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Dance and exercise – a study and a publications review

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Not much new here – more evidence that dance exercises and physical exercise in general, is beneficial for people with PD.

Shall We Dance – master’s thesis  by Brittni Lynn McAlister, University of North Colorado

 In the words of one participant, the dance classes have been “. . . completely life-changing.”

Systematic review of exercises for Parkinson’s

This review revealed that people with Parkinson’s disease viewed physical activity as an enjoyable and positive experience, which aided with control of their symptoms and enhanced their wellbeing and quality of life.

 

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Almost let these references get away

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Some recent articles about music and dance – thought I had already published this – it appears not. Either that, or I’m more cognitively impaired than I thought I was. If this keeps up, I’ll have normal intelligence:

Dopamine, Oxytocin, Serotonin, and Endorphins 

Acronym is DOSE, and it’s a short article talking about how dance is good for you because it releases several different hormones and neurotransmitters – and not just because it makes you feel good – but because it does….😎

Language of music and psychophysical foundations  

from the abstract: “Application of music in rehabilitation medicine requires an understanding of the mechanisms of music perception. This article discusses differences in character of the basic melodic elements and addresses some of the specifics of tonal space. Colloquially, music is called the language of emotion. Bearing in mind that high-level cognitive functioning in humans is inseparable from affective consciousness, investigating the mechanisms of emotional processing belongs to an important area of cognitive sciences. Studying music perception can help to advance methods of music therapy and to elucidate major aspects of human consciousness.” (emphasis added)(Article is on ReseaechGate; membership(.

Drumming program to improve social interactions

Although the article is about subjects with autism spectrum disorder (ASD), I think that the results are likely to be replicable with or generalizable to Parkinson’s Disease folks.

” results suggest that the children with ASD significantly improved in the domains of enjoyment and fun, and showed a positive trend for developing improved social relationships with peers and camp counselor partners.”

 

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Dance/movement, quality of life, and social skills, oh my!

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First, an abstract:

Use of Dance/Movement therapy for autism spectrum

“… future research must demonstrate greater scientific rigor in documenting the efficacy of DMT treatment interventions. It also found that imitation (mirroring) interventions helped individuals with ASD improve their social skills.” (Bold added) (This article was one of those reviews of published articles. The abstract does include a list of references, many of which are available online).

Next, an open access article on multidisciplinary approach:
(This sounds like another article recently posted. Would investigate, but having Parkinson’s means there’s never enough time to do everything you want to do).

Enhanced Quality of Life

Objectives: To compare the effects of inpatient enhanced multidisciplinary care (EMC) and multidisciplinary rehabilitation (MR)
on the symptoms and quality of life (QOL) of patients with Parkinson disease (PD) and to clarify the relation between reduction in
symptoms and the improved QOL. Methods: This study was a quasi-randomized controlled (alternate allocation), assessor blinded, single-center study. We recruited 80 patients with idiopathic Parkinson disease, Hoehn and Yahr stage 2 to 4, on stable
medication. Patients were included in an EMC or MR group. Both rehabilitation programs were performed for 8 weeks (17 h/wk).
Main outcome measures were Parkinson’s Disease Questionnaire-39 and Unified Parkinson’s Disease Rating Scale. Results: The
EMC induced significant improvements in QOL compared to MR. We found that body axis symptoms (rising from a chair,
posture, postural stability, falling, and walking) as well as nonmotor symptoms (depression) in patients with PD were relieved by
the inpatient EMC. Conclusions: Enhanced multidisciplinary care for patients with PD appears to be effective in improving the
QOL. The improvement in motor and nonmotor symptoms, including depression, may contribute to the improved QOL.

Finally, another open access article that might be of interest to those using technology: analysis of respiration to evaluate movement.

The role of respiration audio in multimodal analysis of movement qualities

A little out in left field, but who knows?

That’s all for today, folks. Read and ponder.

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Teamwork helps

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An open access article:

Multi-disciplinary approach for rehab to improve QOL

From the abstract:

Results:Patients reported higher functional status (d=0.37,p<0.001), general self-efficacy(d=0.28,p<0.01), and quality of life (d=0.32,p<0.001) at three weeks follow-up, comparedto their baseline scores. The regression analysis showed that having a better initial functionalstatus (β=−0.26,p<0.05) and lower quality of life (β=0.51,p<0.001) were associated withmore improvements in quality of life.
Conclusion:The study suggests that actual functioning in persons with Parkinson’s diseaseis a better predictor of improved quality of life than self-efficacy beliefs and that those whohave lower levels of initial quality of life benefit more from rehabilitation.

The program was only three weeks long, but was inpatient and apparently intensive:

The multidisciplinary rehabilitation program had a duration of three weeks and was an inpatient program. Upon arrival, participants were awarded a primary contact to ensure a unified team working toward goals set by the participant him/herself. The multidisciplinary team consisted of 10 different professions, such as occupational therapists, physical therapists, doctors, neurologists, nurses, sports educators, cognitive behavioral therapists, and nutritionists. Commencing the multidisciplinary rehabilitation program, participants were assessed by the relevant professional/s and typically had close follow-up the first week with individual and group-based exercise

 

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New approach – direct brain infusions to regrow dopaminergic neural cells

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This approach might help, but apparently it will take about 18 months to get results in moderately advanced cases. (emphasis added to abstract below).

One wonders whether complementary therapeutic treatments (exercise, dance (movement + rhythm), singing, or music instrument training were being used by any of the participants, or whether this was the only treatment these subjects were using during this time. Certainly worth trying this in combination with other, non-invasive treatments (says the cyborg with electrodes stimulating the subthalamus nigra substantia).

Journal of Parkinson’s Disease research pre-press

Abstract.
Background: Intraputamenal glial cell line-derived neurotrophic factor (GDNF), administered every 4 weeks to patients with moderately advanced Parkinson’s disease, did not show significant clinical improvements against placebo at 40 weeks,
although it significantly increased [18F]DOPA uptake throughout the entire putamen.
Objective: This open-label extension study explored the effects of continued (prior GDNF patients) or new (prior placebo patients) exposure to GDNF for another 40 weeks.
Methods: Using the infusion protocol of the parent study, all patients received GDNF without disclosing prior treatment allocations (GDNF or placebo). The primary outcome was the percentage change from baseline to Week 80 in the OFF state
Unified Parkinson’s Disease Rating Scale (UPDRS) motor score.
Results: All 41 parent study participants were enrolled. The primary outcome decreased by 26.7 ± 20.7% in patients on GDNF for 80 weeks (GDNF/GDNF; N = 21) and 27.6 ± 23.6% in patients on placebo for 40 weeks followed by GDNF for 40 weeks
(placebo/GDNF, N = 20; least squares mean difference: 0.4%, 95% CI: –13.9, 14.6, p = 0.96). Secondary endpoints did not show significant differences between the groups at Week 80 either. Prespecified comparisons between GDNF/GDNF at Week 80 and placebo/GDNF at Week 40 showed significant differences for mean OFF state UPDRS motor (–9.6 ± 6.7 vs. –3.8 ± 4.2 points, p = 0.0108) and activities of daily living score (–6.9 ± 5.5 vs. –1.0 ± 3.7 points, p = 0.0003). No treatment-emergent safety concerns were identified.

Conclusions: The aggregate study results, from the parent and open-label extension suggest that future testing with GDNF will likely require an 80- rather than a 40-week randomized treatment period and/or a higher dose.

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Might mitophagy be enlisted in the fight against Parkinson’s?

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Mitochondrial dysfunction and Parkinson’s

During aging, the process of mitophagy, a system that allows the removal of dysfunctional mitochondria through lysosomal degradation, starts to malfunction. Because of this defect, damaged mitochondria are not removed correctly, and their decomposing components accumulate inside the cells. Dysfunctional mitochondria that are not removed by mitophagy produce high amounts of reactive oxygen species (ROS) and, thus, cause oxidative stress. Oxidative stress, in turn, is very harmful for the cells, neuronal cells, in particular. Consequently, the process of mitophagy plays a crucial role in mitochondria-related disease. Mitochondrial dysfunctions and oxidative stress are well-established factors contributing to Parkinson’s disease (PD), one of the most common neurodegenerative disorders. In this review, we report various known antioxidants for PD treatments and describe the stimulation of mitophagy process as a novel and exciting method for reducing oxidative stress in PD patients. We describe the different mechanisms responsible for mitochondria removal through the mitophagy process. In addition, we review the functional connection between mitophagy induction and reduction of oxidative stress in several in vitro models of PD and also agents (drugs and natural compounds) already known to be antioxidants and to be able to activate mitophagy. Finally, we propose that there is an urgent need to test the use of mitophagy-inducing antioxidants in order to fight PD.

 

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Music on the brain

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Rhythmic Auditory Stimulation (RAS) and Argentinean Tango

Results: Results showed significant improvements in the Tinetti scale total (mean±SD of post-pre change: 5.3±2.8, p<0.01), gait (2.5±1.2 p<0.01), and balance scores (2.8±2.0 p<0.01). TUG also improved by 3.6±0.8 seg (p<0.01). Statistically non-significant changes were recorded in mobility, bodily discomfort, stigma, social support and cognition PDQ-39 domains, with Cohen’s d sizes of 0.5-0.6 and NNTs of 5-7.

Conclusion: RAS could be combined with Argentinean Tango. Positive effects on gait and balance were observed, together with a trend towards improvement in some quality of life domains. A randomized, blinded, controlled trial in a larger number of patients followed-up during a longer period is underway.

And this:Brief review of music and cognition

Given that the participants were not musicians, it can be inferred that the results of the research can be applied in other non-musical contexts, what we call “generalization” in cognitive rehabilitation, which means, non-musical gains can be transferred to daily activities. In this perspective Billhiartz et. al. (2000) argue that there is a link between musical instruction and development in non-musical skills.

… we agree that music is an important element in human life that can be used in many contexts. The musical activity is multisensorial, simultaneously integrating several systems, mainly the sensorimotor, cognitive, and affective, within a specific context, which consecrates in the sphere of embodied musical cognition.

An interview with Tom Moore

This is just a darn interesting interview with a musician and musicologist. You can’t make this stuff up.

 

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back to square one

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Basic clinical features do not predict dopamine transporterbinding in idiopathic REM behavior disorder 

REM sleep behavior disorder (RBD) is strongly associated with development of Parkinson’s Disease and otherα-synuclein-relateddisorders. Dopamine transporter (DAT) binding deficit predicts conversion toα-synuclein-related disorders in individuals with RBD.In turn, identifying which individuals with RBD have the highest likelihood of having abnormal DAT binding would be useful. Theobjective of this analysis was to examine if there are basic clinical predictors of DAT deficit in RBD. Participants referred for inclusionin the RBD cohort of the Parkinson Progression Markers Initiative were included. Assessments at the screening visit including DATSPECT imaging, physical examination, cognitive function screen, and questionnaire-based non-motor assessment. The group withDAT binding deficit (n=49) was compared to those without (n=26). There were no significant differences in demographic orclinical features between the two groups. When recruiting RBD cohorts enriched for high risk of neurodegenerative disorders, ourdata support the need for objective biomarker assessments.npj Parkinson’s Disease (2019) 5:2 ; https://doi.org/10.1038/s41531-018-0073-

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Exergame based therapy and other stuff

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Rehab through exer-games

Conclusion:Recent evidence indicates exergame-based therapy has been widely proven to be feasible, safe, and atleast as effective as traditional PD rehabilitation. Further insight into new sensors, best practices and different cognitivestadiums of PD (such as PD with Mild Cognitive Impairment), as well as task specificity, are required. Also, studieslinking game parameters and results with traditional assessment methods, such as UPDRS scores, are required.

Study protocol re: PD movement interventions

The goal of this study is to begin to address this
challenge by piloting a novel, hypothesis-driven, non-
pharmacological intervention to improve motor function
and diminish motor fatigue in PD. This novel approach is
based on the use of hypothesis-driven cognitive task inter-
ventions to stimulate the motor system and ameliorate
motor symptoms

Palmomental reflex is an important clinical marker of REM sleep behavior disorder in patients with Parkinson’s disease Yadav R, Mahale R, Pal PK – Ann Mov Disord

 

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Autism and Parkinson’s, and data-driven subtyping of PD

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Found this reference to a study involving autistic children.
Since Parkinson’s is a movement disorder, it stands to reason that music would be beneficial to both groups as a therapy (and it is).
http://irj.uswr.ac.ir/article-1-889-en.pdf
“Highlights
● A growing body of evidence suggests that motor impairments are frequently present in children with autism.
● Music therapy along with physical activity might benefit children with autism.
● We observed a significant difference between the experimental and control group after applying music therapy along with play therapy.
Plain Language Summary: Children with autism show motor impairments. Music therapy along with physical activity is a significant treatment in improving motor coordination. In this study, 30 children with autism were participated in 15 music therapy sessions. Music therapy are presented in two methods: (a) inactive one; listening to music and (b) active one; playing and rhythmic movements. Based on the results, motor coordination was achieved in the posttest.”
 
Directly related to Parkinson’s is this research paper on data-driven subtyping of PD:
“466 patients with idiopathic PD were investigated and three subtypes were identified. Subtype I (Mild Baseline, Moderate Motor Progression) is comprised of 43.1% of the participants, with average age 58.79 ± 9.53 years, and was characterized by moderate functional decay in motor ability but stable cognitive ability. Subtype II (Moderate Baseline, Mild Progression) is comprised of 22.9% of the participants, with average age 61.93 ± 6.56 years, and was characterized by mild functional decay in both motor and non-motor symptoms. Subtype III (Severe Baseline, Rapid Progression) is comprised 33.9% of the patients, with average age 65.32 ± 8.86 years, and was characterized by rapid progression of both motor and non-motor symptoms. These subtypes suggest that when comprehensive clinical and biomarker data are incorporated into a deep learning algorithm, the disease progression rates do not necessarily associate with baseline severities, and the progression rate of non-motor symptoms is not necessarily correlated with the progression rate of motor symptoms.”
 
In other words, everybody’s Parkinson’s journey is unique.