38 to -0.14). We are uncertain of the effects on FOG post-intervention when comparing: exercise with cueing to without cueing (Hedges' g= -0.58, 95% CI= -0.86 to -0.29, 95% PI= -1.23 to 0.08); action observation training plus movement strategy practice to practice alone (Hedges' g= -0.56, 95% CI= -1.16 to 0.05); and dance to multimodal exercises (Hedges' g= -0.64, 95% CI= -1.53 to 0.25). CONCLUSIONS We are uncertain if physical therapy/exercise, cognitive or behavioral therapies, are effective at reducing FOG.Implications for rehabilitationFOG leads to impaired mobility and falls, but the effect of rehabilitation interventions (including physical therapy/exercise and cognitive/behavioral therapies) on FOG is small and uncertain.Until more robust evidence is generated, clinicians should assess FOG using both self-report and physical measures, as well as other related impairments such as cognition, anxiety, and fear of falling.Interventions for FOG should be personalized based on the individual's triggers and form part of a broader exercise program addressing gait, balance, and falls prevention.Interventions should continue over the long term and be closely monitored and adjusted as individual circumstances change.
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Affiliation(s)
- Lina Goh
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Colleen G Canning
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jooeun Song
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lindy Clemson
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Natalie E Allen
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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24
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Qian Y, Fu X, Zhang H, Yang Y, Wang G. Comparative efficacy of 24 exercise types on postural instability in adults with Parkinson's disease: a systematic review and network meta-analysis. BMC Geriatr 2023; 23:522. [PMID: 37641007 PMCID: PMC10463698 DOI: 10.1186/s12877-023-04239-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To compare, rank and evaluate the 24 exercise types that improve postural instability in patients with Parkinson's disease (PD). METHODS We searched the data in PubMed, MEDLINE, Embase, PsycINFO, Cochrane library, and Web of Science from their inception date to January 23, 2023. Randomized controlled trials (RCTs) that aimed at determining the effectiveness of physical activity interventions on postural instability in adults with PD. This review focused on different balance outcome categories: (a) balance test batteries (BBS); (b) static steady-state balance (sSSB); (c) dynamic steady-state balance (dSSB); (d) proactive balance (PB); (e) reactive balance (RB). RESULTS Among 10,474 records, 199 studies (patients = 9523) were eligible for qualitative synthesis. The random-effects NMA model revealed that the following exercise training modalities had the highest p score of being best when compared with control group: body-weight support treadmill training (BWS_TT) for BBS (p score = 0.97; pooled standardised mean difference (95% CI): 1.56 (0.72 to 2.39)) and dSSB (1.00; 1.53 (1.07 to 2.00)), aquatic exercise (AQE) for sSSB (0.85; 0.94 (0.33 to 1.54)), Pilates for PB (0.95; 1.42 (0.59 to 2.26)). Balance and gait training with the external cue or attention (BGT_ECA) and robotic assisted gait balance (RA_GT) had similar superior effects in improving RB. The confidence in evidence was often low according to Confidence in Network Meta-Analysis. CONCLUSIONS There is low quality evidence that BWS_TT, AQE, Pilates, BGT_ECA and RA_GT are possibly the most effective treatments, pending outcome of interest, for adults with PD.
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Affiliation(s)
- Yujia Qian
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, China
| | - Xueying Fu
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, 85 Minglun Rd, Shunhe District, Kaifeng City, 475001, China
| | - Haoyang Zhang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, 85 Minglun Rd, Shunhe District, Kaifeng City, 475001, China
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, No. 1 Xuefu Road, Chaohu Economic Development Zone, Hefei, Anhui Province, 238000, China.
| | - Guotuan Wang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, 85 Minglun Rd, Shunhe District, Kaifeng City, 475001, China.
- School of Physical Education and Health, Krasnoyarsk State Pedagogical University named after V.P. Astafyev Street. Ada Lebedeva, House 89, Krasnoyarsk City, 660049, Russia.
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25
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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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26
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Alarcón TA, Presti-Silva SM, Simões APT, Ribeiro FM, Pires RGW. Molecular mechanisms underlying the neuroprotection of environmental enrichment in Parkinson's disease. Neural Regen Res 2023; 18:1450-1456. [PMID: 36571341 PMCID: PMC10075132 DOI: 10.4103/1673-5374.360264] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Parkinson's disease is the most common movement disorder, affecting about 1% of the population over the age of 60 years. Parkinson's disease is characterized clinically by resting tremor, bradykinesia, rigidity and postural instability, as a result of the progressive loss of nigrostriatal dopaminergic neurons. In addition to this neuronal cell loss, Parkinson's disease is characterized by the accumulation of intracellular protein aggregates, Lewy bodies and Lewy neurites, composed primarily of the protein α-synuclein. Although it was first described almost 200 years ago, there are no disease-modifying drugs to treat patients with Parkinson's disease. In addition to conventional therapies, non-pharmacological treatment strategies are under investigation in patients and animal models of neurodegenerative disorders. Among such strategies, environmental enrichment, comprising physical exercise, cognitive stimulus, and social interactions, has been assessed in preclinical models of Parkinson's disease. Environmental enrichment can cause structural and functional changes in the brain and promote neurogenesis and dendritic growth by modifying gene expression, enhancing the expression of neurotrophic factors and modulating neurotransmission. In this review article, we focus on the current knowledge about the molecular mechanisms underlying environmental enrichment neuroprotection in Parkinson's disease, highlighting its influence on the dopaminergic, cholinergic, glutamatergic and GABAergic systems, as well as the involvement of neurotrophic factors. We describe experimental pre-clinical data showing how environmental enrichment can act as a modulator in a neurochemical and behavioral context in different animal models of Parkinson's disease, highlighting the potential of environmental enrichment as an additional strategy in the management and prevention of this complex disease.
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Affiliation(s)
- Tamara Andrea Alarcón
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | - Sarah Martins Presti-Silva
- Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria; Department of Biochemistry and Immunology, Institute o Biological Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Ana Paula Toniato Simões
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | - Fabiola Mara Ribeiro
- Department of Biochemistry and Immunology, Institute o Biological Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Rita Gomes Wanderley Pires
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
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Putzolu M, Manzini V, Gambaro M, Cosentino C, Bonassi G, Botta A, Ravizzotti E, Avanzino L, Pelosin E, Mezzarobba S. Home-based exercise training by using a smartphone app in patients with Parkinson's disease: a feasibility study. Front Neurol 2023; 14:1205386. [PMID: 37448748 PMCID: PMC10338039 DOI: 10.3389/fneur.2023.1205386] [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: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Background Parkinson's disease (PD) patients experience deterioration in mobility with consequent inactivity and worsened health and social status. Physical activity and physiotherapy can improve motor impairments, but several barriers dishearten PD patients to exercise regularly. Home-based approaches (e.g., via mobile apps) and remote monitoring, could help in facing this issue. Objective This study aimed at testing the feasibility, usability and training effects of a home-based exercise program using a customized version of Parkinson Rehab® application. Methods Twenty PD subjects participated in a two-month minimally supervised home-based training. Daily session consisted in performing PD-specific exercises plus a walking training. We measured: (i) feasibility (training adherence), usability and satisfaction (via an online survey); (ii) safety; (iii) training effects on PD severity, mobility, cognition, and mood. Evaluations were performed at: baseline, after 1-month of training, at the end of training (T2), and at 1-month follow-up (T3). Results Eighteen out of twenty participants completed the study without important adverse events. Participants' adherence was 91% ± 11.8 for exercise and 105.9% ± 30.6 for walking training. Usability and satisfaction survey scored 70.9 ± 7.7 out of 80. Improvements in PD severity, mobility and cognition were found at T2 and maintained at follow-up. Conclusion The home-based training was feasible, safe and seems to positively act on PD-related symptoms, mobility, and cognition in patients with mild to moderate stage of PD disease. Additionally, the results suggest that the use of a mobile app might increase the amount of daily physical activity in our study population. Remote monitoring and tailored exercise programs appear to be key elements for promoting exercise. Future studies in a large cohort of PD participants at different stages of disease are needed to confirm these findings.
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Affiliation(s)
- Martina Putzolu
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
| | - Virginia Manzini
- La Colletta Hospital, Azienda Sanitaria Locale 3, Arenzano, Italy
| | | | - Carola Cosentino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Gaia Bonassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Elisa Ravizzotti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Susanna Mezzarobba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
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28
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Souza RJD, Shigaki IADA, Terra MB, Barboza NM, Bueno MEB, Mesas AE, Smaili SM. Effectiveness of Neurofunctional Physical Therapy on the Quality of Sleep of Individuals with Parkinson's Disease: Case Series. Sleep Sci 2023; 16:206-215. [PMID: 37425968 PMCID: PMC10325842 DOI: 10.1055/s-0043-1770801] [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] [Indexed: 07/11/2023] Open
Abstract
Objective Sleep disorders are disabling and highly prevalent comorbidities in Parkinson's disease (PD). This study's objective was to verify the effectiveness of neurofunctional physiotherapy in sleep quality, objectively and subjectively assessing it among individuals with PD. Methods A sample of individuals with PD was assessed before and after 32 physiotherapy sessions and three months later (follow-up). The following instruments were used: Pittsburgh Sleep Quality Index (PSQI); Epworth Sleepiness Scale (ESS); Parkinson's Disease Sleep Scale (PDSS), and actigraphy. Results Nineteen individuals aged 67.37 years old ( ± 8.03) on average were included. No differences were found in any of the variables measured by the actigraphy or the ESS. Improvement was found from pre- to post-intervention in terms of nocturnal movements (p = 0.04; d = 0.46) and total score (p = 0.03; d = 0.53) obtained on the PDSS. Improvement was also found in the PDSS sleep onset/maintenance domain (p = 0.001; d = 0.75) between pre-intervention and follow-up. The participants' total score obtained in the PSQI improved from pre- to post-intervention (p = 0.03; d = 0.44). Significant differences were found in nighttime sleep (p = 0.02; d = 0.51) and nocturnal movements (p = 0.02; d = 0.55), and in the PDSS total score (p = 0.04; d = 0.63) between pre- and post-intervention when only the poor sleepers subgroup (n = 13) was considered, while improvements were found in sleep onset/maintenance (p = 0.003; d = 0.91) between pre-intervention and follow-up. Discussion Neurofunctional physiotherapy was ineffective in improving objective parameters of sleep but was effective in improving the perception of sleep quality subjectively assessed among individuals with PD, especially those who perceived themselves to be poor sleepers.
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Affiliation(s)
- Rogério José de Souza
- Department of Physiotherapy, Londrina State University (UEL), Londrina, Paraná, Brazil
| | | | | | | | | | - Arthur Eumann Mesas
- Centro de Estudios Sociosanitario, Universidad de Castilla-La Mancha, Cuenca, Cuenca, Spain
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29
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Tonkin PG, Miller TD, Hartmann TE, Skein M. The effects of exercise on non-motor experiences of daily living experienced in Parkinson's Disease: A systematic review and network meta-analysis. Clin Park Relat Disord 2023; 9:100203. [PMID: 37293547 PMCID: PMC10245098 DOI: 10.1016/j.prdoa.2023.100203] [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: 02/27/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Whilst non-motor experiences of daily living (NMeDL) reduce quality of life (QoL) in people with Parkinson's Disease (PD), research dedicated to NMeDL is lacking compared to motor symptoms. The aim of this Network Meta-Analysis (NMA) was to compare and determine the effects of exercise and dual-task training interventions on NMeDL for people with early-to-mid stage PD. Methods Eight electronic databases were systematically searched, identifying randomised control trials (RCTs) that assessed the effect of interventions on the Movement Disease Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS); Part I scores. A fixed-effect pairwise and NMA were completed and confidence in estimates were assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. Results Five RCTs involving exercise were identified, involving 218 participants. No dual-tasking studies were suitable. Pairwise comparisons favoured tango and mixed-treadmill training (TT) when compared to control, however 95% Confidence Intervals (CI) crossed the line of no effect (MD = 0). Indirect comparisons revealed tango had clinically meaningful reductions in Part I scores compared to speed-TT and body-weight resistance training, (MD -4.47; 95% CI -8.50 to -0.44 and MD -4.38; 95% CI -7.86 to -0.90), indicating improved NMeDL. Compared to control, low confidence evidence suggests tango and mixed-TT improves NMeDL. Conclusions Tango and mixed-TT are the most effective exercise interventions for improving NMeDL. Adoption of an exercise program in the early stages of PD, irrespective of modality, may be effective and holds potential clinical importance immediately following a diagnosis of PD.Other: Prospero Registration Number; CRD42022322470.
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Li J, Xu Y, Liu T, Xu Y, Zhao X, Wei J. The Role of Exercise in Maintaining Mitochondrial Proteostasis in Parkinson's Disease. Int J Mol Sci 2023; 24:ijms24097994. [PMID: 37175699 PMCID: PMC10179072 DOI: 10.3390/ijms24097994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Parkinson's disease (PD) is the second most common rapidly progressive neurodegenerative disease and has serious health and socio-economic consequences. Mitochondrial dysfunction is closely related to the onset and progression of PD, and the use of mitochondria as a target for PD therapy has been gaining traction in terms of both recognition and application. The disruption of mitochondrial proteostasis in the brain tissue of PD patients leads to mitochondrial dysfunction, which manifests as mitochondrial unfolded protein response, mitophagy, and mitochondrial oxidative phosphorylation. Physical exercise is important for the maintenance of human health, and has the great advantage of being a non-pharmacological therapy that is non-toxic, low-cost, and universally applicable. In this review, we investigate the relationships between exercise, mitochondrial proteostasis, and PD and explore the role and mechanisms of mitochondrial proteostasis in delaying PD through exercise.
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Affiliation(s)
- Jingwen Li
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng 475000, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Yanli Xu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Tingting Liu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Yuxiang Xu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Xiantao Zhao
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng 475000, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Jianshe Wei
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng 475000, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
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Iemmolo M, Ghersi G, Bivona G. The Cytokine CX3CL1 and ADAMs/MMPs in Concerted Cross-Talk Influencing Neurodegenerative Diseases. Int J Mol Sci 2023; 24:ijms24098026. [PMID: 37175729 PMCID: PMC10179166 DOI: 10.3390/ijms24098026] [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: 03/29/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Neuroinflammation plays a fundamental role in the development and progression of neurodegenerative diseases. It could therefore be said that neuroinflammation in neurodegenerative pathologies is not a consequence but a cause of them and could represent a therapeutic target of neuronal degeneration. CX3CL1 and several proteases (ADAMs/MMPs) are strongly involved in the inflammatory pathways of these neurodegenerative pathologies with multiple effects. On the one hand, ADAMs have neuroprotective and anti-apoptotic effects; on the other hand, they target cytokines and chemokines, thus causing inflammatory processes and, consequently, neurodegeneration. CX3CL1 itself is a cytokine substrate for the ADAM, ADAM17, which cleaves and releases it in a soluble isoform (sCX3CL1). CX3CL1, as an adhesion molecule, on the one hand, plays an inhibiting role in the pro-inflammatory response in the central nervous system (CNS) and shows neuroprotective effects by binding its membrane receptor (CX3CR1) present into microglia cells and maintaining them in a quiescent state; on the other hand, the sCX3CL1 isoform seems to promote neurodegeneration. In this review, the dual roles of CX3CL1 and ADAMs/MMPs in different neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (MH), and multiple sclerosis (MS), are investigated.
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Affiliation(s)
- Matilda Iemmolo
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128 Palermo, Italy
| | - Giulio Ghersi
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128 Palermo, Italy
| | - Giulia Bivona
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, University of Palermo, 90133 Palermo, Italy
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Xiao Y, Yang T, Shang H. The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease. Brain Sci 2023; 13:brainsci13030437. [PMID: 36979247 PMCID: PMC10046387 DOI: 10.3390/brainsci13030437] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Rehabilitation is a high-potential approach to improving physical and cognitive functions in Parkinson’s disease (PD). Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. Patients perform motor and cognitive tasks at the same time in dual-task training. The previous studies of dual-task training in PD had high heterogeneity and achieved controversial results. In the current review, we aim to summarize the current evidence of the effect of dual-task training on motor and cognitive functions in PD patients to support the clinical practice of dual-task training. In addition, we also discuss the current opinions regarding the mechanism underlying the interaction between motor and cognitive training. In conclusion, dual-task training is suitable for PD patients with varied disease duration to improve their motor function. Dual-task training can improve motor symptoms, single-task gait speed, single-task steep length, balance, and objective experience of freezing of gait in PD. The improvement in cognitive function after dual-task training is mild.
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Bueno MEB, Silva TCOD, de Souza RJ, Volpe RP, Moura FA, Smaili SM. Acute effects of transcranial direct current stimulation combined with physical therapy on the balance and gait in individuals with Parkinson's disease: A randomized controlled trial. Clin Neurol Neurosurg 2023; 226:107604. [PMID: 36739707 DOI: 10.1016/j.clineuro.2023.107604] [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: 12/12/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
Application methods of transcranial direct current stimulation (tDCS) in Parkinson's disease (PD) are quite divergent making it difficult to define the clinical effectiveness of the tDCS on PD. Thus, the aim of this study was to verify the acute effects of tDCS when applied to different targets (Cz or C3-Cz-C4) combined to physical therapy to improve balance and gait in individuals with PD. A randomized controlled trial was conducted, with 50 individuals who were separated into four groups: 1) Real tDCS (Cz) + physical therapy, 2) Real tDCS (C3-Cz-C4) + physical therapy, 3) Sham tDCS + physical therapy and 4) Educational lecture + physical therapy. The current intensity was 2 mA, applied for 20 min. For the instrumental assessment of balance and gait, the 3D motion analysis system was used. For the biomechanical analysis of gait, three different conditions were performed: normal gait, dual task gait and obstacle gait. For balance analysis, the following positions were utilized: Romberg with eyes opened, Romberg with eyes closed, Tandem with eyes opened and Tandem with eyes closed. All evaluations were performed pre-intervention, post-intervention (immediately at the end of the intervention) and were followed-up on (24 h after the end of the intervention). No statistically significant differences were found for all gait and balance outcomes when considering the interaction between time (pre, post and follow-up assessments) versus group (Education, Sham, Cz and C3-Cz-C4). In conclusion, it was found that one session of tDCS, stimulating Cz or C3-Cz-C4 combined with physical therapy, was not effective in improving the balance and gait in people with PD as compared to sham tDCS or educational lecture plus physiotherapy.
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Affiliation(s)
- Maria Eduarda Brandão Bueno
- Neurofunctional Physical Therapy Research Group (GPFIN), Graduate Program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil.
| | - Taís Caroline Oliveira da Silva
- Neurofunctional Physical Therapy Research Group (GPFIN), Graduate Program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil.
| | - Rogério José de Souza
- Neurofunctional Physical Therapy Research Group (GPFIN), Graduate Program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil.
| | - Renata Pasquarelli Volpe
- Neurofunctional Physical Therapy Research Group (GPFIN), Graduate Program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil.
| | - Felipe Arruda Moura
- Laboratory of Applied Biomechanics, Sport Sciences Department - State University of Londrina, Paraná, Brazil.
| | - Suhaila Mahmoud Smaili
- Department of Physiotherapy, Neurofunctional Physical Therapy Research Group (GPFIN), Master's and Doctoral Degree Program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil.
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Wang Y, Pu Z, Zhang Y, Du Z, Guo Z, Bai Q. Exercise training has a protective effect in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine mice model with improved neural and intestinal pathology and modified intestinal flora. Behav Brain Res 2023; 439:114240. [PMID: 36455673 DOI: 10.1016/j.bbr.2022.114240] [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: 09/16/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease with the exact etiology still unclear, but gut microbial disorders are thought to be related to the initiation and progression of it. Exercise training has a significant effect on the intestinal flora, so to investigate the promotion effect of exercise training on Parkinson's disease, we performed a rotarod walking training (5 times a week at 25 rpm for 20 min for 8 weeks) on a chronic mouse model of Parkinson's disease induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and observed the locomotor function of mice, function of dopaminergic neurons, intestinal mucosal barrier condition, intestinal inflammation and the structure and composition of intestinal flora. The results showed in these PD mice, exercise training improved their motility, increased the dopamine (DA) content in the striatum, along with promoted the gene expression of tyrosine hydroxylase and brain-derived neurotrophic factor in the striatum, which suggests this exercise training might protect striatal dopaminergic neurons from MPTP damage; the results also showed exercise training promoted recovery from ileal pathology, reduced the gene expression of intestinal inflammatory factors, and significantly altered the composition and structure of the intestinal flora in these mice.
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Affiliation(s)
- Yongjun Wang
- Chongqing Technology and Business University, No. 19 Xue Fu Road, Nanan District, Chongqing 401334, PR China.
| | - Zhengjia Pu
- School of Public Health, Chongqing Medical University, No. 61 Daxuecheng Middle Road, Shapingba District, Chongqing 401334, PR China.
| | - Yiran Zhang
- School of Public Health, Chongqing Medical University, No. 61 Daxuecheng Middle Road, Shapingba District, Chongqing 401334, PR China.
| | - Zhaohui Du
- Chongqing Technology and Business University, No. 19 Xue Fu Road, Nanan District, Chongqing 401334, PR China.
| | - Zeming Guo
- School of Public Health, Chongqing Medical University, No. 61 Daxuecheng Middle Road, Shapingba District, Chongqing 401334, PR China.
| | - Qunhua Bai
- School of Public Health, Chongqing Medical University, No. 61 Daxuecheng Middle Road, Shapingba District, Chongqing 401334, PR China.
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Jäggi S, Wachter A, Adcock M, de Bruin ED, Möller JC, Marks D, Schweinfurther R, Giannouli E. Feasibility and effects of cognitive-motor exergames on fall risk factors in typical and atypical Parkinson's inpatients: a randomized controlled pilot study. Eur J Med Res 2023; 28:30. [PMID: 36647177 PMCID: PMC9841664 DOI: 10.1186/s40001-022-00963-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND People with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive-motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD. METHODS Forty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1-4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effects RESULTS: Adherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time-group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2. DISCUSSION Exergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted. TRIAL REGISTRATION The study has been registered at ClinicalTrials.gov (ID: NCT04872153).
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Affiliation(s)
- Salome Jäggi
- grid.5801.c0000 0001 2156 2780Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Annina Wachter
- grid.5801.c0000 0001 2156 2780Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuela Adcock
- grid.5801.c0000 0001 2156 2780Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- grid.5801.c0000 0001 2156 2780Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland ,grid.4714.60000 0004 1937 0626Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden ,grid.460104.70000 0000 8718 2812Department of Health, OST – Eastern Swiss University of Applied Sciences, St.Gallen, Switzerland
| | - Jens Carsten Möller
- Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland ,grid.10253.350000 0004 1936 9756Department of Neurology, Philipps University, Marburg, Germany
| | - Detlef Marks
- Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Raoul Schweinfurther
- Parkinson Center, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Eleftheria Giannouli
- grid.5801.c0000 0001 2156 2780Department of Health Sciences & Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland ,grid.6612.30000 0004 1937 0642Department of Sport, Exercise and Health, Division of Sports and Exercise Medicine, University of Basel, Basel, Switzerland
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Yang CL, Huang JP, Wang TT, Tan YC, Chen Y, Zhao ZQ, Qu CH, Qu Y. Effects and parameters of community-based exercise on motor symptoms in Parkinson's disease: a meta-analysis. BMC Neurol 2022; 22:505. [PMID: 36581847 PMCID: PMC9797903 DOI: 10.1186/s12883-022-03027-z] [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: 09/17/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Community-based exercise is a continuation and complement to inpatient rehabilitation for Parkinson's disease and does not require a professional physical therapist or equipment. The effects, parameters, and forms of each exercise are diverse, and the effect is affected by many factors. A meta-analysis was conducted to determine the effect and the best parameters for improving motor symptoms and to explore the possible factors affecting the effect of community-based exercise. METHODS: We conducted a comprehensive search of six databases: PEDro, PubMed/Medline, CENTRAL, Scopus, Embase, and WOS. Studies that compared community-based exercise with usual care were included. The intervention mainly included dance, Chinese martial arts, Nordic walking, and home-based exercise. The primary outcome measure was the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) score. The mean difference (95% CI) was used to calculate the treatment outcomes of continuous outcome variables, and the I2 statistic was used to estimate the heterogeneity of the statistical analysis. We conducted subgroup analysis and meta-regression analysis to determine the optimal parameters and the most important influencing factors of the exercise effect. RESULTS: Twenty-two studies that enrolled a total of 809 subjects were included in the analysis. Exercise had a positive effect on the UPDRS-III (MD = -5.83; 95% CI, -8.29 to -3.37), Timed Up and Go test (MD = -2.22; 95% CI -3.02 to -1.42), UPDRS ((MD = -7.80; 95% CI -10.98 to -6.42), 6-Minute Walk Test (MD = 68.81; 95% CI, 32.14 to 105.48), and Berg Balance Scale (MD = 4.52; 95% CI, 2.72 to 5.78) scores. However, the heterogeneity of each included study was obvious. Weekly frequency, age, and duration of treatment were all factors that potentially influenced the effect. CONCLUSIONS This meta-analysis suggests that community-based exercise may benefit motor function in patients with PD. The most commonly used modalities of exercise were tango and tai chi, and the most common prescription was 60 min twice a week. Future studies should consider the influence of age, duration of treatment, and weekly frequency on the effect of exercise. PROSPERO TRIAL REGISTRATION NUMBER CRD42022327162.
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Affiliation(s)
- Chun-Lan Yang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.508104.8Minda Hospital of Hubei Minzu University, Enshi, 445000 Hubei China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Jia-Peng Huang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Ting-Ting Wang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Ying-Chao Tan
- Enshi Prefecture Central Hospital, Enshi, 445000 Hubei China
| | - Yin Chen
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Zi-Qi Zhao
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Chao-Hua Qu
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Yun Qu
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
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Wang R, Zhou H, Wang YC, Chang XL, Wang XQ. Benefits of Tai Chi Quan on neurodegenerative diseases: A systematic review. Ageing Res Rev 2022; 82:101741. [PMID: 36220604 DOI: 10.1016/j.arr.2022.101741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Neurodegenerative diseases have become an important concern with the accelerated aging process. Tai Chi Quan (TCQ) has positive benefits for brain health and chronic diseases. The aim of this study was to summarize the protective effects of TCQ for motor function, cognition, quality of life, and mood in patients with neurodegenerative diseases. METHODS A systematic search was conducted via PubMed database and the Web of Science core collection database until August 20, 2021. The available English systematic reviews, meta-analyses, and clinical trials were included. Two reviewers completed the screening and assessment process independently. RESULTS A total of 28 studies on Parkinson's disease, 21 on cognitive impairment, and 9 on multiple sclerosis met the included criteria. The study found that TCQ remarkably improved general motor function and balance, and prevented falls for Parkinson's disease. TCQ significantly improved global cognitive function for cognitive impairment. TCQ was likely safe and beneficial for multiple sclerosis as result of heterogeneous outcomes and small samples. CONCLUSION TCQ exercise can effectively improve the motor function, global cognitive function, and falls in patients with neurodegenerative diseases. However, the positive effects of TCQ on the quality of life and mood of patients with neurodegenerative diseases need further evidence.
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Affiliation(s)
- Rui Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Hao Zhou
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Yu-Chen Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China
| | - Xiao-Long Chang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
| | - Xue-Qiang Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai 200438, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai 200438, China.
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Li H, Liu Q, Yang J, Gu S, Shi J, Li H, Cheng J. The effect and mechansim of β-arrestins in the regulation of microglia polarization in the pathogenesis of Parkinson's disease. Minerva Med 2022; 113:1036-1038. [PMID: 34672167 DOI: 10.23736/s0026-4806.21.07829-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Haining Li
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Qiang Liu
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Juan Yang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Shue Gu
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Jin Shi
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Hui Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Jiang Cheng
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China -
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Pan S, Wei H, Yuan S, Kong Y, Yang H, Zhang Y, Cui X, Chen W, Liu J, Zhang Y. Probiotic Pediococcus pentosaceus ameliorates MPTP-induced oxidative stress via regulating the gut microbiota–gut–brain axis. Front Cell Infect Microbiol 2022; 12:1022879. [PMID: 36439235 PMCID: PMC9682001 DOI: 10.3389/fcimb.2022.1022879] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
Recent evidence demonstrated that functional bacteria were involved in the regulation of Parkinson’s disease (PD). However, the mechanism of probiotics in improving PD was unclear. Here the antioxidant effect and the mechanism of probiotics Pediococcus pentosaceus (PP) on PD were studied by regulating the gut–brain axis. In this study, male C57BL/6J mice were injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intraperitoneally to establish a PD model and were then treated with PP for 4 weeks. Subsequently, a series of neurobehavioral tests to evaluate the motor function of the mice was performed. Additionally, degeneration of dopaminergic neurons, accumulation of α-synuclein, the production of an oxidative stress response, and the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins were evaluated. Moreover, the gut microbial composition and the level of metabolite γ-aminobutyric acid (GABA) were assessed. The results showed that PP treatment could improve MPTP-induced motor deficits, the degeneration of dopaminergic neurons, and the accumulation of α-synuclein. Moreover, PP treatment significantly increased the levels of SOD1, Gpx1, and Nrf2, while it decreased the levels of Keap1 in the brain of MPTP-induced mice. Notably, PP treatment improved the gut microbial dysbiosis and increased the level of GABA in MPTP-induced mice. These findings indicated that PP might represent a promising candidate, due to the metabolite of GABA, that could be used for the treatment of PD.
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Affiliation(s)
- Sipei Pan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hongming Wei
- Department of Geriatrics, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shushu Yuan
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Kong
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huiqun Yang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuhe Zhang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaorui Cui
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weian Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
- *Correspondence: Jiaming Liu, ; Yang Zhang,
| | - Yang Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- *Correspondence: Jiaming Liu, ; Yang Zhang,
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Amprimo G, Masi G, Priano L, Azzaro C, Galli F, Pettiti G, Mauro A, Ferraris C. Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson's Disease: An Integrated Approach Based on Azure Kinect. SENSORS (BASEL, SWITZERLAND) 2022; 22:8173. [PMID: 36365870 PMCID: PMC9654712 DOI: 10.3390/s22218173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson’s disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase in patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. An experimental test involving 20 parkinsonian subjects and 15 healthy controls was organized. Preliminary results show the system’s ability to quantify specific and statistically significant (p < 0.05) features of motor performance, easily monitor changes as the disease progresses over time, and at the same time permit the use of exergames in virtual reality both for training and as a support for motor condition assessment (for example, detecting an average reduction in arm swing asymmetry of about 14% after arm training). The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.
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Affiliation(s)
- Gianluca Amprimo
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Giulia Masi
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
| | - Lorenzo Priano
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Corrado Azzaro
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Federica Galli
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Giuseppe Pettiti
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Alessandro Mauro
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Claudia Ferraris
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
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Assessing the Effect of 12 Weeks of Pilates and Aquatic Exercise on Muscle Strength and Range of Motion in Patients with Mild to Moderate Parkinson’s Disease. Asian J Sports Med 2022. [DOI: 10.5812/asjsm-123190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Parkinson's disease is a chronic, progressive and degenerative disorder of the central nervous system with four main symptoms of bradykinesia, tremor, muscular rigidity, and postural instability. Objectives: The effect of 12 weeks of Pilates and aquatic exercise on muscle strength and range of motion (ROM) in male patients with Parkinson's disease was assessed in this article. Methods: In this quasi-experimental study, 25 male patients reporting to Al-Zahra Hospital, Isfahan, were selected randomly and grouped in Pilates (n = 7), Aquatic exercise (n = 10), and Control (n = 8). The experimental groups received 1-hour sessions of training three times a week for 12 weeks. Muscle strength and ROM of each patient was measured through the Biodex Isokinetic System 3 before entering the study and after the final assigned session. Results: Pilates and Aquatic exercise groups had a significant improvement in ROM, while no significant difference was observed in the control group. Muscle strength and ROM increased significantly in the experimental groups compared to the control group (P < 0.05). The effect of Pilates on muscle strength was not significant (P < 0.05). Conclusions: Non-pharmacological modalities could be contributive in the patients with Parkinson's disease recovery and lead to significant improvements in their physiological parameters of muscle strength and ROM. Next to the pharmacological treatments, patients could benefit from inexpensive and readily available options like Pilates and aquatic exercises to alleviate the disease symptoms. Further studies should be run to reveal the aforementioned and plausible benefits of these complementary activities.
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Shahhar AZM, Qasheesh M, Shaphe MA. Effectiveness of Nintendo Wii on Balance in People with Parkinson's Disease: A Systematic Review. J Lifestyle Med 2022; 12:105-112. [PMID: 36628175 PMCID: PMC9798876 DOI: 10.15280/jlm.2022.12.3.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/19/2022] [Indexed: 12/24/2022] Open
Abstract
The use of exergaming exercises is increasingly becoming accepted as an alternative to surgical and medical therapies for Parkinson's disease (PD). Although the area has attracted some results, there is still no conclusive evidence on the benefit of exergaming exercises in improving PD patients' body balance. The current study is a systematic review aiming at examining the effectiveness of the Nintendo Wii Fit ("Wii Fit") game on improving the balance in people with Parkinson's disease. A total of 200 articles were selected online after conducting an extensive search on PubMed, Cochrane, PEDro, CAPES Periodic, ResearchGate, Web of Science, and ProQuest. Upon reviewing the identified sources, ten articles were included, of which four were randomized control trials. The results show that at least five weeks of Wii Fit exercises effectively enhance PD patients' body balance and life outcomes. However, better results occur when patients combine Wii Fit with other conventional exercises.
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Affiliation(s)
| | - Mohammed Qasheesh
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Mohammad Abu Shaphe
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia,Corresponding author: Mohammad Abu Shaphe, Department of Physical Theraphy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Kingdom of Saudi ArabiaTel: 966-597165564, Fax: 966-173232760, E-mail:
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Kang Z, Xing H, Lin Q, Meng F, Gong L. Effectiveness of therapeutic massage for improving motor symptoms in Parkinson's disease: A systematic review and meta-analysis. Front Neurol 2022; 13:915232. [PMID: 36133798 PMCID: PMC9483027 DOI: 10.3389/fneur.2022.915232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Parkinson's disease (PD) causes movement disorders [called motor symptoms (MS)], and motor dysfunction poses a great barrier to the quality of life. Although pharmacological therapy like levodopa can relieve the symptoms, it can also cause complications, such as psychosis, nausea, and dyskinesia. A therapy with more minor side effects is needed for PD. Therapeutic massages are the most commonly used forms of complementary and alternative medicine (CAM), but no systematic review and meta-analysis have focused on the efficacy of massage on PD. Objective To evaluate the quality of evidence and efficacy of therapeutic massage for improving MS in PD. Methods We independently searched four electronic databases, including Chinese National Knowledge Infrastructure (CNKI), MEDLINE/PubMed, Embase, and Cochrane Library, for randomized controlled trials (RCTs) about therapeutic massage and other available manual therapies improving MS in PD from January 1, 2012, to December 31, 2021 (recent 10 years). The main outcome measures were total effectiveness and the Unified Parkinson's Disease Rating Scale (UPDRS), including UPDRS total, II, and III. For the statistical analysis, the risk ratio, standard mean difference, and 95% confidence interval (CI) were used to calculate effect sizes between groups. To determine heterogeneity, statistical index I2 was used. Results A total of 363 PD participants in seven RCTs and one randomized pilot-control study were included in this meta-analysis. The total effectiveness showed that therapeutic massage was more effective than the intervention of the control group for improving MS [ratio risk (RR): 1.33, 95% CI (1.14–1.55), p = 0.0002]. The UPDRS-III scores showed that massage improves motor function more than the control group [SMD = −0.46, 95% CI (−0.67, −0.24), p < 0.00001]. But we found that massage performed no better than the control group in improving daily life activities [SMD = −0.15, 95% CI (−0.40, 0.10), p = 0.23]. Conclusion Therapeutic massage was effective in improving MS in PD. It is suggested to be an appropriate form of CAM in treating PD. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=323182, identifier: CRD42022323182.
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Affiliation(s)
- Zhiran Kang
- Department of Tuina, Shanghai YueYang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hua Xing
- Department of Tuina, Shanghai YueYang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qiang Lin
- Department of Tuina, Shanghai General Hospital, Shanghai, China
| | - Fanchao Meng
- Department of Tuina, Shanghai YueYang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li Gong
- Department of Tuina, Shanghai YueYang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Li Gong
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de Almeida EJR, Ibrahim HJ, Chitolina Schetinger MR, de Andrade CM, Cardoso AM. Modulation of Inflammatory Mediators and Microglial Activation Through Physical Exercise in Alzheimer's and Parkinson's Diseases. Neurochem Res 2022; 47:3221-3240. [PMID: 35962936 DOI: 10.1007/s11064-022-03713-x] [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: 11/23/2021] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 12/19/2022]
Abstract
Neuroinflammation is an inflammatory process in the central nervous system (CNS), in addition to being one of the main features of Alzheimer's disease (AD) and Parkinson's disease (PD). Microglia are known for their immune functions and have multiple reactive phenotypes related to the types of stages involving neurodegenerative diseases. Depending on the state of activation of microglia in the CNS, it can be neuroprotective or neurotoxic. In this context, AD is a neurodegenerative and neuroinflammatory disease characterized by the deposition of beta-amyloid plaques, formation of fibrillar tangles of tau protein, and loss of neurons due to neurotoxic activation of microglia. However, PD is characterized by the loss of dopaminergic neurons in the substantia nigra and accumulation of alpha-synuclein in the cortical regions, spinal cord, and brain stem, which occurs by microglial activation, contributing to the neuroinflammatory process. In this aspect, the activation of microglia in both pathologies triggers high levels of inflammatory markers, such as interleukins, and causes the neuroinflammatory process of the diseases. Thus, physical exercise is pointed out as neuroprotective, as it can act to strengthen neurogenesis and reduce the inflammatory process. Therefore, the present review addresses the neuroprotective effect of microglia after different types of physical exercise protocols and evaluates the activity and effects of inflammatory and anti-inflammatory parameters and mechanisms of AD and PD. This review will discuss the anti-inflammatory effects of physical exercise through microglia activation with neuroprotective activity and the role of pro-and anti-inflammatory cytokines in AD and PD.
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Affiliation(s)
| | | | | | - Cinthia Melazzo de Andrade
- Department of Small Animal Clinic, Center of Rural Sciences, Federal University of Santa Maria-RS, Room 121, Veterinary Hospital Building, Avenue Roraima No. 1000, Santa Maria, RS, 97105-900, Brazil
| | - Andréia Machado Cardoso
- Graduate Program in Physical Education From Federal University of Santa Maria, Santa Maria, RS, Brazil. .,Graduate Program in Biomedical Sciences From Federal University of Fronteira Sul, Campus Chapecó, Rodovia SC 484 - Km 02, Fronteira Sul, SC, 89815-899, Brazil.
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Physical Therapy for at Least 6 Months Improves Motor Symptoms in Parkinson’s Patients: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3393191. [PMID: 35959355 PMCID: PMC9357765 DOI: 10.1155/2022/3393191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
Objective Long-term physical therapy helps to improve the motor symptoms of patients with Parkinson's disease, but the effectiveness is not clear. The purpose of this study was to evaluate the effect of long-term physical therapy on improving motor symptoms or daily activities in Parkinson's patients with drug use or discontinuation, as well as its impact on drug treatment dose. A subgroup analysis was conducted on different treatment methods to determine the most effective treatment method. Methods The researchers independently searched databases, including PubMed, Medline, Embase, Ovid, Cochrane Library, and ISI Web of science. The search deadline was June 2022. A randomized controlled trial was conducted on Parkinson's disease patients with HY stages 1-3 who received continuous physical therapy for 6 months or more. Systematic evaluation and meta-analysis were carried out by using common clinical evaluation indicators, namely, MDS-UPDRS exercise score, daily activity (ADL) score, or LED dose. The quality of the literature was assessed using the modified Jadad scale of Cochrane's bias risk tool. Results A total of 523 Parkinson's disease patients with HY stages of 1-3 were included in the study. The results showed that long-term physical therapy could improve patients' motor symptoms with combined antiparkinsonian drugs (Z = 2.61 and P = 0.009) and had a significant positive effect on the motor symptoms of patients with discontinued antiparkinsonian drugs (Z = 2.73 and P = 0.006). Meanwhile, it could reduce the LED dose of patients with Parkinson's disease. The difference was statistically significant (Z = 2.58 and P = 0.010). Conclusion The results of this study indicated that physical therapy for at least 6 months or longer for patients with mild to moderate Parkinson's HY could effectively improve the motor symptoms of Parkinson's patients, whether or not combined with antiparkinson drugs. Meanwhile, long-term physical therapy reduced the LED dose of patients treated with drugs compared with patients in the control group who received short-term physical therapy, other types of intervention group, or no treatment.
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Hang W, Fan HJ, Li YR, Xiao Q, Jia L, Song LJ, Gao Y, Jin XM, Xiao BG, Yu JZ, Ma CG, Chai Z. Wuzi Yanzong pill attenuates MPTP-induced Parkinson's Disease via PI3K/Akt signaling pathway. Metab Brain Dis 2022; 37:1435-1450. [PMID: 35488941 DOI: 10.1007/s11011-022-00993-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
Wuzi Yanzong Pill (WYP) was found to play a protective role on nerve cells and neurological diseases, however the molecular mechanism is unclear. To understand the molecular mechanisms that underly the neuroprotective effect of WYP on dopaminergic neurons in Parkinson's disease (PD). PD mouse model was induced by the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Gait and hanging tests were used to assess motor behavioral function. Immunofluorescence assay was used to determine TH-positive neurons in substantia nigra (SN). Apoptosis, dopamine and neurotrophic factors as well as expression of PI3K/Akt pathway were detected by TUNEL staining, ELISA and western blotting, respectively. First, it was observed that WYP intervention improved abnormal motor function in MPTP-induced PD model, alleviated the loss of TH+ neurons in SN, and increased dopamine content in brain, revealing a potential protective effect. Second, network pharmacology was used to analyze the possible targets and pathways of WYP action in the treatment of PD. A total of 126 active components related to PD were screened in WYP, and the related core targets included ALB, GAPDH, Akt1, TP53, IL6 and TNF. Particularly, the effect of WYP on PD may be medicate through PI3K/Akt signaling pathway and apoptotic regulation. The WYP treated PD mice had higher expression of p-PI3K, p-Akt and Bcl-2 but lower expression of Bax and cleaved caspase-3 than the non-WYP treated PD mice. Secretion of brain-derived neurotrophic factor (BDNF) and cerebral dopamine neurotrophic factor (CDNF) were also increased in the treated mice. WYP may inhibit apoptosis and increase the secretion of neurotrophic factor via activating PI3K/ Akt signaling pathway, thus protecting the loss of dopamine neurons in MPTP-induced PD mice.
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Affiliation(s)
- Wei Hang
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Hui-Jie Fan
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Yan-Rong Li
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Qi Xiao
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Lu Jia
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Li-Juan Song
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China
| | - Yao Gao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China
| | - Xiao-Ming Jin
- Department of Anatomy and Cell Biology, Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Bao-Guo Xiao
- Huashan Hospital, Fudan University, Shanghai, 200025, China
| | - Jie-Zhong Yu
- Institute of Brain Science, Shanxi Datong University, Datong, 037009, China
| | - Cun-Gen Ma
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China.
- Institute of Brain Science, Shanxi Datong University, Datong, 037009, China.
| | - Zhi Chai
- The Key Research Laboratory of Benefiting Qi for Acting Blood Circulation Method to Treat Multiple Sclerosis of State Administration of Traditional Chinese Medicine/Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, 030619, China.
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Chen JW, Du SH, Chen TC, Zhu K. Research Hotspots and Trends of Exercise on Parkinson's Disease: A Global Bibliometric Analysis From 2012 to 2021. Front Hum Neurosci 2022; 16:908049. [PMID: 35693536 PMCID: PMC9184738 DOI: 10.3389/fnhum.2022.908049] [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: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background Parkinson's disease is a chronic neurodegenerative disease, which can be alleviated in drug treatment, but with evident side effects. At the same time, increasing evidence shows that exercise can significantly improve the symptoms of patients with Parkinson's disease, with an effect that cannot be achieved by drug treatment. The related research on exercise on Parkinson's disease increases rapidly with the passage of time. However, the research analysis on Parkinson's disease by means of bibliometrics is rare. The purpose of this study is to perform a bibliometric analysis of the research hotspots and development trends of the global movement on Parkinson's disease from 2012 to 2021. Methods The literature was derived from the Web of Science core collection database, and the social science citation index was set as SCI-EXPANDED. The language was set to English, and the literature category was set as article and review and published from 2012 to 2021. CiteSpace and other software were used to analyze the relationship among published documents, countries, institutions, journals, authors, references, disciplines, and keywords. Results A total of 2,222 articles were included in the analysis. The analysis showed that the publication volume increased with the increase in years, with a total of 76 countries and 546 academic journals published; the largest number was that of the United States. The journals are mainly concentrated in the fields of neurology, sports, and ophthalmology. Rush University and Movement Disorders journals are the main institutions and journals. The cited keywords show that trial, cognition, and interference are the research hotspots and development trends in recent years. Conclusion The number of published articles on Parkinson's disease by exercise has increased rapidly in the past 10 years, and the bibliometric analysis can provide useful information for future research teams and researchers.
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Affiliation(s)
- Ji-Wei Chen
- Department of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Shu-Hao Du
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Tian-Cong Chen
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Tian-Cong Chen
| | - Kun Zhu
- Department of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
- Kun Zhu
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Sun H, Zhao F, Liu Y, Ma T, Jin H, Quan K, Leng B, Zhao J, Yuan X, Li Z, Li F, Kwok LY, Zhang S, Sun Z, Zhang J, Zhang H. Probiotics synergized with conventional regimen in managing Parkinson's disease. NPJ Parkinsons Dis 2022; 8:62. [PMID: 35610236 PMCID: PMC9130297 DOI: 10.1038/s41531-022-00327-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/05/2022] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is mainly managed by pharmacological therapy (e.g., Benserazide and dopamine agonists). However, prolonged use of these drugs would gradually diminish their dopaminergic effect. Gut dysbiosis was observed in some patients with PD, suggesting close association between the gut microbiome and PD. Probiotics modulate the host's gut microbiota beneficially. A 3-month randomized, double-blind, placebo-controlled clinical trial was conducted to investigate the beneficial effect of probiotic co-administration in patients with PD. Eighty-two PD patients were recruited and randomly divided into probiotic [n = 48; Bifidobacterium animalis subsp. lactis Probio-M8 (Probio-M8), Benserazide, dopamine agonists] and placebo (n = 34; placebo, Benserazide, dopamine agonists) groups. Finally, 45 and 29 patients from Probio-M8 and placebo groups provided complete fecal and serum samples for further omics analysis, respectively. The results showed that Probio-M8 co-administration conferred added benefits by improving sleep quality, alleviating anxiety, and gastrointestinal symptoms. Metagenomic analysis showed that, after the intervention, there were significantly more species-level genome bins (SGBs) of Bifidobacterium animalis, Ruminococcaceae, and Lachnospira, while less Lactobacillus fermentum and Klebsiella oxytoca in Probio-M8 group (P < 0.05). Interestingly, Lactobacillus fermentum correlated positively with the scores of UPDRS-III, HAMA, HAMD-17, and negatively with MMSE. Klebsiella oxytoca correlated negatively with feces hardness. Moreover, co-administering Probio-M8 increased SGBs involved in tryptophan degradation, gamma-aminobutyric acid, short-chain fatty acids, and secondary bile acid biosynthesis, as well as serum acetic acid and dopamine levels (P < 0.05). Taken together, Probio-M8 synergized with the conventional regimen and strengthened the clinical efficacy in managing PD, accompanied by modifications of the host's gut microbiome, gut microbial metabolic potential, and serum metabolites.
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Affiliation(s)
- Hairong Sun
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Feiyan Zhao
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Yuanyuan Liu
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Teng Ma
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Hao Jin
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Keyu Quan
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Bing Leng
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Junwu Zhao
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Xiaoling Yuan
- Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, 264200, China
| | - Zhenguang Li
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Fang Li
- Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121000, China
| | - Lai-Yu Kwok
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Shukun Zhang
- Department of Pathology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China
| | - Zhihong Sun
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China
| | - Jinbiao Zhang
- Department of neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, 264200, China.
| | - Heping Zhang
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, 010018, China.
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49
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The Category of Conventional Physiotherapy: The Case of Parkinson’s Disease Guidelines. J Pers Med 2022; 12:jpm12050730. [PMID: 35629152 PMCID: PMC9143172 DOI: 10.3390/jpm12050730] [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: 04/13/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022] Open
Abstract
This opinion paper reviews the use of the category of “conventional physiotherapy” (CPT) in Parkinson’s disease (PD)-relevant reviews and meta-analyses and points out serious inconsistencies within and among them. These are first discussed in general, leading to the conclusion that, in most cases, the category of CPT encompasses a range of incompatible interventions. This undermines previous conclusions about their superiority or inferiority relative to various other treatment modalities. Next, the update to the European Physiotherapy Guidelines is discussed in detail, since it treats CPT as a global and time-independent category per se, ascribing effects in various domains to it. This introduces several important biases into the findings presented in this publication. These are subsequently discussed, and it is concluded that the categorisation of various physiotherapy techniques under the umbrella term of CPT is empty, or even dangerous, and should be abandoned. Other categories are suggested as a replacement, including “Other Physiotherapy Techniques” and “Multimodal Training”.
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50
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Ribarič S. Physical Exercise, a Potential Non-Pharmacological Intervention for Attenuating Neuroinflammation and Cognitive Decline in Alzheimer's Disease Patients. Int J Mol Sci 2022; 23:ijms23063245. [PMID: 35328666 PMCID: PMC8952567 DOI: 10.3390/ijms23063245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
This narrative review summarises the evidence for considering physical exercise (PE) as a non-pharmacological intervention for delaying cognitive decline in patients with Alzheimer’s disease (AD) not only by improving cardiovascular fitness but also by attenuating neuroinflammation. Ageing is the most important risk factor for AD. A hallmark of the ageing process is a systemic low-grade chronic inflammation that also contributes to neuroinflammation. Neuroinflammation is associated with AD, Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders. Pharmacological treatment of AD is currently limited to mitigating the symptoms and attenuating progression of the disease. AD animal model studies and human studies on patients with a clinical diagnosis of different stages of AD have concluded that PE attenuates cognitive decline not only by improving cardiovascular fitness but possibly also by attenuating neuroinflammation. Therefore, low-grade chronic inflammation and neuroinflammation should be considered potential modifiable risk factors for AD that can be attenuated by PE. This opens the possibility for personalised attenuation of neuroinflammation that could also have important health benefits for patients with other inflammation associated brain disorders (i.e., Parkinson’s disease, late-onset epilepsy, amyotrophic lateral sclerosis and anxiety disorders). In summary, life-long, regular, structured PE should be considered as a supplemental intervention for attenuating the progression of AD in human. Further studies in human are necessary to develop optimal, personalised protocols, adapted to the progression of AD and the individual’s mental and physical limitations, to take full advantage of the beneficial effects of PE that include improved cardiovascular fitness, attenuated systemic inflammation and neuroinflammation, stimulated brain Aβ peptides brain catabolism and brain clearance.
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Affiliation(s)
- Samo Ribarič
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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