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Rotondo R, Padua E, Annino G, Guescini M, Donati-Zeppa S, Goffredo M, Stocchi V, Stocchi F, De Pandis MF. Dose-response effects of physical exercise standardized volume on peripheral biomarkers, clinical response, and brain connectivity in Parkinson's disease: a prospective, observational, cohort study. Front Neurol 2024; 15:1412311. [PMID: 39022736 PMCID: PMC11251892 DOI: 10.3389/fneur.2024.1412311] [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: 04/04/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
Background Exercise has been proposed as the "Universal Prescription for Parkinson's Disease"; however, the specificity of exercise dose in terms of frequency, intensity, duration, and type to be prescribed remains to be elucidated. The 2018 US updated guidelines and WHO Guidelines on Physical Activity and Sedentary Behavior recommend older adults (> 65+ years) to achieve weekly minimal activity levels, indicating the intensity of aerobic exercise as the metabolic equivalent of task and duration as minutes/week (150-300 min/week at a moderate intensity of 3-5.9 MET- or 75-150 min/week of a vigorous intensity of ≥6 MET). Translating these recommendations to PD patients, the study aimed to assess the dose-response effects of standardized volume of structured exercise, measured as METs-minutes/week (weekly energy expenditure) of two different rehabilitation settings to quantify the change in neurotrophic factors. The exercise-induced benefits between the two rehabilitation settings will be evaluated based on motor and non-motor symptoms, kinematic parameters of gait, cognitive function, quality of life, and cortical activity and brain connectivity. Methods METEX-PD is a pilot, prospective, observational, cohort study. The study will enroll consecutively thirty (N = 30) participants with mild-to-moderate Parkinson's disease diagnosis to be assigned to a non-intensive or intensive rehabilitation group. The non-intensive rehabilitation group will achieve a range of 180-270 METs-min/week (90 min/week of low-intensity aerobic exercise, 2-3 METs), while the intensive rehabilitation group will exercise at 1350-1980 METs-min/week (225 min/week of high-intensity aerobic exercise, 6-8.8 METs). The METEX-PD trial will last 12 weeks, including 4 weeks of aerobic training program and two follow-ups. Assessments will be performed at baseline (T0), at the end of the exercise program (T1-end of the program), and 4- and 8 weeks after the end of the training program (FU-1 and FU-2). The primary outcome is the change from baseline in peripheral blood BDNF levels. Secondary outcomes are differences in peripheral biomarkers, functional-motor assessments, clinical-functional evaluations, and brain imaging. Conclusion METEX-PD trial will enable us to estimate the change in BDNF levels and other peripheral biomarkers under precise exercise-induced energy expenditure. The primary results of the METEX-PD study will allow the development of a larger multicenter randomized controlled trial to investigate the molecular pathways inducing the change in selected neurotrophic factors, such as BDNF, IGF-1, or irisin, and the downstream mechanisms of neuroplasticity in PD patients.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
- Center of Space Bio-Medicine, Department of Medicine Systems, Tor Vergata University, Rome, Italy
| | - Michele Guescini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Sabrina Donati-Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Michela Goffredo
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Vilberto Stocchi
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
| | - Fabrizio Stocchi
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Maria Francesca De Pandis
- San Raffaele Cassino, Cassino, Italy
- Department of Human Science and Promotion of Quality of Life, San Raffaele Rome Open University, Rome, Italy
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2
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Kasanga EA, Soto I, Centner A, McManus R, Shifflet MK, Navarrete W, Han Y, Lisk J, Ehrhardt T, Wheeler K, Mhatre-Winters I, Richardson JR, Bishop C, Nejtek VA, Salvatore MF. Moderate intensity aerobic exercise alleviates motor deficits in 6-OHDA lesioned rats and reduces serum levels of biomarkers of Parkinson's disease severity without recovery of striatal dopamine or tyrosine hydroxylase. Exp Neurol 2024; 379:114875. [PMID: 38944332 DOI: 10.1016/j.expneurol.2024.114875] [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: 03/20/2024] [Revised: 06/11/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
Alleviation of motor impairment by aerobic exercise (AE) in Parkinson's disease (PD) patients points to activation of neurobiological mechanisms that may be targetable by therapeutic approaches. However, evidence for AE-related recovery of striatal dopamine (DA) signaling or tyrosine hydroxylase (TH) loss has been inconsistent in rodent studies. This ambiguity may be related to the timing of AE intervention in relation to the status of nigrostriatal neuron loss. Here, we replicated human PD at diagnosis by establishing motor impairment with >80% striatal DA and TH loss prior to initiating AE, and assessed its potential to alleviate motor decline and restore DA and TH loss. We also evaluated if serum levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP), biomarkers of human PD severity, changed in response to AE. 6-hydroxydopamine (6-OHDA) was infused unilaterally into rat medial forebrain bundle to induce progressive nigrostriatal neuron loss over 28 days. Moderate intensity AE (3× per week, 40 min/session), began 8-10 days post-lesion following establishment of impaired forelimb use. Striatal tissue DA, TH protein and mRNA, and serum levels of NfL/GFAP were determined 3-wks after AE began. Despite severe striatal DA depletion at AE initiation, forelimb use deficits and hypokinesia onset were alleviated by AE, without recovery of striatal DA or TH protein loss, but reduced NfL and GFAP serum levels. This proof-of-concept study shows AE alleviates motor impairment when initiated with >80% striatal DA loss without obligate recovery of striatal DA or TH protein. Moreover, the AE-related reduction of NfL and GFAP serum levels may serve as objective blood-based biomarkers of AE efficacy.
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Affiliation(s)
- Ella A Kasanga
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Isabel Soto
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Ashley Centner
- Department of Psychology, Binghamton University, Binghamton, NY, United States of America
| | - Robert McManus
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Marla K Shifflet
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Walter Navarrete
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Yoonhee Han
- Department of Environmental Health Sciences, Robert Stempel School of Public Health & Social Work, Florida International University, Miami, FL, United States of America; Isakson Center for Neurological Disease Research, College of Veterinary Medicine, University of Georgia, Athens, GA, United States of America
| | - Jerome Lisk
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Travis Ehrhardt
- Clearcut Ortho Rehab & Diagnostics, Fort Worth, TX, United States of America
| | - Ken Wheeler
- Clearcut Ortho Rehab & Diagnostics, Fort Worth, TX, United States of America
| | - Isha Mhatre-Winters
- Department of Environmental Health Sciences, Robert Stempel School of Public Health & Social Work, Florida International University, Miami, FL, United States of America; Isakson Center for Neurological Disease Research, College of Veterinary Medicine, University of Georgia, Athens, GA, United States of America
| | - Jason R Richardson
- Department of Environmental Health Sciences, Robert Stempel School of Public Health & Social Work, Florida International University, Miami, FL, United States of America; Isakson Center for Neurological Disease Research, College of Veterinary Medicine, University of Georgia, Athens, GA, United States of America
| | - Christopher Bishop
- Department of Psychology, Binghamton University, Binghamton, NY, United States of America
| | - Vicki A Nejtek
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Michael F Salvatore
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, United States of America.
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3
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Loughlin H, Jackson J, Looman C, Starll A, Goldman J, Shan Z, Yu C. Aerobic exercise improves depressive symptoms in the unilateral 6-OHDA-lesioned rat model of Parkinson's disease. IBRO Neurosci Rep 2024; 16:468-475. [PMID: 38560366 PMCID: PMC10981038 DOI: 10.1016/j.ibneur.2024.03.004] [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: 12/31/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Aerobic exercise has been shown to have established benefits on motor function in Parkinson's disease (PD). However, the impact of exercise on depressive symptoms in PD remains unclear. This study aimed to investigate the effects of regular exercise, specifically using a forced running wheel, on both motor performance and the prevalence of depression in a unilateral 6-OHDA-lesioned rat model of PD. The behavioral outcomes of exercise were assessed through the rotarod test (RT), forelimb adjusting step test (FAST), sucrose consumption test (SCT), and novelty sucrose splash test (NSST). Our data revealed evident depressive symptoms in the PD animals, characterized by reduced sucrose consumption in the SCT and diminished exploratory activity in the NSST compared to the naïve control group. Specifically, after 11 weeks of exercise, the PD exercise group demonstrated the most significant improvements in sucrose consumption in the SCT. Additionally, this group exhibited reduced immobility and increased exploratory behavior compared to the PD control group in the NSST. Furthermore, the PD exercise group displayed the greatest improvement in correcting forelimb stepping bias. Our results suggested that a regimen of running wheel exercise enhances motor abilities and mitigates the occurrence of depressive behaviors caused by 6-OHDA dopamine depletion in the PD rat model.
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Affiliation(s)
- Hannah Loughlin
- Department of Biomedical Engineering, Michigan Technological University, United States
| | - Jacob Jackson
- Department of Biomedical Engineering, Michigan Technological University, United States
| | - Chloe Looman
- Department of Biomedical Engineering, Michigan Technological University, United States
| | - Alayna Starll
- Department of Biomedical Engineering, Michigan Technological University, United States
| | - Jeremy Goldman
- Department of Biomedical Engineering, Michigan Technological University, United States
| | - Zhiying Shan
- Department of Kinesiology and Integrative Physiology, United States
| | - Chunxiu Yu
- Department of Biomedical Engineering, Michigan Technological University, United States
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Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2024; 4:CD013856. [PMID: 38588457 PMCID: PMC11001292 DOI: 10.1002/14651858.cd013856.pub3] [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: 04/10/2024]
Abstract
BACKGROUND Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear. OBJECTIVES To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs). SEARCH METHODS An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. MAIN RESULTS We included 154 RCTs with a total of 7837 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 60 (2721 participants), and 48 (3029 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson's Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (60 studies; 2721 participants) suggests that dance and gait/balance/functional training probably have a moderate beneficial effect on the severity of motor signs (dance: mean difference (MD) -10.18, 95% confidence interval (CI) -14.87 to -5.36; gait/balance/functional training: MD -7.50, 95% CI -11.39 to -3.48; moderate confidence), and multi-domain training probably has a small beneficial effect on the severity of motor signs (MD -5.90, 95% CI -9.11 to -2.68; moderate confidence). The evidence also suggests that endurance, aqua-based, strength/resistance, and mind-body training might have a small beneficial effect on the severity of motor signs (endurance training: MD -5.76, 95% CI -9.78 to -1.74; aqua-based training: MD -5.09, 95% CI -10.45 to 0.40; strength/resistance training: MD -4.96, 95% CI -9.51 to -0.40; mind-body training: MD -3.62, 95% CI -7.24 to 0.00; low confidence). The evidence is very uncertain about the effects of "Lee Silverman Voice training BIG" (LSVT BIG) and flexibility training on the severity of motor signs (LSVT BIG: MD -6.70, 95% CI -16.48 to 3.08; flexibility training: MD 4.20, 95% CI -1.61 to 9.92; very low confidence). Quality of life The evidence from the NMA (48 studies; 3029 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -15.15, 95% CI -23.43 to -6.87; moderate confidence). The evidence also suggests that mind-body, gait/balance/functional, and multi-domain training and dance might have a small beneficial effect on QoL (mind-body training: MD -7.22, 95% CI -13.57 to -0.70; gait/balance/functional training: MD -6.17, 95% CI -10.75 to -1.59; multi-domain training: MD -5.29, 95% CI -9.51 to -1.06; dance: MD -3.88, 95% CI -10.92 to 3.00; low confidence). The evidence is very uncertain about the effects of gaming, strength/resistance, endurance, and flexibility training on QoL (gaming: MD -8.99, 95% CI -23.43 to 5.46; strength/resistance training: MD -6.70, 95% CI -12.86 to -0.35; endurance training: MD -6.52, 95% CI -13.74 to 0.88; flexibility training: MD 1.94, 95% CI -10.40 to 14.27; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types. AUTHORS' CONCLUSIONS We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD.
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Affiliation(s)
- Moritz Ernst
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Lieker
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Caro-Valenzuela
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Cryns
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Resarch, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Ambulatory Assessment in Psychology, Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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5
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Daadi EW, Daadi ES, Oh T, Li M, Kim J, Daadi MM. Combining physical & cognitive training with iPSC-derived dopaminergic neuron transplantation promotes graft integration & better functional outcome in parkinsonian marmosets. Exp Neurol 2024; 374:114694. [PMID: 38272159 DOI: 10.1016/j.expneurol.2024.114694] [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: 12/08/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
Parkinson's disease (PD) is a relentlessly progressive and currently incurable neurodegenerative disease with significant unmet medical needs. Since PD stems from the degeneration of midbrain dopaminergic (DA) neurons in a defined brain location, PD patients are considered optimal candidates for cell replacement therapy. Clinical trials for cell transplantation in PD are beginning to re-emerge worldwide with a new focus on induced pluripotent stem cells (iPSCs) as a source of DA neurons since they can be derived from adult somatic cells and produced in large quantities under current good manufacturing practices. However, for this therapeutic strategy to be realized as a viable clinical option, fundamental translational challenges need to be addressed including the manufacturing process, purity and efficacy of the cells, the method of delivery, the extent of host reinnervation and the impact of patient-centered adjunctive interventions. In this study we report on the impact of physical and cognitive training (PCT) on functional recovery in the nonhuman primate (NHP) model of PD after cell transplantation. We observed that at 6 months post-transplant, the PCT group returned to normal baseline in their daily activity measured by actigraphy, significantly improved in their sensorimotor and cognitive tasks, and showed enhanced synapse formation between grafted cells and host cells. We also describe a robust, simple, efficient, scalable, and cost-effective manufacturing process of engraftable DA neurons derived from iPSCs. This study suggests that integrating PCT with cell transplantation therapy could promote optimal graft functional integration and better outcome for patients with PD.
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Affiliation(s)
- Etienne W Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Elyas S Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Thomas Oh
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Mingfeng Li
- Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jeffrey Kim
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA; Department of Cell Systems & Anatomy, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA
| | - Marcel M Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA; Department of Cell Systems & Anatomy, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA; Department of Radiology, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
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6
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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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7
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de Laat B, Hoye J, Stanley G, Hespeler M, Ligi J, Mohan V, Wooten DW, Zhang X, Nguyen TD, Key J, Colonna G, Huang Y, Nabulsi N, Patel A, Matuskey D, Morris ED, Tinaz S. Intense exercise increases dopamine transporter and neuromelanin concentrations in the substantia nigra in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:34. [PMID: 38336768 PMCID: PMC10858031 DOI: 10.1038/s41531-024-00641-1] [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: 08/26/2023] [Accepted: 01/15/2024] [Indexed: 02/12/2024] Open
Abstract
Parkinson's disease (PD) is characterized by a progressive loss of dopaminergic neurons. Exercise has been reported to slow the clinical progression of PD. We evaluated the dopaminergic system of patients with mild and early PD before and after a six-month program of intense exercise. Using 18F-FE-PE2I PET imaging, we measured dopamine transporter (DAT) availability in the striatum and substantia nigra. Using NM-MRI, we evaluated the neuromelanin content in the substantia nigra. Exercise reversed the expected decrease in DAT availability into a significant increase in both the substantia nigra and putamen. Exercise also reversed the expected decrease in neuromelanin concentration in the substantia nigra into a significant increase. These findings suggest improved functionality in the remaining dopaminergic neurons after exercise. Further research is needed to validate our findings and to pinpoint the source of any true neuromodulatory and neuroprotective effects of exercise in PD in large clinical trials.
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Affiliation(s)
- Bart de Laat
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA.
- Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Jocelyn Hoye
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Gelsina Stanley
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | | | | | | | | | | | - Thanh D Nguyen
- Department of Radiology, Weil Cornell Medicine, New York, NY, USA
| | - Jose Key
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Giulia Colonna
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Amar Patel
- Department of Neurology, Yale University, New Haven, CT, USA
| | - David Matuskey
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Neurology, Yale University, New Haven, CT, USA
| | - Evan D Morris
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Sule Tinaz
- Department of Neurology, Yale University, New Haven, CT, USA
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8
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Salvatore MF. Dopamine Signaling in Substantia Nigra and Its Impact on Locomotor Function-Not a New Concept, but Neglected Reality. Int J Mol Sci 2024; 25:1131. [PMID: 38256204 PMCID: PMC10815979 DOI: 10.3390/ijms25021131] [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: 12/01/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
The mechanistic influences of dopamine (DA) signaling and impact on motor function are nearly always interpreted from changes in nigrostriatal neuron terminals in striatum. This is a standard practice in studies of human Parkinson's disease (PD) and aging and related animal models of PD and aging-related parkinsonism. However, despite dozens of studies indicating an ambiguous relationship between changes in striatal DA signaling and motor phenotype, this perseverating focus on striatum continues. Although DA release in substantia nigra (SN) was first reported almost 50 years ago, assessment of nigral DA signaling changes in relation to motor function is rarely considered. Whereas DA signaling has been well-characterized in striatum at all five steps of neurotransmission (biosynthesis and turnover, storage, release, reuptake, and post-synaptic binding) in the nigrostriatal pathway, the depth of such interrogations in the SN, outside of cell counts, is sparse. However, there is sufficient evidence that these steps in DA neurotransmission in the SN are operational and regulated autonomously from striatum and are present in human PD and aging and related animal models. To complete our understanding of how nigrostriatal DA signaling affects motor function, it is past time to include interrogation of nigral DA signaling. This brief review highlights evidence that changes in nigral DA signaling at each step in DA neurotransmission are autonomous from those in striatum and changes in the SN alone can influence locomotor function. Accordingly, for full characterization of how nigrostriatal DA signaling affects locomotor activity, interrogation of DA signaling in SN is essential.
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Affiliation(s)
- Michael F Salvatore
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Huang Y, Chen Q, Wang Z, Wang Y, Lian A, Zhou Q, Zhao G, Xia K, Tang B, Li B, Li J. Risk factors associated with age at onset of Parkinson's disease in the UK Biobank. NPJ Parkinsons Dis 2024; 10:3. [PMID: 38167894 PMCID: PMC10762149 DOI: 10.1038/s41531-023-00623-9] [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: 07/31/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
Substantial evidence shown that the age at onset (AAO) of Parkinson's disease (PD) is a major determinant of clinical heterogeneity. However, the mechanisms underlying heterogeneity in the AAO remain unclear. To investigate the risk factors with the AAO of PD, a total of 3156 patients with PD from the UK Biobank were included in this study. We evaluated the effects of polygenic risk scores (PRS), nongenetic risk factors, and their interaction on the AAO using Mann-Whitney U tests and regression analyses. We further identified the genes interacting with nongenetic risk factors for the AAO using genome-wide environment interaction studies. We newly found physical activity (P < 0.0001) was positively associated with AAO and excessive daytime sleepiness (P < 0.0001) was negatively associated with AAO, and reproduced the positive associations of smoking and non-steroidal anti-inflammatory drug intake and the negative association of family history with AAO. In the dose-dependent analyses, smoking duration (P = 1.95 × 10-6), coffee consumption (P = 0.0150), and tea consumption (P = 0.0008) were positively associated with AAO. Individuals with higher PRS had younger AAO (P = 3.91 × 10-5). In addition, we observed a significant interaction between the PRS and smoking for AAO (P = 0.0316). Specifically, several genes, including ANGPT1 (P = 7.17 × 10-7) and PLEKHA6 (P = 4.87 × 10-6), may influence the positive relationship between smoking and AAO. Our data suggests that genetic and nongenetic risk factors are associated with the AAO of PD and that there is an interaction between the two.
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Affiliation(s)
- Yuanfeng Huang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Qian Chen
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Zheng Wang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Yijing Wang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Aojie Lian
- National Health Commission Key Laboratory of Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, Hunan, China
| | - Qiao Zhou
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
| | - Guihu Zhao
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Kun Xia
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China
| | - Beisha Tang
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China
| | - Bin Li
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
| | - Jinchen Li
- National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Bioinformatics Center, Xiangya Hospital & Furong Laboratory, Central South University, Changsha 410008, Hunan, China.
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha 410008, Hunan, China.
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Luthra NS, Christou DD, Clow A, Corcos DM. Targeting neuroendocrine abnormalities in Parkinson's disease with exercise. Front Neurosci 2023; 17:1228444. [PMID: 37746149 PMCID: PMC10514367 DOI: 10.3389/fnins.2023.1228444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Parkinson's Disease (PD) is a prevalent and complex age-related neurodegenerative condition for which there are no disease-modifying treatments currently available. The pathophysiological process underlying PD remains incompletely understood but increasing evidence points to multiple system dysfunction. Interestingly, the past decade has produced evidence that exercise not only reduces signs and symptoms of PD but is also potentially neuroprotective. Characterizing the mechanistic pathways that are triggered by exercise and lead to positive outcomes will improve understanding of how to counter disease progression and symptomatology. In this review, we highlight how exercise regulates the neuroendocrine system, whose primary role is to respond to stress, maintain homeostasis and improve resilience to aging. We focus on a group of hormones - cortisol, melatonin, insulin, klotho, and vitamin D - that have been shown to associate with various non-motor symptoms of PD, such as mood, cognition, and sleep/circadian rhythm disorder. These hormones may represent important biomarkers to track in clinical trials evaluating effects of exercise in PD with the aim of providing evidence that patients can exert some behavioral-induced control over their disease.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Demetra D. Christou
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, McCormick School of Engineering, Northwestern University, Chicago, IL, United States
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11
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Curtin D, Taylor EM, Bellgrove MA, Chong TTJ, Coxon JP. D2 receptor blockade eliminates exercise-induced changes in cortical inhibition and excitation. Brain Stimul 2023; 16:727-733. [PMID: 37100200 DOI: 10.1016/j.brs.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/07/2023] [Accepted: 04/23/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Although cardiorespiratory exercise is known to affect cortical excitatory and inhibitory activity, the neurochemical mechanisms driving this effect are poorly understood. Animal models of Parkinson's disease identify dopamine D2 receptor expression as a candidate mechanism, but the link between the D2 receptor and exercise-induced changes in cortical activity in humans is unknown. OBJECTIVE Here, we examined the effect of a selective dopamine D2 receptor antagonist, sulpiride, on exercise-induced changes in cortical activity. METHODS We acquired measures of excitatory and inhibitory activity of the primary motor cortex using transcranial magnetic stimulation (TMS) from 23 healthy adults, both before and after a 20-min bout of high-intensity interval cycling exercise. We examined the effect of D2 receptor blockade (800 mg sulpiride) on these measures within a randomised, double-blind, placebo-controlled crossover design. RESULTS Sulpiride abolished exercise-induced modulation of the cortical excitation:inhibition balance relative to placebo (P < 0.001, Cohen's d = 1.76). Sulpiride blocked both the increase in glutamatergic excitation and reduction in gamma-aminobutyric acid (GABA) inhibition that was observed following exercise in the placebo condition. CONCLUSION Our results provide causal evidence that D2 receptor blockade eliminates exercise-induced changes in excitatory and inhibitory cortical networks, and have implications for how exercise should be prescribed in diseases of dopaminergic dysfunction.
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Affiliation(s)
- Dylan Curtin
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Eleanor M Taylor
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Mark A Bellgrove
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia
| | - Trevor T-J Chong
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia; Department of Neurology, Alfred Health, Melbourne, Victoria, 3004, Australia; Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
| | - James P Coxon
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, 3800, Australia.
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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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13
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Kurtoğlu E, Payas A, Düz S, Arık M, Uçar İ, Tokmak TT, Erbay MF, Acer N, Unur E. Analysis of changes in brain morphological structure of taekwondo athletes by diffusion tensor imaging. J Chem Neuroanat 2023; 129:102250. [PMID: 36791923 DOI: 10.1016/j.jchemneu.2023.102250] [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: 11/09/2022] [Revised: 02/02/2023] [Accepted: 02/12/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE Taekwondo, which is the most preferred sport among the martial arts, is known to improve individuals physically, spiritually and mentally. The aim of this study is to reveal the effect of teakwondo sport on the brain and brain structures. DESIGN;: 30 taekwondo athletes and 15 control groups were included in this study. Diffusion tensor MR images of each participant were taken. The information was obtained by the self-declaration of the athletes, whether they were sports years, amateur or elite. METHOD Total brain volume and volumes of white matter, gray matter, frontal lobe, precentral gyrus, corticospinal tract, basal nuclei, postcentral gyrus, hippocampus and amigdala and the ratio of these volumes to total brain volume were evaluated statistically between the groups using MriCloud software and ROIEditor program. RESULTS An increase in total brain volume, gray matter, frontal lobe and precentral gyrus volume in athletes was associated with taekwondo training. When the ratio of brain parts to total brain volume was examined, it was determined that there was a difference in the ratio of gray matter, white matter volumes in amateur athletes, right frontal lobe, left corticospinal tract, right postcentral gyrus volumes in elite athletes, and left postcentral gyrus volumes of both athletes compared to sedentary individuals. CONCLUSIONS The increase in the volume of gray matter, frontal lobe, postcentral gyrus and corticospinal tract together with the brain volume shows that taekwondo exercise contributes to physical, spiritual and mental development.
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Affiliation(s)
- Erdal Kurtoğlu
- Erciyes University, Department of Anatomy, Kayseri, Turkey.
| | - Ahmet Payas
- Hitit University, Sungurlu Vocational School, Department of Therapy and Rehabilitation, Çorum, Turkey
| | - Serkan Düz
- İnönü University, Faculty of Sports Sciences, Coaching Education, Malatya, Turkey
| | - Mustafa Arık
- Kayseri City and Education Hospital, Department of Orthopedics and Traumatology, Kayseri, Turkey
| | - İlyas Uçar
- Erciyes University, Department of Anatomy, Kayseri, Turkey
| | | | | | - Niyazi Acer
- Arel University, Department of Anatomy, İstanbul, Turkey
| | - Erdoğan Unur
- Erciyes University, Department of Anatomy, Kayseri, Turkey
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Modulation of nigral dopamine signaling mitigates parkinsonian signs of aging: evidence from intervention with calorie restriction or inhibition of dopamine uptake. GeroScience 2023; 45:45-63. [PMID: 35635679 PMCID: PMC9886753 DOI: 10.1007/s11357-022-00583-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/29/2022] [Indexed: 02/03/2023] Open
Abstract
Identifying neurobiological mechanisms of aging-related parkinsonism, and lifestyle interventions that mitigate them, remain critical knowledge gaps. No aging study, from rodent to human, has reported loss of any dopamine (DA) signaling marker near the magnitude associated with onset of parkinsonian signs in Parkinson's disease (PD). However, in substantia nigra (SN), similar loss of DA signaling markers in PD or aging coincide with parkinsonian signs. Alleviation of these parkinsonian signs may be possible by interventions such as calorie restriction (CR), which augment DA signaling markers like tyrosine hydroxylase (TH) expression in the SN, but not striatum. Here, we interrogated respective contributions of nigral and striatal DA mechanisms to aging-related parkinsonian signs in aging (18 months old) rats in two studies: by the imposition of CR for 6 months, and inhibition of DA uptake within the SN or striatum by cannula-directed infusion of nomifensine. Parkinsonian signs were mitigated within 12 weeks after CR and maintained until 24 months old, commensurate with increased D1 receptor expression in the SN alone, and increased GDNF family receptor, GFR-α1, in the striatum, suggesting increased GDNF signaling. Nomifensine infusion into the SN or striatum selectively increased extracellular DA. However, only nigral infusion increased locomotor activity. These results indicate mechanisms that increase components of DA signaling in the SN alone mitigate parkinsonian signs in aging, and are modifiable by interventions, like CR, to offset parkinsonian signs, even at advanced age. Moreover, these results give evidence that changes in nigral DA signaling may modulate some parameters of locomotor activity autonomously from striatal DA signaling.
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Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 1:CD013856. [PMID: 36602886 PMCID: PMC9815433 DOI: 10.1002/14651858.cd013856.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear. OBJECTIVES To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs). SEARCH METHODS An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. MAIN RESULTS We included 156 RCTs with a total of 7939 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 71 (3196 participants), and 55 (3283 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (71 studies; 3196 participants) suggests that dance has a moderate beneficial effect on the severity of motor signs (mean difference (MD) -10.32, 95% confidence interval (CI) -15.54 to -4.96; high confidence), and aqua-based, gait/balance/functional, and multi-domain training might have a moderate beneficial effect on the severity of motor signs (aqua-based: MD -7.77, 95% CI -13.27 to -2.28; gait/balance/functional: MD -7.37, 95% CI -11.39 to -3.35; multi-domain: MD -6.97, 95% CI -10.32 to -3.62; low confidence). The evidence also suggests that mind-body training and endurance training might have a small beneficial effect on the severity of motor signs (mind-body: MD -6.57, 95% CI -10.18 to -2.81; endurance: MD -6.43, 95% CI -10.72 to -2.28; low confidence). Flexibility training might have a trivial or no effect on the severity of motor signs (MD 2.01, 95% CI -4.82 to 8.98; low confidence). The evidence is very uncertain about the effects of strength/resistance training and "Lee Silverman Voice training BIG" (LSVT BIG) on the severity of motor signs (strength/resistance: MD -6.97, 95% CI -11.93 to -2.01; LSVT BIG: MD -5.49, 95% CI -14.74 to 3.62; very low confidence). Quality of life The evidence from the NMA (55 studies; 3283 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -14.98, 95% CI -23.26 to -6.52; moderate confidence). The evidence also suggests that endurance training might have a moderate beneficial effect, and that gait/balance/functional and multi-domain training might have a small beneficial effect on QoL (endurance: MD -9.16, 95% CI -15.68 to -2.82; gait/balance/functional: MD -5.64, 95% CI -10.04 to -1.23; multi-domain: MD -5.29, 95% CI -9.34 to -1.06; low confidence). The evidence is very uncertain about the effects of mind-body training, gaming, strength/resistance training, dance, LSVT BIG, and flexibility training on QoL (mind-body: MD -8.81, 95% CI -14.62 to -3.00; gaming: MD -7.05, 95% CI -18.50 to 4.41; strength/resistance: MD -6.34, 95% CI -12.33 to -0.35; dance: MD -4.05, 95% CI -11.28 to 3.00; LSVT BIG: MD 2.29, 95% CI -16.03 to 20.44; flexibility: MD 1.23, 95% CI -11.45 to 13.92; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types. AUTHORS' CONCLUSIONS We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD.
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Affiliation(s)
- Moritz Ernst
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Lieker
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Caro-Valenzuela
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Cryns
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Resarch, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Ambulatory Assessment in Psychology, Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Feng SH, Chuang HJ, Yeh KC, Pan SL. Association of Osteoarthritis With Increased Risk of Parkinson's Disease: A Population-Based, Longitudinal Follow-Up Study. Arthritis Care Res (Hoboken) 2022; 74:1842-1848. [PMID: 34105302 DOI: 10.1002/acr.24708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/06/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate whether patients with osteoarthritis (OA) are at a higher risk of developing Parkinson's disease (PD). METHODS This retrospective cohort study was conducted using Taiwan's Longitudinal Health Insurance Database 2005. We enrolled 33,360 patients who were 50-64 years old and had OA in 2002-2005 to form the OA group. The comparison group consisted of 33,360 age- and sex-matched, randomly sampled subjects without OA. Then, their PD-free survival curves were generated using the Kaplan-Meier method. Multivariable Cox proportional hazards regression analysis was employed to estimate the effect of having OA on patients' subsequent risk of PD. RESULTS Of the 2 groups, the OA group had a significantly higher risk of developing PD (adjusted hazard ratio [HRadj ] 1.41 [95% confidence interval (95% CI) 1.16-1.70], P = 0.0003). The PD-free survival rate of the OA group was also significantly lower than that of the comparison group (P = 0.0004). The subgroup analysis showed that patients with knee or hip OA appeared to have a higher magnitude of PD risk (HRadj 1.55 [95% CI 1.14-2.11]) than patients with non-knee and non-hip OA (HRadj 1.42 [95% CI 1.06-1.89]) or with uncategorized OA (HRadj 1.32 [95% CI 1.05-1.64]). CONCLUSION Our findings suggest that OA is linked to an increased risk of developing PD.
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Affiliation(s)
- Shih-Hao Feng
- National Taiwan University Hospital Chu-Tung Branch, Hsin-Chu County, Taiwan
| | - Hung-Jui Chuang
- National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Kuo-Cheng Yeh
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shin-Liang Pan
- National Taiwan University Hospital, National Taiwan University, and National Taiwan University College of Medicine, Taipei, Taiwan
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17
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Rosenfeldt AB, Miller Koop M, Penko AL, Hastilow K, Zimmerman E, Schindler D, Alberts JL. Community-based high-intensity cycling improves disease symptoms in individuals with Parkinson's disease: A six-month pragmatic observational study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6122-e6134. [PMID: 36214623 PMCID: PMC10092122 DOI: 10.1111/hsc.14049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Participation in supervised, laboratory-based aerobic exercise protocols holds promise in slowing the progression of Parkinson's disease (PD). Gaps remain regarding exercise adherence and effectiveness of laboratory protocols translated to community-based programs. The aim of the project was to monitor exercise behaviour and evaluate its effect on disease progression over a 6 month period in people with PD participating in a community-based Pedalling for Parkinson's (PFP) cycling program. A pragmatic, observational study design was utilised to monitor exercise behaviour at five community sites. The Movement Disorders Society-Unified Parkinson's disease Rating Scale Motor III (MDS-UPDRS-III) and other motor and non-motor outcomes were gathered at enrollment and following 6 months of exercise. Attendance, heart rate, and cadence data were collected for each exercise session. On average, people with PD (N = 41) attended nearly 65% of the offered PFP classes. Average percent of age-estimated maximum heart rate was 69.3 ± 11.9%; average cadence was 74.9 ± 9.0 rpms. The MDS-UPDRS III significantly decreased over the 6-month exercise period (37.2 ± 11.7 to 33.8 ± 11.7, p = 0.001) and immediate recall significantly improved (42.3 ± 12.4 to 47.1 ± 12.7, p = 0.02). Other motor and non-motor metrics did not exhibit significant improvement. Participants who attended ~74% or more of available PFP classes experienced the greatest improvement in MDS-UPDRS III scores; of those who attended less than 74% of classes, cycling greater than or equal to 76 rpms lead to improvement. Attendance and exercise intensity data indicated that a laboratory-based exercise protocol can be successfully translated to a community setting. Consistent attendance and pedalling at a relatively high cadence may be key variables to PD symptom mitigation. Improvement in clinical ratings coupled with lack of motor and non-motor symptom progression over 6 months provides rationale for further investigation of the real-world, disease-modifying potential of aerobic exercise for people with PD.
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Affiliation(s)
- Anson B. Rosenfeldt
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Mandy Miller Koop
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Amanda L. Penko
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Karissa Hastilow
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Eric Zimmerman
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - David Schindler
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Jay L. Alberts
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
- Neurological Institute, Center for Neurological RestorationCleveland ClinicClevelandOhioUSA
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NADPH and Mitochondrial Quality Control as Targets for a Circadian-Based Fasting and Exercise Therapy for the Treatment of Parkinson's Disease. Cells 2022; 11:cells11152416. [PMID: 35954260 PMCID: PMC9367803 DOI: 10.3390/cells11152416] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 02/01/2023] Open
Abstract
Dysfunctional mitochondrial quality control (MQC) is implicated in the pathogenesis of Parkinson's disease (PD). The improper selection of mitochondria for mitophagy increases reactive oxygen species (ROS) levels and lowers ATP levels. The downstream effects include oxidative damage, failure to maintain proteostasis and ion gradients, and decreased NAD+ and NADPH levels, resulting in insufficient energy metabolism and neurotransmitter synthesis. A ketosis-based metabolic therapy that increases the levels of (R)-3-hydroxybutyrate (BHB) may reverse the dysfunctional MQC by partially replacing glucose as an energy source, by stimulating mitophagy, and by decreasing inflammation. Fasting can potentially raise cytoplasmic NADPH levels by increasing the mitochondrial export and cytoplasmic metabolism of ketone body-derived citrate that increases flux through isocitrate dehydrogenase 1 (IDH1). NADPH is an essential cofactor for nitric oxide synthase, and the nitric oxide synthesized can diffuse into the mitochondrial matrix and react with electron transport chain-synthesized superoxide to form peroxynitrite. Excessive superoxide and peroxynitrite production can cause the opening of the mitochondrial permeability transition pore (mPTP) to depolarize the mitochondria and activate PINK1-dependent mitophagy. Both fasting and exercise increase ketogenesis and increase the cellular NAD+/NADH ratio, both of which are beneficial for neuronal metabolism. In addition, both fasting and exercise engage the adaptive cellular stress response signaling pathways that protect neurons against the oxidative and proteotoxic stress implicated in PD. Here, we discuss how intermittent fasting from the evening meal through to the next-day lunch together with morning exercise, when circadian NAD+/NADH is most oxidized, circadian NADP+/NADPH is most reduced, and circadian mitophagy gene expression is high, may slow the progression of PD.
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Rosenfeldt AB, Koop MM, Penko AL, Zimmerman E, Miller DM, Alberts JL. Components of a successful community-based exercise program for individuals with Parkinson’s disease: Results from a participant survey. Complement Ther Med 2022; 70:102867. [DOI: 10.1016/j.ctim.2022.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/03/2022] Open
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20
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Szarowicz CA, Steece-Collier K, Caulfield ME. New Frontiers in Neurodegeneration and Regeneration Associated with Brain-Derived Neurotrophic Factor and the rs6265 Single Nucleotide Polymorphism. Int J Mol Sci 2022; 23:ijms23148011. [PMID: 35887357 PMCID: PMC9319713 DOI: 10.3390/ijms23148011] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022] Open
Abstract
Brain-derived neurotrophic factor is an extensively studied neurotrophin implicated in the pathology of multiple neurodegenerative and psychiatric disorders including, but not limited to, Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, traumatic brain injury, major de-pressive disorder, and schizophrenia. Here we provide a brief summary of current knowledge on the role of BDNF and the common human single nucleotide polymorphism, rs6265, in driving the pathogenesis and rehabilitation in these disorders, as well as the status of BDNF-targeted therapies. A common trend has emerged correlating low BDNF levels, either detected within the central nervous system or peripherally, to disease states, suggesting that BDNF replacement therapies may hold clinical promise. In addition, we introduce evidence for a distinct role of the BDNF pro-peptide as a biologically active ligand and the need for continuing studies on its neurological function outside of that as a molecular chaperone. Finally, we highlight the latest research describing the role of rs6265 expression in mechanisms of neurodegeneration as well as paradoxical advances in the understanding of this genetic variant in neuroregeneration. All of this is discussed in the context of personalized medicine, acknowledging there is no “one size fits all” therapy for neurodegenerative or psychiatric disorders and that continued study of the multiple BDNF isoforms and genetic variants represents an avenue for discovery ripe with therapeutic potential.
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Affiliation(s)
- Carlye A. Szarowicz
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.A.S.); (K.S.-C.)
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA
| | - Kathy Steece-Collier
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.A.S.); (K.S.-C.)
| | - Margaret E. Caulfield
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.A.S.); (K.S.-C.)
- Correspondence: ; Tel.: +1-616-234-0969; Fax: +1- 616-234-0991
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21
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KIZIL N, ÖĞÜT H, OKUYUCU E, GÜLER H, ÖZER C, TURHANOĞLU AD. Parkinson hastalarına yönelik bir rehabilitasyon programının reaksiyon ve hareket zamanı üzerine etkileri: bir elektromiyografik çalışma. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1017006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: The aim of the study was to investigate the effects of a rehabilitation program consisting of specific exercises for Parkinson's Disease (PD) patients on reaction time (RT), movement time (MT), quality of life and disease activity.
Materials and Methods: A total of 26 idiopathic PD patients were included in the study. The exercises specific to Parkinson’s were applied to the patients for 16 weeks. The evaluation of the patients were done before and after the treatment. The disease severity was measured with Unified Parkinson’s Disease Rating Scale (UPDRS), quality of life was measured with Short Form-36 (SF-36). RT and MT measurements were done electromyographically.
Results: There was no statistically significant difference in UPDRS total and sub-section values and SF-36 quality of life evaluation before and after the exercise program. While a significant decrease was observed in the RT values of the patients after the 16 week exercise program compared to prior to the program (Deltoid RT 370.46 ± 25 to 219.58 ± 17, biceps RT 370.42 ± 27 to 216.49 ± 14 and triceps RT 445.21 ± 31 to 247.53 ± 23, respectively).
Conclusion: In PD, the rehabilitation program specific to the disease leads to a significant decrease in RT. Although the exercise has no statistically significant effect on disease activity, quality of life and MT values, it was seen that it still led to improvement.
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Affiliation(s)
- Nurhan KIZIL
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | | | - Esra OKUYUCU
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | - Hayal GÜLER
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | - Cahit ÖZER
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
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22
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Bastioli G, Arnold JC, Mancini M, Mar AC, Gamallo-Lana B, Saadipour K, Chao MV, Rice ME. Voluntary Exercise Boosts Striatal Dopamine Release: Evidence for the Necessary and Sufficient Role of BDNF. J Neurosci 2022; 42:4725-4736. [PMID: 35577554 PMCID: PMC9186798 DOI: 10.1523/jneurosci.2273-21.2022] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/09/2022] [Accepted: 04/10/2022] [Indexed: 11/21/2022] Open
Abstract
Physical exercise improves motor performance in individuals with Parkinson's disease and elevates mood in those with depression. Although underlying factors have not been identified, clues arise from previous studies showing a link between cognitive benefits of exercise and increases in brain-derived neurotrophic factor (BDNF). Here, we investigated the influence of voluntary wheel-running exercise on BDNF levels in the striatum of young male wild-type (WT) mice, and on the striatal release of a key motor-system transmitter, dopamine (DA). Mice were allowed unlimited access to a freely rotating wheel (runners) or a locked wheel (controls) for 30 d. Electrically evoked DA release was quantified in ex vivo corticostriatal slices from these animals using fast-scan cyclic voltammetry. We found that exercise increased BDNF levels in dorsal striatum (dStr) and increased DA release in dStr and in nucleus accumbens core and shell. Increased DA release was independent of striatal acetylcholine (ACh), and persisted after a week of rest. We tested a role for BDNF in the influence of exercise on DA release using mice that were heterozygous for BDNF deletion (BDNF+/-). In contrast to WT mice, evoked DA release did not differ between BDNF+/- runners and controls. Complementary pharmacological studies using a tropomyosin receptor kinase B (TrkB) agonist in WT mouse slices showed that TrkB receptor activation also increased evoked DA release throughout striatum in an ACh-independent manner. Together, these data support a causal role for BDNF in exercise-enhanced striatal DA release and provide mechanistic insight into the beneficial effects of exercise in neuropsychiatric disorders, including Parkinson's, depression, and anxiety.SIGNIFICANCE STATEMENT Exercise has been shown to improve movement and cognition in humans and rodents. Here, we report that voluntary exercise for 30 d leads to an increase in evoked DA release throughout the striatum and an increase in BDNF in the dorsal (motor) striatum. The increase in DA release appears to require BDNF, indicated by the absence of DA release enhancement with running in BDNF+/- mice. Activation of BDNF receptors using a pharmacological agonist was also shown to boost DA release. Together, these data support a necessary and sufficient role for BDNF in exercise-enhanced DA release and provide mechanistic insight into the reported benefits of exercise in individuals with dopamine-linked neuropsychiatric disorders, including Parkinson's disease and depression.
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Affiliation(s)
| | - Jennifer C Arnold
- Neurosurgery, New York University Grossman School of Medicine, New York, New York 10016
| | | | - Adam C Mar
- Departments of Neuroscience and Physiology and
| | | | - Khalil Saadipour
- Skirball Institute of Biomolecular Medicine, New York University Grossman School of Medicine, New York, New York 10016
| | - Moses V Chao
- Skirball Institute of Biomolecular Medicine, New York University Grossman School of Medicine, New York, New York 10016
| | - Margaret E Rice
- Departments of Neuroscience and Physiology and
- Neurosurgery, New York University Grossman School of Medicine, New York, New York 10016
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23
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Bastos P, Meira B, Mendonça M, Barbosa R. Distinct gait dimensions are modulated by physical activity in Parkinson's disease patients. J Neural Transm (Vienna) 2022; 129:879-887. [PMID: 35426538 PMCID: PMC9011371 DOI: 10.1007/s00702-022-02501-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022]
Abstract
Parkinson’s disease (PD) is the fastest growing neurodegenerative disease, but disease-modifying or preventive treatments are lacking. Physical activity is a modifiable factor that decreases the PD risk and improves motor symptoms in PD. Understanding which dimensions of gait performance correlate with physical activity in PD can have important pathophysiological and therapeutic implications. Clinical/demographic data together with physical activity levels were collected from thirty-nine PD patients. Gait analysis was performed wearing seven inertial measurement units on the lower body, reconstructing the subjects’ lower body motion using 3D kinematic biomechanical models. Higher physical activity scores were significantly correlated with MDS-UPDRS part III scores (r = − 0.58, p value = 9.2 × 10−5), age (r = − 0.39, p value = 1.5 × 10−2) and quality-of-life (r = − 0.47, p value = 5.9 × 10−3). Physical activity was negatively associated with MDS-UPDRS part III scores after adjusting for age and disease duration (β = − 0.08530, p value = 0.0010). The effect of physical activity on quality-of-life was mediated by the MDS-UPDRS part III (62.10%, 95% CI = 0.0758–1.78, p value = 0.022). The level of physical activity was correlated primarily with spatiotemporal performance. While spatiotemporal performance displays the strongest association with physical activity, other quality-of-movement dimensions of clinical relevance (e.g., smoothness, rhythmicity) fail to do so. Interventions targeting these ought to be leveraged for performance enhancement in PD through neuroprotective and brain network connectivity strengthening. It remains to be ascertained to which extent these are amenable to modulation.
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Affiliation(s)
- Paulo Bastos
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Lisbon, Portugal
| | - Bruna Meira
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Marcelo Mendonça
- Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Raquel Barbosa
- Neurology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
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Razi O, Tartibian B, Laher I, Govindasamy K, Zamani N, Rocha-Rodrigues S, Suzuki K, Zouhal H. Multimodal Benefits of Exercise in Patients With Multiple Sclerosis and COVID-19. Front Physiol 2022; 13:783251. [PMID: 35492581 PMCID: PMC9048028 DOI: 10.3389/fphys.2022.783251] [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: 09/25/2021] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.
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Affiliation(s)
- Omid Razi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
| | - Bakhtyar Tartibian
- Department of Sports Injuries, Faculty of Physical Education and Sports Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Karuppasamy Govindasamy
- Department of Physical Education & Sports Science, SRM Institute of Science and Technology, Kattankulathur, India
| | - Nastaran Zamani
- Department of Biology, Faculty of Science, Payame-Noor University, Tehran, Iran
| | - Silvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Quinta de Prados, Edifício Ciências de Desporto, Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, i3S, Porto, Portugal
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- *Correspondence: Katsuhiko Suzuki, ; Hassane Zouhal,
| | - Hassane Zouhal
- Laboratoire Mouvement, Sport, Santé, University of Rennes, Rennes, France
- Institut International des Sciences du Sport (2I2S), Irodouer, France
- *Correspondence: Katsuhiko Suzuki, ; Hassane Zouhal,
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25
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Lin YP, Chen RS, Chen VCF, Liu CH, Chan HL, Chang YJ. Effects of Lower Limb Cycling Training on Different Components of Force and Fatigue in Individuals With Parkinson’s Disease. Front Bioeng Biotechnol 2022; 10:829772. [PMID: 35309995 PMCID: PMC8924445 DOI: 10.3389/fbioe.2022.829772] [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: 12/06/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
The strength of lower extremity is important for individuals to maintain balance and ambulation functions. The previous studies showed that individuals with Parkinson’s disease suffered from fatigue and strength loss of central origin. The purpose of this study was to investigate the effect of lower extremities’ cycling training on different components of force and fatigue in individuals with Parkinson’s disease. Twenty-four individuals (13 males, 11 females, mean age: 60.58 ± 8.21 years) diagnosed with idiopathic Parkinson’s disease were randomized into training and control groups. The maximum voluntary contraction (MVC) force, voluntary activation level (VA), and twitch force of knee extensors were measured using a custom-made system with surface electrical stimulation. The general, central, and peripheral fatigue indexes (GFI, CFI, and PFI) were calculated after a fatiguing cycling protocol. Subjects received 8 weeks of low resistance cycling training (training group) or self-stretching (control group) programs. Results showed that MVC, VA, and twitch force improved (p < 0.05) only in the training group. Compared to the baseline, central fatigue significantly improved in the training group, whereas peripheral fatigue showed no significant difference in two groups. The cycling training was beneficial for individuals with Parkinson’s disease not only in muscle strengthening but also in central fatigue alleviation. Further in-depth investigation is required to confirm the effect of training and its mechanism on central fatigue.
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Affiliation(s)
- Yen-Po Lin
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Rou-Shayn Chen
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | | | - Chun-Hsien Liu
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiao-Lung Chan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Ju Chang
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Ya-Ju Chang,
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26
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Bastos P, Barbosa R. Motor reserve: How to build neuronal resilience against ageing and neurodegeneration? Rev Neurol (Paris) 2022; 178:845-854. [DOI: 10.1016/j.neurol.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/14/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
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Becker G, Lespine LF, Bahri MA, Serrano ME, Lemaire C, Luxen A, Tirelli E, Plenevaux A. Exercise against cocaine sensitization in mice: a [18F]fallypride micro-PET study. Brain Commun 2022; 4:fcab294. [PMID: 35169698 PMCID: PMC8833578 DOI: 10.1093/braincomms/fcab294] [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: 06/02/2021] [Revised: 10/18/2021] [Accepted: 12/12/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Wheel-running exercise in laboratory rodents (animal model useful to study the neurobiology of aerobic exercise) decreases behavioural markers of vulnerability to addictive properties of various drugs of abuse including cocaine. However, neurobiological mechanisms underpinning this protective effect are far from fully characterized. Here, 28-day-old female C57BL/6J mice were housed with (n = 48) or without (n = 48) a running wheel for 6 weeks before being tested for acute locomotor responsiveness and initiation of locomotor sensitization to intraperitoneal injections of 8 mg/kg cocaine. The long-term expression of sensitization took place 3 weeks after the last session. On the day after, all mice underwent a micro-PET imaging session with [18F]fallypride radiotracer (dopamine 2/3 receptors antagonist). Exercised mice were less sensitive to acute and sensitized cocaine hyperlocomotor effects, such attenuation being particularly well marked for long-term expression of sensitization (η2P = 0.262). Chronic administration of cocaine was associated with a clear-cut increase of [18F]fallypride binding potential in mouse striatum (η2P = 0.170) while wheel-running exercise was associated with a moderate decrease in dopamine 2/3 receptors density in striatum (η2P = 0.075), a mechanism that might contribute to protective properties of exercise against drugs of abuse vulnerability.
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Affiliation(s)
- Guillaume Becker
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
| | - Louis-Ferdinand Lespine
- Department of Psychology, University of Liège, 4000 Liege, Belgium
- Pôle MOPHA, Pôle Est, Centre Hospitalier Le Vinatier, Bron, France
| | - Mohamed Ali Bahri
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
| | - Maria Elisa Serrano
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
| | - Christian Lemaire
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
| | - André Luxen
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
| | - Ezio Tirelli
- Department of Psychology, University of Liège, 4000 Liege, Belgium
| | - Alain Plenevaux
- GIGA—Cyclotron Research Center—In Vivo Imaging, University of Liège, 4000 Liege, Belgium
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Wang X, Li M, Xie J, Chen D, Geng X, Sun S, Liu B, Wang M. Beta Band Modulation by Dopamine D2 receptors in the Primary Motor Cortex and Pedunculopontine Nucleus in a Rat Model of Parkinson’s Disease. Brain Res Bull 2022; 181:121-128. [DOI: 10.1016/j.brainresbull.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 11/02/2022]
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Jarrahi B, McEwen SC, Holschneider DP, Schiehser DM, Petkus AJ, Gomez ME, Van Horn JD, Filoteo V, Jakowec MW, Petzinger GM. The Effects of Cardiorespiratory and Motor Skill Fitness on Intrinsic Functional Connectivity of Neural Networks in Individuals with Parkinson's Disease. Brain Plast 2021; 7:77-95. [PMID: 34868875 PMCID: PMC8609487 DOI: 10.3233/bpl-200115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Studies in aging older adults have shown the positive association between cognition and exercise related fitness, particularly cardiorespiratory fitness. These reports have also demonstrated the association of high cardiorespiratory fitness, as well as other types of fitness, on the reversal of age-related decline in neural network connectivity, highlighting the potential role of fitness on age- and disease-related brain changes. While the clinical benefits of exercise are well-documented in Parkinson’s disease (PD), the extent to which cardiorespiratory fitness (assessed by estimated VO2max testing) or motor skill fitness (assessed by the Physical Performance Test (PPT)) affects neural network connectivity in PD remains to be investigated. The purpose of this study was to explore the hypothesis that higher fitness level is associated with an increase in the intrinsic network connectivity of cognitive networks commonly affected in PD. Methods: In this cross-sectional resting state fMRI, we used a multivariate statistical approach based on high-dimensional independent component analysis (ICA) to investigate the association between two independent fitness metrics (estimated VO2max and PPT) and resting state network connectivity. Results: We found that increased estimated VO2max was associated with increased within network connectivity in cognitive networks known to be impaired in PD, including those sub-serving memory and executive function. There was a similar trend for high levels of PPT to be associated with increased within network connectivity in distinct resting state networks. The between functional network connectivity analysis revealed that cardiorespiratory fitness was associated with increased functional connectivity between somatosensory motor network and several cognitive networks sub-serving memory, attention, and executive function. Conclusion: This study provides important empirical data supporting the potential association between two forms of fitness and multiple resting state networks impacting PD cognition. Linking fitness to circuit specific modulation of resting state network connectivity will help establish a neural basis for the positive effects of fitness and specific exercise modalities and provide a foundation to identify underlying mechanisms to promote repair.
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Affiliation(s)
- Behnaz Jarrahi
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sarah C McEwen
- Pacific Brain Health Center, Pacific Neuroscience Institute, Santa Monica, CA, USA.,Department of Translational Neurosciences and Neurotherapeutics, Providence Saint John's Cancer Institute, Santa Monica, CA, USA
| | - Daniel P Holschneider
- Department of Neurology, University of Southern California, Los Angeles, CA, USA.,Department of Psychiatry and the Behavioral Sciences, University of Southern California, San Pablo St., Los Angeles, CA, USA
| | - Dawn M Schiehser
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Andrew J Petkus
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Megan E Gomez
- Department of Psychology, Tibor Rubin Veterans Administration Medical Center, Long Beach, CA, USA
| | - Jack D Van Horn
- Department of Psychology and School of Data Science, University of Virginia, Charlottesville, VA, USA
| | - Vincent Filoteo
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, USA.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Michael W Jakowec
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Giselle M Petzinger
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
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Ferreira AFF, Binda KH, Real CC. The effects of treadmill exercise in animal models of Parkinson's disease: A systematic review. Neurosci Biobehav Rev 2021; 131:1056-1075. [PMID: 34688727 DOI: 10.1016/j.neubiorev.2021.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/04/2021] [Accepted: 10/18/2021] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD) is a progressive disabling brain disorder. Physical exercise has been shown to alleviate the symptoms of PD and, consequently, improve patient quality of life. Exercise mechanisms involved in beneficial effects on PD have been widely investigated. This study aims to systematically review the literature on the use of treadmill exercise in PD animal models. The study was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Searches were conducted in MEDLINE, EMBASE, and ISI databases. In total, 78 studies were included. The dopaminergic system, behavior, neuroplasticity, neuroinflammation, mitochondria, and musculoskeletal systems were some of the outcomes evaluated by the selected studies. Based on the systematic review center for laboratory animal experimentation (SYRCLE) RoB tool, the methodologies revealed a high risk of bias and lack of information about study design, which needs attention for data reproducibility. This review can guide future studies that aim to fill existing gaps regarding the effects of treadmill exercise in PD animal models.
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Affiliation(s)
- Ana Flávia F Ferreira
- Laboratory of Cellular Neurobiology, Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Karina Henrique Binda
- Laboratory of Functional Neuroanatomy of Pain, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil; Translational Neuropsychiatry Unit (TNU), Aarhus University, Aarhus, Denmark
| | - Caroline Cristiano Real
- Translational Neuropsychiatry Unit (TNU), Aarhus University, Aarhus, Denmark; Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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31
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Rezaee Z, Marandi SM, Esfarjani F. Age-related biochemical dysfunction in 6-OHDA model rats subject to induced- endurance exercise. Arch Gerontol Geriatr 2021; 98:104554. [PMID: 34688079 DOI: 10.1016/j.archger.2021.104554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 01/30/2023]
Abstract
Exercise can alleviate the disorders considered as the normal consequences of aging. Whether or not the treadmill endurance training affects the biochemical markers in the Parkinson's disease model rats after the 6-hydroxydopamine (6-OHDA) injection is assessed in this article. The experimental groups of N=8 rats consist of 1) Saline and Young sedentary (S-Young); 2) Saline and Old sedentary (S-Old); 3) Young and 6-OHDA without exercise (Y); 4) Young and 6-OHDA with exercise (YE); 5) Old and 6-OHDA without exercise (O); and 6) Old and 6-OHDA with exercise (OE). An 8 μg of 6-OHDA is injected into the right MFB. The rotation due to apomorphine, weight variation, and some biochemical expression are measured in the rats' striatum. Exposure to 6-OHDA: increase weight loss by (%8) and rotation by (%90), reduce the protein levels of Bdnf by (30%), Th by (43%), and Tfam by (24%), in aging rats (P<0.05). The P53 level rose after the injection compared with the same Saline group (Old rats: 27% and Young rats: 14%), the highest in the O group. The findings indicate that endurance exercise amends the mitochondrial parameters and the apomorphine-induced rotation impairments in the presence of 6-OHDA injection. These positive effects of treadmill running in unilateral 6-OHDA lesioned rat model are age-dependent and are more significant in younger rats.
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Affiliation(s)
- Zeinab Rezaee
- Exercise Physiology, Department of Physical Education and Sport Science, University of Isfahan, Isfahan, Iran.
| | - Sayed Mohammad Marandi
- Exercise Physiology, Department of Physical Education and Sport Science, University of Isfahan, Isfahan, Iran.
| | - Fahimeh Esfarjani
- Exercise Physiology, Department of Physical Education and Sport Science, University of Isfahan, Isfahan, Iran.
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32
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Ishikuro K, Hattori N, Imanishi R, Furuya K, Nakata T, Dougu N, Yamamoto M, Konishi H, Nukui T, Hayashi T, Anada R, Matsuda N, Hirosawa H, Tanaka R, Shibata T, Mori K, Noguchi K, Kuroda S, Nakatsuji Y, Nishijo H. A Parkinson's disease patient displaying increased neuromelanin-sensitive areas in the substantia nigra after rehabilitation with tDCS: a case report. Neurocase 2021; 27:407-414. [PMID: 34503372 DOI: 10.1080/13554794.2021.1975768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous studies have reported that transcranial direct current stimulation (tDCS) of the frontal polar area (FPA) ameliorated motor disability in patients with Parkinson's disease (PD). Here we report changes in neuromelanin (NM) imaging of dopaminergic neurons before and after rehabilitation combined with anodal tDCS over the FPA for 2 weeks in a PD patient. After the intervention, the patient showed clinically meaningful improvements while the NM-sensitive area in the SN increased by 18.8%. This case study is the first report of NM imaging of the SN in a PD patient who received tDCS.Abbreviations FPA: front polar area; PD: Parkinson's disease; NM: neuromelanin; DCI: DOPA decarboxylase inhibitor; STEF: simple test for evaluating hand function; TUG: timed up and go test; TMT: trail-making test; SN: substantia nigra; NM-MRI: neuromelanin magnetic resonance imaging; MCID: the minimal clinically important difference; SNpc: substantia nigra pars compacta; VTA: ventral tegmental area; LC: locus coeruleus; PFC: prefrontal cortex; M1: primary motor cortex; MDS: Movement Disorder Society; MIBG: 123I-metaiodobenzylguanidine; SBR: specific binding ratio; SPECT: single-photon emission computed tomography; DAT: dopamine transporter; NIBS: noninvasive brain stimulation; tDCS: transcranial direct current stimulation; MAOB: monoamine oxidase B; DCI: decarboxylase inhibitor; repetitive transcranial magnetic stimulation: rTMS; diffusion tensor imaging: DTI; arterial spin labeling: ASL.
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Affiliation(s)
- Koji Ishikuro
- Department of Rehabilitation, Toyama University Hospital, Toyama, Japan
| | - Noriaki Hattori
- Department of Rehabilitation, Toyama University Hospital, Toyama, Japan
| | - Rieko Imanishi
- Department of Rehabilitation, Toyama University Hospital, Toyama, Japan
| | - Kohta Furuya
- Department of Rehabilitation, Toyama University Hospital, Toyama, Japan
| | - Takeshi Nakata
- Department of Rehabilitation, Toyama University Hospital, Toyama, Japan
| | - Nobuhiro Dougu
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Mamoru Yamamoto
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hirofumi Konishi
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Takamasa Nukui
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tomohiro Hayashi
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Ryoko Anada
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Noriyuki Matsuda
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hiroaki Hirosawa
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Ryo Tanaka
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Takashi Shibata
- Department of Neurosurgery, Faculty of Medicine, Toyama, Japan
| | - Koichi Mori
- Department of Radiology, Faculty of Medicine, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, Faculty of Medicine, Toyama, Japan
| | - Satoshi Kuroda
- Department of Neurosurgery, Faculty of Medicine, Toyama, Japan
| | - Yuji Nakatsuji
- Department of Neurology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hisao Nishijo
- System Emotional Science, Faculty of Medicine, University of Toyama, Toyama, Japan
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33
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Scheffer DDL, Freitas FC, Aguiar AS, Ward C, Guglielmo LGA, Prediger RD, Cronin SJF, Walz R, Andrews NA, Latini A. Impaired dopamine metabolism is linked to fatigability in mice and fatigue in Parkinson's disease patients. Brain Commun 2021; 3:fcab116. [PMID: 34423297 PMCID: PMC8374980 DOI: 10.1093/braincomms/fcab116] [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: 11/30/2020] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 11/21/2022] Open
Abstract
Fatigue is a common symptom of Parkinson’s disease that compromises significantly the patients’ quality of life. Despite that, fatigue has been under-recognized as symptom, its pathophysiology remains poorly understood, and there is no adequate treatment so far. Parkinson’s disease is characterized by the progressive loss of midbrain dopaminergic neurons, eliciting the classical motor symptoms including slowing of movements, muscular rigidity and resting tremor. The dopamine synthesis is mediated by the rate-limiting enzyme tyrosine hydroxylase, which requires tetrahydrobiopterin as a mandatory cofactor. Here, we showed that reserpine administration (1 mg/kg, two intraperitoneal injections with an interval of 48 h) in adult Swiss male mice (8–10 weeks; 35–45 g) provoked striatal depletion of dopamine and tetrahydrobiopterin, and intolerance to exercise. The poor exercise performance of reserpinized mice was not influenced by emotional or anhedonic factors, mechanical nociceptive thresholds, electrocardiogram pattern alterations or muscle-impaired bioenergetics. The administration of levodopa (100 mg/kg; i.p.) plus benserazide (50 mg/kg; i.p.) rescued reserpine-induced fatigability-like symptoms and restored striatal dopamine and tetrahydrobiopterin levels. Remarkably, it was observed, for the first time, that impaired blood dopamine metabolism inversely and idependently correlated with fatigue scores in eighteen idiopathic Parkinson’s disease patients (male n = 13; female n = 5; age 61.3 ± 9.59 years). Altogether, this study provides new experimental and clinical evidence that fatigue symptoms might be caused by the impaired striatal dopaminergic neurotransmission, pointing to a central origin of fatigue in Parkinson’s disease.
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Affiliation(s)
- Débora da Luz Scheffer
- LABOX, Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Fernando Cini Freitas
- Graduate Program in Medical Sciences, University Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil.,Neurology Division, Hospital Governador Celso Ramos, Florianópolis, SC 88015-270, Brazil
| | - Aderbal Silva Aguiar
- LABOX, Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Catherine Ward
- Kirby Neurobiology Center, Boston Children's Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | | | - Rui Daniel Prediger
- Departamento de Farmacologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Shane J F Cronin
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences, A-1090 Vienna, Austria
| | - Roger Walz
- Graduate Program in Medical Sciences, University Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil.,Center for Applied Neuroscience, University Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil.,Neurology Division, Departament of Internal Medicine, University Hospital, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Nick A Andrews
- Kirby Neurobiology Center, Boston Children's Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA.,The Salk in Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Alexandra Latini
- LABOX, Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil.,Kirby Neurobiology Center, Boston Children's Hospital and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
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34
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McLaurin KA, Harris M, Madormo V, Harrod SB, Mactutus CF, Booze RM. HIV-Associated Apathy/Depression and Neurocognitive Impairments Reflect Persistent Dopamine Deficits. Cells 2021; 10:2158. [PMID: 34440928 PMCID: PMC8392364 DOI: 10.3390/cells10082158] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 12/12/2022] Open
Abstract
Individuals living with human immunodeficiency virus type 1 (HIV-1) are often plagued by debilitating neurocognitive impairments and affective alterations;the pathophysiology underlying these deficits likely includes dopaminergic system dysfunction. The present review utilized four interrelated aims to critically examine the evidence for dopaminergic alterations following HIV-1 viral protein exposure. First, basal dopamine (DA) values are dependent upon both brain region andexperimental approach (i.e., high-performance liquid chromatography, microdialysis or fast-scan cyclic voltammetry). Second, neurochemical measurements overwhelmingly support decreased DA concentrations following chronic HIV-1 viral protein exposure. Neurocognitive impairments, including alterations in pre-attentive processes and attention, as well as apathetic behaviors, provide an additional line of evidence for dopaminergic deficits in HIV-1. Third, to date, there is no compelling evidence that combination antiretroviral therapy (cART), the primary treatment regimen for HIV-1 seropositive individuals, has any direct pharmacological action on the dopaminergic system. Fourth, the infection of microglia by HIV-1 viral proteins may mechanistically underlie the dopamine deficit observed following chronic HIV-1 viral protein exposure. An inclusive and critical evaluation of the literature, therefore, supports the fundamental conclusion that long-term HIV-1 viral protein exposure leads to a decreased dopaminergic state, which continues to persist despite the advent of cART. Thus, effective treatment of HIV-1-associated apathy/depression and neurocognitive impairments must focus on strategies for rectifying decreases in dopamine function.
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Affiliation(s)
| | | | | | | | | | - Rosemarie M. Booze
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA; (K.A.M.); (M.H.); (V.M.); (S.B.H.); (C.F.M.)
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35
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Zhang R, Manza P, Tomasi D, Kim SW, Shokri-Kojori E, Demiral SB, Kroll DS, Feldman DE, McPherson KL, Biesecker CL, Wang GJ, Volkow ND. Dopamine D1 and D2 receptors are distinctly associated with rest-activity rhythms and drug reward. J Clin Invest 2021; 131:e149722. [PMID: 34264865 DOI: 10.1172/jci149722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Certain components of rest-activity rhythms such as greater eveningness (delayed phase), physical inactivity (blunted amplitude) and shift work (irregularity) are associated with increased risk for drug use. Dopaminergic (DA) signaling has been hypothesized to mediate the associations, though clinical evidence is lacking. METHODS We examined associations between rhythm components and striatal D1 (D1R) and D2/3 receptor (D2/3R) availability in 32 healthy adults (12 female, age: 42.40±12.22) and its relationship to drug reward. Rest-activity rhythms were assessed by one-week actigraphy combined with self-reports. [11C]NNC112 and [11C]raclopride Positron Emission Tomography (PET) scans were conducted to measure D1R and D2/3R availability, respectively. Additionally, self-reported drug-rewarding effects of 60 mg oral methylphenidate were assessed. RESULTS We found that delayed rhythm was associated with higher D1R availability in caudate, which was not attributable to sleep loss or 'social jet lag', whereas physical inactivity was associated with higher D2/3R availability in nucleus accumbens (NAc). Delayed rest-activity rhythm, higher caudate D1R and NAc D2/3R availability were associated with greater sensitivity to the rewarding effects of methylphenidate. CONCLUSION These findings reveal specific components of rest-activity rhythms associated with striatal D1R, D2/3R availability and drug-rewarding effects. Personalized interventions that target rest-activity rhythms may help prevent and treat substance use disorders. TRIAL REGISTRATION ClinicalTrials.gov: NCT03190954FUNDING. This work was accomplished with support from the National Institute on Alcohol Abuse and Alcoholism (ZIAAA000550).
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Affiliation(s)
- Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Sung Won Kim
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Ehsan Shokri-Kojori
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Sukru B Demiral
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Danielle S Kroll
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Dana E Feldman
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Katherine L McPherson
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Catherine L Biesecker
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, United States of America
| | - Nora D Volkow
- National Institute on Drug Abuse, NIH, Bethesda, United States of America
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36
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Ozdurak Singin RH, Duz S, Kiraz M. Cortical and Subcortical Brain Volume Alterations Following Endurance Running at 38.6 km and 119.2 km in Male Athletes. Med Sci Monit 2021; 27:e926060. [PMID: 34155188 PMCID: PMC8234558 DOI: 10.12659/msm.926060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Although several studies have shown that ultramarathon running causes severe physical and mental stress and harms organ systems, its effect on brain tissue remains unclear. The purpose of this study was to investigate the volumetric change of cortical and subcortical brain structures following 38.6-km and 119.8-km mountain races. MATERIAL AND METHODS A total of 23 healthy male runners (age, 49.05±5.99 years) were classified as short-trail (ST; n=9) and ultra-trail (UT; n=14) endurance running. Pre- and post-test scanning of brain tissue was performed by using a 3-Tesla magnetic resonance imaging (MRI). Pre- and post-race differences in cortical and subcortical volumes in the ST and UT groups were separately determined by Wilcoxon signed-rank test. RESULTS Cortical gray matter (GM) and cerebral GM volume significantly increased after the race in both ST and UT groups, whereas the volume of the thalamus, caudate, pallidus, and hippocampus significantly increased only in the UT group. Cerebrospinal fluid (CSF) and white-matter (WM) volumes did not change after endurance running and remained unaltered in both groups. CONCLUSIONS Endurance running has a site-specific acute effect on cortical and subcortical structures and may attenuate GM volume decrease in older adult male athletes. The increased volume of subcortical structures might be a response of physical exercise and additional physical stress experienced by ultramarathon runners.
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Affiliation(s)
| | - Serkan Duz
- Faculty of Sport Sciences, Inonu University, Malatya, Turkey
| | - Murat Kiraz
- Department of Neurosurgery, Faculty of Medicine, Hitit University, Çorum, Turkey
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37
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Binda KH, Lillethorup TP, Real CC, Bærentzen SL, Nielsen MN, Orlowski D, Brooks DJ, Chacur M, Landau AM. Exercise protects synaptic density in a rat model of Parkinson's disease. Exp Neurol 2021; 342:113741. [PMID: 33965411 DOI: 10.1016/j.expneurol.2021.113741] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/04/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by Lewy body and neurite pathology associated with dopamine terminal dysfunction. Clinically, it is associated with motor slowing, rigidity, and tremor. Postural instability and pain are also features. Physical exercise benefits PD patients - possibly by promoting neuroplasticity including synaptic regeneration. OBJECTIVES In a parkinsonian rat model, we test the hypotheses that exercise: (a) increases synaptic density and reduces neuroinflammation and (b) lowers the nociceptive threshold by increasing μ-opioid receptor expression. METHODS Brain autoradiography was performed on rats unilaterally injected with either 6-hydroxydopamine (6-OHDA) or saline and subjected to treadmill exercise over 5 weeks. [3H]UCB-J was used to measure synaptic vesicle glycoprotein 2A (SV2A) density. Dopamine D2/3 receptor and μ-opioid receptor availability were assessed with [3H]Raclopride and [3H]DAMGO, respectively, while neuroinflammation was detected with the 18kDA translocator protein (TSPO) marker [3H]PK11195. The nociceptive threshold was determined prior to and throughout the exercise protocol. RESULTS We confirmed a dopaminegic deficit with increased striatal [3H]Raclopride D2/3 receptor availability and reduced nigral tyrosine hydroxylase immunoreactivity in the ipsilateral hemisphere of all 6-OHDA-injected rats. Sedentary rats lesioned with 6-OHDA showed significant reduction of ipsilateral striatal and substantia nigra [3H]UCB-J binding while [3H]PK11195 showed increased ipsilateral striatal neuroinflammation. Lesioned rats who exercised had higher levels of ipsilateral striatal [3H]UCB-J binding and lower levels of neuroinflammation compared to sedentary lesioned rats. Striatal 6-OHDA injections reduced thalamic μ-opioid receptor availability but subsequent exercise restored binding. Exercise also raised thalamic and hippocampal SV2A synaptic density in 6-OHDA lesioned rats, accompanied by a rise in nociceptive threshold. CONCLUSION These data suggest that treadmill exercise protects nigral and striatal synaptic integrity in a rat lesion model of PD - possibly by promoting compensatory mechanisms. Exercise was also associated with reduced neuroinflammation post lesioning and altered opioid transmission resulting in an increased nociceptive threshold.
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Affiliation(s)
- K H Binda
- Translational Neuropsychiatry Unit, Aarhus University, Universitetsbyen 13, Building 2b, Aarhus C 8000, Denmark; Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark; Laboratory of Functional Neuroanatomy of Pain, Departamento de Anatomia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - T P Lillethorup
- Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark.
| | - C C Real
- Translational Neuropsychiatry Unit, Aarhus University, Universitetsbyen 13, Building 2b, Aarhus C 8000, Denmark; Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark; Laboratory of Nuclear Medicine (LIM 43), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - S L Bærentzen
- Translational Neuropsychiatry Unit, Aarhus University, Universitetsbyen 13, Building 2b, Aarhus C 8000, Denmark; Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark.
| | - M N Nielsen
- Translational Neuropsychiatry Unit, Aarhus University, Universitetsbyen 13, Building 2b, Aarhus C 8000, Denmark.
| | - D Orlowski
- Center for Experimental Neuroscience (CENSE), Department of Clinical Medicine, Aarhus University and Department of Neurosurgery, Aarhus University Hospital, Aarhus N, 8200, Denmark.
| | - D J Brooks
- Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark; Institute for Translational and Clinical Research, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - M Chacur
- Laboratory of Functional Neuroanatomy of Pain, Departamento de Anatomia, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - A M Landau
- Translational Neuropsychiatry Unit, Aarhus University, Universitetsbyen 13, Building 2b, Aarhus C 8000, Denmark; Department of Nuclear Medicine and PET, Aarhus University and Hospital, Palle Juul-Jensens Boulevard 165, J109, Aarhus N 8200, Denmark.
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Toval A, Garrigos D, Kutsenko Y, Popović M, Do-Couto BR, Morales-Delgado N, Tseng KY, Ferran JL. Dopaminergic Modulation of Forced Running Performance in Adolescent Rats: Role of Striatal D1 and Extra-striatal D2 Dopamine Receptors. Mol Neurobiol 2021; 58:1782-1791. [PMID: 33394335 PMCID: PMC7932989 DOI: 10.1007/s12035-020-02252-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/04/2020] [Indexed: 12/24/2022]
Abstract
Improving exercise capacity during adolescence impacts positively on cognitive and motor functions. However, the neural mechanisms contributing to enhance physical performance during this sensitive period remain poorly understood. Such knowledge could help to optimize exercise programs and promote a healthy physical and cognitive development in youth athletes. The central dopamine system is of great interest because of its role in regulating motor behavior through the activation of D1 and D2 receptors. Thus, the aim of the present study is to determine whether D1 or D2 receptor signaling contributes to modulate the exercise capacity during adolescence and if this modulation takes place through the striatum. To test this, we used a rodent model of forced running wheel that we implemented recently to assess the exercise capacity. Briefly, rats were exposed to an 8-day period of habituation in the running wheel before assessing their locomotor performance in response to an incremental exercise test, in which the speed was gradually increased until exhaustion. We found that systemic administration of D1-like (SCH23390) and/or D2-like (raclopride) receptor antagonists prior to the incremental test reduced the duration of forced running in a dose-dependent manner. Similarly, locomotor activity in the open field was decreased by the dopamine antagonists. Interestingly, this was not the case following intrastriatal infusion of an effective dose of SCH23390, which decreased motor performance during the incremental test without disrupting the behavioral response in the open field. Surprisingly, intrastriatal delivery of raclopride failed to impact the duration of forced running. Altogether, these results indicate that the level of locomotor response to incremental loads of forced running in adolescent rats is dopamine dependent and mechanistically linked to the activation of striatal D1 and extra-striatal D2 receptors.
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Affiliation(s)
- Angel Toval
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Daniel Garrigos
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Yevheniy Kutsenko
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Miroljub Popović
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Bruno Ribeiro Do-Couto
- Department of Human Anatomy and Psychobiology, Faculty of Psychology, University of Murcia, Murcia, Spain
| | - Nicanor Morales-Delgado
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
- Department of Histology and Anatomy, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
| | - Kuei Y Tseng
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - José Luis Ferran
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain.
- Institute of Biomedical Research of Murcia - IMIB, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
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39
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Physical interventions for people with Parkinson's disease: a systematic review and network meta-analysis. Hippokratia 2021. [DOI: 10.1002/14651858.cd013856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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40
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High intensity aerobic exercise improves information processing and motor performance in individuals with Parkinson's disease. Exp Brain Res 2021; 239:777-786. [PMID: 33394100 DOI: 10.1007/s00221-020-06009-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Parkinson's disease (PD) adversely affects information processing and motor performance. The impact of aerobic exercise on modifying the deleterious effects of PD underlying information and motor control processes is not well established. The primary aim of this project was to determine the effects of an 8-week high intensity exercise intervention on information processing and movement execution in individuals with PD. A secondary aim sought to understand the effects of antiparkinsonian medication relative to exercise on motor control processes. Data were collected at baseline (on- and off-medication) and upon completion of the exercise intervention (off-medication). Information processing and motor execution were evaluated via simple and choice reaction time paradigms (SRT and CRT) performed on a mobile device. Neither exercise nor medication impacted information processing or movement execution under the SRT paradigm. However, under CRT, exercise improved movement execution and information processing: total time was significantly reduced from 814 to 747 ms (p < 0.001), reaction time improved from 543 to 502 ms (p < 0.001), movement time improved from 270 to 246 ms (p = 0.01), and movement velocity improved from 28 cm/sec to 30 cm/sec (p = 0.01). Improvements in total time and reaction time in the CRT paradigm persisted 4 and 8 weeks following exercise cessation. Antiparkinsonian medication improved motor execution, but not information processing. The improvement in information processing following aerobic exercise, but not levodopa administration, suggests high intensity exercise may be enhancing neural processing and non-motor pathways outside those impacted by medication. The persistence of symptom improvement despite exercise intervention cessation indicates exercise is a candidate for disease modification. Trial registration: The trial was first registered at ClinicalTrials.gov on 7/10/2012 under registration number NCT01636297.
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Zeigelboim BS, José MR, Severiano MIR, Santos GJBD, Teive HAG, Liberalesso PBN, Marques JM, Rosa MRD, Santos RS, Malisky JS. The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life. Int Arch Otorhinolaryngol 2021; 25:e64-e70. [PMID: 33542753 PMCID: PMC7850887 DOI: 10.1055/s-0040-1702973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/26/2019] [Indexed: 10/29/2022] Open
Abstract
Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result ( p = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale ( p = 0.011; 95% CI -0.85; -0.17) first and ( p = 0.002, 95% CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment ( p = 0.011, 95% CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk ( p = 0.034, 95% CI -12.5; -0.3) and ski slalom games ( p = 0.005, 95% CI -34.8; -6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.
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Affiliation(s)
| | - Maria Renata José
- Department of Otoneurology, Universidade Tuiuti do Paraná (UTP), Curitiba, PR, Brazil
| | | | | | | | | | - Jair Mendes Marques
- Department of Otoneurology, Universidade Tuiuti do Paraná (UTP), Curitiba, PR, Brazil
| | | | - Rosane Sampaio Santos
- Department of Otoneurology, Universidade Tuiuti do Paraná (UTP), Curitiba, PR, Brazil
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Yang P, Knight WC, Li H, Guo Y, Perlmutter JS, Benzinger TLS, Morris JC, Xu J. Dopamine D1 + D3 receptor density may correlate with parkinson disease clinical features. Ann Clin Transl Neurol 2020; 8:224-237. [PMID: 33348472 PMCID: PMC7818081 DOI: 10.1002/acn3.51274] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/11/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
Objective Dopamine D2‐like receptors – mainly dopamine D2 receptors (D2R) and dopamine D3 receptors (D3R) – are believed to be greatly involved in the pathology of Parkinson disease (PD) progression. However, these receptors have not been precisely examined in PD patients. Our aim was to quantitatively calculate the exact densities of dopamine D1 receptors (D1R), D2R, and D3R in control, Alzheimer disease (AD), and Lewy body disease (LBD) patients (including PD, Dementia with Lewy bodies, and Parkinson disease dementia); and analyze the relationship between dopamine receptors and clinical PD manifestations. Methods We analyzed the densities of D1R, D2R, and D3R in the striatum and substantia nigra (SN) using a novel quantitative autoradiography procedure previously developed by our group. We also examined the expression of D2R and D3R mRNA in the striatum by in situ hybridization. Results The results showed that although no differences of striatal D1R were found among all groups; D2R was significantly decreased in the striatum of PD patients when compared with control and AD patients. Some clinical manifestations: age of onset, PD stage, dopamine responsiveness, and survival time after onset; showed a better correlation with striatal D1R + D3R densities combined compared to D1R or D3R alone. Interpretation There is a possibility that we may infer the results in diagnosis, treatment, and prognosis of PD by detecting D1R + D3R as opposed to using dopamine D1 or D3 receptors alone. This is especially true for elderly patients with low D2R expression as is common in this disease.
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Affiliation(s)
- Pengfei Yang
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - William C Knight
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Huifangjie Li
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Yingqiu Guo
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Joel S Perlmutter
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.,Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.,Department of Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.,Department of Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
| | - Jinbin Xu
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
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43
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McMahon J, Chazot P. Dance and Parkinson's: Biological perspective and rationale. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Paul Chazot
- Department of Biosciences Durham University Durham UK
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44
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Policastro G, Brunelli M, Tinazzi M, Chiamulera C, Emerich DF, Paolone G. Cytokine-, Neurotrophin-, and Motor Rehabilitation-Induced Plasticity in Parkinson's Disease. Neural Plast 2020; 2020:8814028. [PMID: 33293946 PMCID: PMC7714573 DOI: 10.1155/2020/8814028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/06/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
Neuroinflammation and cytokine-dependent neurotoxicity appear to be major contributors to the neuropathology in Parkinson's disease (PD). While pharmacological advancements have been a mainstay in the treatment of PD for decades, it is becoming increasingly clear that nonpharmacological approaches including traditional and nontraditional forms of exercise and physical rehabilitation can be critical adjunctive or even primary treatment avenues. Here, we provide an overview of preclinical and clinical research detailing the biological role of proinflammatory molecules in PD and how motor rehabilitation can be used to therapeutically modulate neuroinflammation, restore neural plasticity, and improve motor function in PD.
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Affiliation(s)
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Michele Tinazzi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | | | - Giovanna Paolone
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
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45
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Zhang L, Yuan Y, Wu W, Sun Z, Lei L, Fan J, Gao B, Zou J. Medium-Intensity Treadmill Exercise Exerts Beneficial Effects on Bone Modeling Through Bone Marrow Mesenchymal Stromal Cells. Front Cell Dev Biol 2020; 8:600639. [PMID: 33330492 PMCID: PMC7732523 DOI: 10.3389/fcell.2020.600639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/28/2020] [Indexed: 01/04/2023] Open
Abstract
As a type of multipotential cells, bone marrow mesenchymal stromal cells (BMMSCs) can differentiate into chondrocytes, osteoblasts, and adipocytes under different loading condition or specific microenvironment. Previous studies have shown that BMMSCs and their lineage-differentiated progeny (for example, osteoblasts), and osteocytes are mechanosensitive in bone. The appropriate physical activity and exercise could help attenuate bone loss, effectively stimulate bone formation, increase bone mineral density (BMD), prevent the progression of osteoporosis, and reduce the risk of bone fractures. Bone morphogenetic protein (BMP) is originally discovered as a protein with heterotopic bone-inducing activity in the bone matrix that exerts a critical role in multiple stages of bone metabolism. In the present study, the medium-intensity treadmill exercise enhanced bone formation and increased osteocalcin (OCN) and osteopontin (OPN) mRNA expression as well as activation of the BMP-Smad signaling pathway in vivo. In order to investigate the effect of a BMP-Smad signaling pathway, we injected mice with activated enzyme inhibitors (LDN-193189HCL) and subjected the mice to treadmill exercise intervention. LDN-193189HCL attenuated the BMD and bone mass mediated by medium-intensity exercise and BMP-Smad signaling pathway.
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Affiliation(s)
- Lingli Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yu Yuan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Wei Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhongguang Sun
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Le Lei
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jing Fan
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Bo Gao
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jun Zou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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46
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Taghipour M, Sabahi P, Pooriamehr A, Miladi-Gorji H. Swimming exercise during morphine abstinence in parents-to-be attenuated morphine-induced conditioned place preference and locomotor sensitization only in male rat offspring. Neurosci Lett 2020; 740:135433. [PMID: 33075421 DOI: 10.1016/j.neulet.2020.135433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
This study was designed to examine the effects of swimming exercise during morphine abstinence in parents-to-be before mating on morphine-induced conditioned place preference (CPP) and locomotor sensitization in the pubertal male and female rat offspring. Male and female Wistar rats were injected with bi-daily doses (10 mg/kg, 12 h intervals) of morphine for 14 days. The exercising rats exposed to a regular swimming exercise (45 min/d, five days per a week) during 30 days of morphine abstinence before mating. Then, the pubertal male and female rat offspring were tested for morphine-induced CPP and locomotor sensitization (using the open field). The results showed that the pubertal male offspring of the morphine-abstinent parents-to-be exhibited an increase in CPP to morphine and locomotor activity after morphine challenge than the offspring from the control group. While, swimming exercise in morphine-abstinent parents-to-be decreased CPP score and locomotor activity in the pubertal male offspring than control offspring. Thus, exposure to swimming exercise in morphine-abstinent parents-to-be before mating may exert a protective effect against morphine-induced reward and locomotor sensitization in their pubertal offspring which may prevent the vulnerability of the first generation to drug abuse following opiate-addicted parents before mating.
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Affiliation(s)
- Mona Taghipour
- Faculty of Psychology and Educational Sciences, University of Semnan, Semnan, Iran
| | - Parviz Sabahi
- Faculty of Psychology and Educational Sciences, University of Semnan, Semnan, Iran
| | - Alireza Pooriamehr
- Faculty of Psychology and Educational Sciences, University of Semnan, Semnan, Iran
| | - Hossein Miladi-Gorji
- Laboratory of Animal Addiction Models, Research Center of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran; Department of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
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47
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Schootemeijer S, van der Kolk NM, Bloem BR, de Vries NM. Current Perspectives on Aerobic Exercise in People with Parkinson's Disease. Neurotherapeutics 2020; 17:1418-1433. [PMID: 32808252 PMCID: PMC7851311 DOI: 10.1007/s13311-020-00904-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body's large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VO2max), motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson's disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VO2max) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life.
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Affiliation(s)
- Sabine Schootemeijer
- Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, Netherlands
| | - Nicolien M van der Kolk
- Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, Netherlands
| | - Bastiaan R Bloem
- Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, Netherlands.
| | - Nienke M de Vries
- Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, Netherlands
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48
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Alberts JL, Rosenfeldt AB. The Universal Prescription for Parkinson's Disease: Exercise. JOURNAL OF PARKINSONS DISEASE 2020; 10:S21-S27. [PMID: 32925109 PMCID: PMC7592674 DOI: 10.3233/jpd-202100] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Over the past two decades, aerobic exercise has emerged as a mainstream recommendation to aid in treating Parkinson's disease (PD). Despite the acknowledgement of the benefits of exercise for people with PD (PwPD), frequently, exercise recommendations lack specificity in terms of frequency, intensity and duration. Additionally, conflating physical activity with exercise has contributed to providing vague exercise recommendations to PwPD. Therefore, the beneficial effects of exercise may not be fully realized in PwPD. Data provided by animal studies and select human trials indicate aerobic exercise may facilitate structural and functional changes in the brain. Recently, several large human clinical trials have been completed and collectively support the use of aerobic exercise, specifically high-intensity aerobic exercise, in improving PD motor symptoms. Data from these and other studies provide the basis to include aerobic exercise as an integral component in treating PD. Based on positive clinical findings and trials, it is advised that PwPD perform aerobic exercise in the following dose: 3x/week, 30-40-minute main exercise set, 60-80% of heart rate reserve or 70-85% of heart rate max. In lieu of heart rate, individuals can achieve an intensity of 14-17 on a 20-point RPE scale. Ongoing clinical trials, SPARX3 and CYCLE-II, have potential to further develop patient-specific exercise recommendations through prognostic modeling.
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Affiliation(s)
- Jay L Alberts
- Cleveland Clinic, Department of Biomedical Engineering, Cleveland, OH, USA.,Cleveland Clinic, Center for Neurological Restoration, Cleveland, OH, USA
| | - Anson B Rosenfeldt
- Cleveland Clinic, Department of Biomedical Engineering, Cleveland, OH, USA
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49
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Chung SJ, Lee JJ, Lee PH, Sohn YH. Emerging Concepts of Motor Reserve in Parkinson's Disease. J Mov Disord 2020; 13:171-184. [PMID: 32854486 PMCID: PMC7502292 DOI: 10.14802/jmd.20029] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/05/2020] [Indexed: 01/18/2023] Open
Abstract
The concept of cognitive reserve (CR) in Alzheimer's disease (AD) explains the differences between individuals in their susceptibility to AD-related pathologies. An enhanced CR may lead to less cognitive deficits despite severe pathological lesions. Parkinson's disease (PD) is also a common neurodegenerative disease and is mainly characterized by motor dysfunction related to striatal dopaminergic depletion. The degree of motor deficits in PD is closely correlated to the degree of dopamine depletion; however, significant individual variations still exist. Therefore, we hypothesized that the presence of motor reserve (MR) in PD explains the individual differences in motor deficits despite similar levels of striatal dopamine depletion. Since 2015, we have performed a series of studies investigating MR in de novo patients with PD using the data of initial clinical presentation and dopamine transporter PET scan. In this review, we summarized the results of these published studies. In particular, some premorbid experiences (i.e., physical activity and education) and modifiable factors (i.e., body mass index and white matter hyperintensity on brain image studies) could modulate an individual's capacity to tolerate PD pathology, which can be maintained throughout disease progression.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Jae Jung Lee
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
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50
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Schirinzi T, Canevelli M, Suppa A, Bologna M, Marsili L. The continuum between neurodegeneration, brain plasticity, and movement: a critical appraisal. Rev Neurosci 2020; 31:723-742. [DOI: 10.1515/revneuro-2020-0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/08/2020] [Indexed: 01/09/2023]
Abstract
Abstract
While the “physiological” aging process is associated with declines in motor and cognitive features, these changes do not significantly impair functions and activities of daily living. Differently, motor and cognitive impairment constitute the most common phenotypic expressions of neurodegeneration. Both manifestations frequently coexist in the same disease, thus making difficult to detect “pure” motor or cognitive conditions. Movement disorders are often characterized by cognitive disturbances, and neurodegenerative dementias often exhibit the occurrence of movement disorders. Such a phenotypic overlap suggests approaching these conditions by highlighting the commonalities of entities traditionally considered distinct. In the present review, we critically reappraised the common clinical and pathophysiological aspects of neurodegeneration in both animal models and patients, looking at motricity as a trait d’union over the spectrum of neurodegeneration and focusing on synaptopathy and oscillopathy as the common pathogenic background. Finally, we discussed the possible role of movement as neuroprotective intervention in neurodegenerative conditions, regardless of the etiology. The identification of commonalities is critical to drive future research and develop novel possible disease-modifying interventions.
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Affiliation(s)
- Tommaso Schirinzi
- Department of Systems Medicine , University of Rome Tor Vergata , Rome , Italy
| | - Marco Canevelli
- Department of Human Neurosciences , Sapienza University of Rome , Rome , Italy
- National Center for Disease Prevention and Health Promotion, National Institute of Health , Rome , Italy
| | - Antonio Suppa
- Department of Human Neurosciences , Sapienza University of Rome , Rome , Italy
- IRCCS Neuromed , Pozzilli , IS , Italy
| | - Matteo Bologna
- Department of Human Neurosciences , Sapienza University of Rome , Rome , Italy
- IRCCS Neuromed , Pozzilli , IS , Italy
| | - Luca Marsili
- Department of Neurology, Gardner Family Center for Parkinson’s Disease and Movement Disorders , University of Cincinnati , 260 Stetson Street , Cincinnati , 45219, OH , USA
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