Abstract
Background: People with Parkinson's disease (PD) experience not only motor problems but also non-motor problems that seriously impede their daily functioning and quality of life. The current pharmacologic treatment of PD is symptomatic, and alternative rehabilitation treatments, which preferably also have a disease-modifying effect and promote neuroplasticity, are needed. Recent studies suggest that high-intensity interval training (HIIT) is promising for promoting neuroplasticity in human PD, with short training time and reduced burden. Biomarkers for neuroplasticity such as brain-derived neurotrophic factor (BDNF) and neurodegeneration (including neurofilament NfL and α-synuclein) may play a role, but their response to HIIT is not well-investigated. Objectives: The aims of this study were (1) to study the effects of 4 weeks of HIIT compared with 4 weeks of continuous aerobic exercise on motor and non-motor outcomes of PD and (2) to investigate the association between HIIT, motor/non-motor performances changes, and blood biomarker levels for neuroplasticity and neurodegeneration. Study Design: Single-subject research design with alternating treatment setup (ABACA) and frequent repeated measurements was used. Each participant received different intervention conditions (B/C) interspersed with baseline periods (A, i.e., ABACA or ACABA), and frequent repeated assessment of outcome measures is done to quantify within-subject, individual response patterns with sufficient power for data analysis. Blood samples were collected once a week in the baseline and training phases (A1 and B/C) and once every 2 weeks in the washout phases (A2 and A3). Intervention: Four subjects with PD on stable dopaminergic medication, two in Hoehn–Yahr stage 1–2, and two in Hoehn–Yahr stage 2.5–3 followed an ABACA or ACABA schedule, consisting of blocks with 30-min sessions of “B” (HIIT) or 50-min sessions of “C” [continuous aerobic exercise (CAE)] 3×/week for 4 weeks, separated by baseline “A” periods of 8 weeks for a total duration of 28 weeks. Outcome Measures: Outcome measures include disease status [Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)], blood biomarkers (BDNF, Nfl, and α-synuclein), measures for functional mobility (including an activity tracker), and activities of daily living, as well as cognition, mood, biorhythm (sleeping problems), and quality of life. Data Analysis: Visual analysis of trends in level, slope, and variability in response patterns was carried out, confirmed by longitudinal regression analysis with phase (ABACA) as the independent variable.
Original language | English |
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Article number | 569880 |
Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | Frontiers in Neurology |
Volume | 11 |
Issue number | October |
Early online date | 22 Oct 2020 |
DOIs | |
Publication status | Published - Oct 2020 |
Externally published | Yes |
Bibliographical note
Copyright © 2020 van Wegen, Hirsch, van de Berg, Vriend, Rietberg, Newman, Vanbellingen and van den Heuvel.Funding
This work was funded by a research grant from the Parkinson Vereniging Netherlands (2019-R05), The Dutch Brain Foundation (DR-2019-00311) and a planning grant from Amsterdam Movement Sciences (2018) awarded to EW. We thank Ruud Overes and Sara Riggare for their input as a patient expert. Funding. This work was funded by a research grant from the Parkinson Vereniging Netherlands (2019-R05), The Dutch Brain Foundation (DR-2019-00311) and a planning grant from Amsterdam Movement Sciences (2018) awarded to EW.
Funders | Funder number |
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Dutch Brain Foundation | DR-2019-00311 |
Parkinson Vereniging Netherlands | |
Parkinson Vereniging | 2019-R05 |
Keywords
- BDNF
- high intensity (strenuous) exercise
- neuroplastic changes
- NFL
- Parkinson's disease
- synuclein alpha