ECSS Paris 2023: OP-MH28
INTRODUCTION: Mitochondrial dysfunction and oxidative stress are associated with Parkinson disease (PD) and are intrinsic factors related to its pathogenesis. Physical activity (PA) enhances cognitive function in older adults, reduces motor deficits, promotes neuron formation, and slows age-related neuronal loss. Herein we compare the effects of two different PA programs in PD patients analyzing relevant clinical aspects and its impact on mitochondrial function. METHODS: Patients with early-stage PD (stage H&Y II; n=24) were randomized into 3 groups of 8 patients. The effects of two different PA programs were compared. The first group performed basic physical training (BPT) based on strength and resistance; a second group performed BPT combined with functional exercises (BPTFE) to stimulate the specific sensorimotor pathways that are most affected in PD (proprioception-balance-coordination) together with dual task training; a third group served as control. Subjects performed 3 sessions per week for 16 weeks. Motor function, quality of life, sleep quality, cognitive aspects, humor and overall satisfaction (CSQ-8) were evaluated. Skin fibroblasts were collected for mitochondrial analysis to explore their potential as biomarkers for PD progression. RESULTS: The CSQ-8 results demonstrated high levels of satisfaction, with mean scores ranging from 3.4 to 4.0 indicating overall positive feedback. The application of BPT and BPTFE programs significantly improved Sit-to-stand (STS) and Timed Up and Go (TUG) test performance (p < 0.001). Specifically, significant improvements were observed in the STS (p = 0.001), with both BPT and BPTFE groups demonstrating superior performance compared to the Controls (p < 0.003). Similarly, the TUG test showed significant improvements (p = 0.0042) in both intervention groups compared to the Controls (p = 0.0039 and p = 0.0028, respectively). However, no statistically significant differences were observed in quality of life (PDQ-39, p = 0.810) or depressive symptoms (BDI, p = 0.577) across the groups. Despite the lack of statistical significance, a small to moderate reduction of discomfort was noted in the BPTFE group compared to controls for both quality of life (MD = -7.71, r_rb = -0.339) and depressive symptoms (MD = -6.57, r_rb = -0.429). Mitochondrial analyses are currently ongoing and will provide further insights into their role in PD. CONCLUSION: These findings confirm that both BPT and BPTFE interventions effectively enhance physical function in PD patients. While clinical outcomes related to mood and quality of life did not reach statistical significance, the observed trends suggest potential benefits, warranting further investigation. These results highlight the importance of incorporating targeted PA programs into PD management.
Read CV Joel MontaneECSS Paris 2023: OP-MH28
INTRODUCTION: Parkinsons disease (PD) is the second most prevalent neurodegenerative disorder, affecting approximately 1% of individuals over 60 years [1]. Current clinical assessment tools, such as the Hoehn-Yahr Scale and the Unified Parkinsons Disease Rating Scale (UPDRS) are non-quantitative, and this could potentially lead to diagnostic errors [2]. This study investigates the potential of ultrasound Nakagami imaging to quantitatively evaluate muscle characteristics in PD patients, as previously proposed for patients with Duchene Muscle Dystrophy [3]. The aim was to determine whether Nakagami imaging can effectively reflect disease severity and thus provide a reliable, quantitative tool for monitoring disease progression. METHODS: The study included 17 PD patients (7M/10F) and 15 healthy controls (7M/8F). Based on UPDRS Part III assessment and Hoehn-Yahr (H-Y) scale scores, PD patients were divided into an early-stage group (H-Y ≤ 2, n = 7) and a late-stage group (H-Y > 2, n = 10). The International Physical Activity Questionnaire (IPAQ) was utilized to assess physical activity levels in all participants. B-mode and Radiofrequency (RF) data were collected from the tibialis anterior (TA) and the gastrocnemius medialis (GM) on the most and the less affected limb by means of an ultrasound apparatus (ArtUs EXT-1H, Telemed UAB). B-mode data were used to investigate muscle geometrical characteristics and RF data to compute the Nakagami parameters. RESULTS: The three groups were matched for age (69-77 years), stature (1.64-1.68 m), body mass (68-73 kg) and IPAQ scores (2231-3210). A 2-way ANOVA (group x limb) indicate no differences between limbs in all the investigated parameters; thus, only the differences between groups are reported. Significant differences in the Nagakami parameters were observed between controls and late-stage patients in GM (p<0.001) and in both the superficial (p<0.01) and deep (p<0.05) compartments of TA. Significant differences were also observed between early-stage and late-stage patients but in GM only (p<0.001). No statistical differences were found between controls and early-stage patients and no differences in muscle geometry were found among groups. Finally, a significant correlation was observed between the GM Nakagami parameter obtained from the most affected side and the Hoehn-Yahr scale (R=0.619, p=0.01). CONCLUSION: Ultrasound Nakagami imaging is a promising quantitative tool for evaluating muscle characteristics in PD patients. The Nakagami parameter can distinguish the severity of the disease, providing a quantitative means to monitor the progression of Parkinson’s disease. Further research is needed to validate these findings on a larger sample of patients and to explore the clinical applicability of this technique. [1] Ascherio et Schwarzschild, The Lancet. Neurology (2016) [2] Rizzo et al., Neurology (2016) [3] Weng et al., Scientific Reports (2017)
Read CV Baptiste BizetECSS Paris 2023: OP-MH28
INTRODUCTION: Parkinson’s disease (PD) is a neurodegenerative disorder that affects neuromuscular control, reducing mobility and quality of life. These deficits arise, in part, from altered motor unit (MU) recruitment and discharge modulation. PD patients exhibit poorer force steadiness and greater MU firing variability than healthy individuals. Additionally, PD symptoms are often asymmetric. Dual tasking, which combines motor and cognitive demands, further challenges neuromuscular control, yet its effects on MU firing behaviour remain unclear. This study examined how dual tasking affects force steadiness and MU behaviour in PD patients compared to healthy controls. METHODS: Fifteen PD patients (6 females, age: 63.8 ± 6.2 years, UPDRS III: 14.7 ± 6.8) and fifteen healthy participants (7 females, age: 63.7 ± 7.2 years) performed a 32-second force-tracking trapezoidal knee extension task at 30% of maximal voluntary contraction (MVC) on an isometric knee dynamometer. The tasks included a) a single visuomotor condition with trapezoidal force tracking, and b) a dual-task condition requiring concurrent serial subtraction by three from a randomly selected number. High-density surface electromyography (HDsEMG) was recorded from the vastus lateralis using 32-electrode arrays, and MU firings were extracted. Outcome measures included force steadiness (coefficient of variation, CV), tracking error rates, mean MU discharge rate (DR), recruitment threshold (RT), and derecruitment threshold (DT). Data were analysed using linear mixed-effects models in R. RESULTS: Results showed that PD exhibited greater CV during the dual task than controls (p = 0.03), indicating increased force variability under cognitive load. Tracking errors were also higher in PD across both tasks (p = 0.01), suggesting impaired force regulation. PD showed an increase (p = 0.01) in DR from 8.96 pps (single-task) to 9.35 pps (dual-task), while controls showed no change. When controlling for task condition, DR was significantly lower in the single-task condition (8.73 pps) than the dual-task condition (9.22 pps, p = 0.03), but no differences were found in controls or in the unaffected limb of PD patients. Recruitment thresholds were lower in PD (17.2% MVC) than controls (18.3% MVC), though the difference was not significant. CONCLUSION: These findings suggest that dual tasking influence force control in PD, increasing MU discharge rates and neuromuscular demands. The results align with previous research, confirming that PD exhibit irregular MU firing patterns and lower recruitment thresholds. Combining force steadiness measures with HDsEMG analysis appears promising for detecting early-stage motor dysfunction in PD. Future studies should explore neuromodulatory and inhibitory mechanisms and assess the potential of this methodology for tracking PD progression and optimizing rehabilitation strategies. Nishikawa et al., Eur J Neurosci, 53(6), 2021. Supported by the H2020 Horizon TwinBrain project (Grant No. 952401)
Read CV Miloš KalcECSS Paris 2023: OP-MH28