ECSS Paris 2023: OP-MH16
INTRODUCTION: Demyelinating syndromes (DS) are chronic, relapsing, autoimmune conditions characterised by inflammation and damage to the nerves in the brain and central nervous system). Although DS disorders such as Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder (NMOSD) are prevalent in the adult population, paediatric onset is rarer and much less studied. These lifelong conditions have severe implications for quality of life, impacting on school performance and social activities, as well as physical, emotional and psychological well-being. Two particularly concerning aspects of these conditions are that they are often accompanied by drastic weight changes and alterations to body composition. METHODS: 16 young people with DS took part in semi-structured interviews, conducted virtually and audio recorded. Questions related to how the condition has impacted their lifestyle, diet, and physical activity levels. Inductive thematic analysis was employed for data analysis. Rigour and credibility were established through detailed immersion and prolonged engagement of the data, multivocality, member reflections, reflexivity and inter-researcher debriefing. RESULTS: Six overarching themes were identified: 1) the influence of the diagnosis on the young person, 2) the implication of the treatment, access to services and effects of steroids, 3) the ways in which the young person mediated the effects of their condition through changes to their diet, physical activity/lifestyle and vice versa, 4) the impact of sleep quality on fatigue levels, 5) a change of identity associated with living with a debilitating lifelong condition, and 6) the influence of family. CONCLUSION: Diagnosis and treatment produced a multitude of intersecting effects on the young people interviewed. Patients fell into three distinct groups, namely some who were very active prior to diagnosis and were highly motivated to strive for activity maintenance post diagnosis. Some patients were not physically active either pre or post diagnosis and struggled to manage their disease course. A third group were moderately active before diagnosis, and then struggled to maintain activity levels or weight after. Some patients in the latter two groups underwent an epiphany leading to a dramatic change in their lifestyle and physical activity levels. The data suggested a range of both facilitators and barriers to being physically active with associated behavioural or emotional responses to the diagnosis, treatment and effects of the conditions. Some of these included the effects of family on diet and lifestyle, peer support, motivational disposition, fatigue, stress, fear of physical activity, alienation from their own bodies, fear of exercise exacerbating symptoms, or access to relevant resources or sources of information. Those who maintained or improved their physical activity levels, were able to manage their disease course more adroitly, taking ownership of their condition, with an improvement in well-being.
Read CV Alexandra ConsterdineECSS Paris 2023: OP-MH16
INTRODUCTION: Parkinson’s disease (PD), the second most common neurodegenerative disease, is characterized by an irreversible loss of dopaminergic neurons in the substantia nigra pars compacta of the basal ganglia, which affects the nervous system, causing motor disturbances (bradykinesia, resting tremor, rigidity, postural instability and gait impairment) [1,2]. Despite it is not clear how alterations in central or peripheral nervous systems controlling skeletal muscle can influence muscle function, PD patients show mitochondrial impairments at skeletal muscle level which can be counteracted by exercise, reducing symptoms and improving patients’ quality of life [1,3,4]. The aim of the study was to highlight the beneficial effects of physical activity training on exercise tolerance and skeletal muscle oxidative capacity in PD patients. METHODS: Eleven trained (PD-TR, age: 58±6 years, disease duration: 8.3±6.4 years) and six sedentary (PD-SED, age: 65±10 years, disease duration: 3.7±2.0 years) PD patients were recruited. The level of physical activity was rated by means of IPAQ-Short. Each subject performed an incremental exercise test on a cycle ergometer up to exhaustion to determine Wpeak and V’O2peak. Vastus lateralis (VL) fractional O2 extraction (DHHbMb), non-invasively evaluated by near-infrared spectroscopy (NIRS), was recorded and expressed as % of a reference value obtained during a transient ischaemia of lower limb [5]. Muscle oxidative capacity (mVO2) of VL was estimated by NIRS from recovery rate constant (k) of TSI changes during brief intermittent arterial occlusions [6]. RESULTS: Wpeak and V’O2peak were higher in PD-TR (232±52 W and 40.1±4.8 ml*kg-1*min-1, respectively) compared to PD-SED (146±36 W and 21.0±1.7 ml*kg-1*min-1, respectively; p<0.01). DHHbMb was higher in PD-TR (68.2±17.1 %) compared to PD-SED (32.4±13.5 %; p<0.01). k was higher in PD-TR (2.52±0.82 min-1) compared to PD-SED (1.39±0.51 min-1, p<0.01). A correlation was found between DHHbMb and k (r=0.77; p<0.001). CONCLUSION: The present findings confirm regular physical activity training improves exercise tolerance in PD patients, mainly through an improved muscle oxidative metabolism. AKNOWLEDGEMENT: This work was supported by the Italian Ministry of Health "Ricerca Corrente 2022-2024" granted to IRCCS Mondino Foundation. REFERENCES [1] Harris et al, J Physiol, 2022 [2] Saiki et al, Sci Rep, 2017 [3] Cardellach et al, Neurology, 1993 [4] Burtscher et al, Int J Mol Sci, 2021 [5] Grassi et al, Med Sci Sports Exerc, 2019 [6] Adami et al, J Appl Physiol, 2018
Read CV Marianna NeriECSS Paris 2023: OP-MH16
INTRODUCTION: Neuropsychological impairments, such as cognitive decline, mild cognitive impairment or dementia, are common in PwP and can impact their daily activities and quality of life. Pharmacological procedures have limited effects to treat those, and research suggests that non-pharmacological interventions, such as exercise or cognitive training, could have the potential to improve cognition. Considering the efficacy of exercise to also promote physical and cognitive improvements, the implementation of the combined modalities could be more beneficial than single-domain training. Aim: to investigate BDNF and pro-BDNF kinetics in PwP during different acute exercise interventions and their relationship with measures of cognitive function, with the overall aim to evaluate if there are added beneficial outcomes from combining physical and cognitive tasks compared to engaging with aerobic exercise only. METHODS: 6 participants (age 61 ± 12 years; Hoehn and Yahr (H&Y) scale I to II) participated in 4 supervised conditions: a session of acute cycling (A), a second acute cycling session 24 h. after A (B), combined acute session of cycling and cognitive tasks (C) and a resting condition (D). In A, B and C participants completed 30 min of cycling at RPE 14 on a cycle ergometer. Outcome measures included blood and saliva biomarkers (BDNF and pro-BDNF) and measures of cognition (the Stroop test and the Free-Recall test). RESULTS: Visits B (second) and C (combined) were able to elicit larger improvements in the Stroop test with large (d=0.853) and small to medium (d=0.349) effects, respectively, and up to 30 and 40% improvements, respectively, in immediate long-term memory (LTM) compared to the resting control visit D. Serum and capillary BDNF levels were positively correlated with cognitive performance, whilst platelet-poor plasma BDNF correlations seemed to be headed in the opposite direction. CONCLUSION: Due to the small sample size of this preliminary study, there was poor sensitivity to detect effects in cognition even though medium to large effect sizes were observed for some comparisons. Therefore, it is not yet fully known to what extent cycling combined with cognitively challenging tasks, compared to cycling alone, improves cognitive function and modulates biomarkers of neuroplasticity in PwP.
Read CV Anna Ferrusola PastranaECSS Paris 2023: OP-MH16