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Jiang Y, Qi Z, Zhu H, Shen K, Liu R, Fang C, Lou W, Jiang Y, Yuan W, Cao X, Chen L, Zhuang Q. Role of the globus pallidus in motor and non-motor symptoms of Parkinson's disease. Neural Regen Res 2025; 20:1628-1643. [PMID: 38845220 PMCID: PMC11688550 DOI: 10.4103/nrr.nrr-d-23-01660] [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: 10/06/2023] [Revised: 01/12/2024] [Accepted: 04/21/2024] [Indexed: 08/07/2024] Open
Abstract
The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore, bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico-striato-pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease, particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremor-dominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia-thalamus network. Therefore, the composition of the globus pallidus neurons, the neurotransmitters that act on them, their electrical activity, and the neural circuits they form can guide the search for new multi-target drugs to treat Parkinson's disease in clinical practice. Examining the potential intra-nuclear and neural circuit mechanisms of deep brain stimulation associated with the globus pallidus can facilitate the management of both motor and non-motor symptoms while minimizing the side effects caused by deep brain stimulation.
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Affiliation(s)
- Yimiao Jiang
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Zengxin Qi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institute of Brain Science, Fudan University, Shanghai, China
| | - Huixian Zhu
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Kangli Shen
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Ruiqi Liu
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Chenxin Fang
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Weiwei Lou
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Yifan Jiang
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Wangrui Yuan
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Xin Cao
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
| | - Liang Chen
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institute of Brain Science, Fudan University, Shanghai, China
| | - Qianxing Zhuang
- Department of Physiology, School of Medicine, Nantong University, Nantong, Jiangsu Province, China
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Rodríguez-Antigüedad J, Olmedo-Saura G, Pagonabarraga J, Martínez-Horta S, Kulisevsky J. Approaches for treating neuropsychiatric symptoms in Parkinson's disease: a narrative review. Ther Adv Neurol Disord 2025; 18:17562864251336903. [PMID: 40433403 PMCID: PMC12106999 DOI: 10.1177/17562864251336903] [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: 01/14/2025] [Accepted: 04/07/2025] [Indexed: 05/29/2025] Open
Abstract
Neuropsychiatric symptoms in Parkinson's disease (PD) are highly prevalent and profoundly disabling, often emerging even before the onset of motor symptoms. As the disease progresses, these symptoms usually become increasingly impairing and are now recognized as having the greatest impact on quality of life not only for patients but also for caregivers. In recent years, there have been significant advances in the diagnosis and management of neuropsychiatric symptoms. However, there are still substantial gaps in therapeutic approaches and algorithms, with limited pharmacological and nonpharmacological treatment options currently available. One of the main reasons for this is the complex molecular and neural bases of these symptoms, which involve both dopaminergic and nondopaminergic neurotransmission systems and extend far beyond the nigrostriatal pathway. As a result, the drugs currently recommended for treating neuropsychiatric symptoms in PD are few and supported by limited evidence. In this context, the experience of the treating neurologist remains critical in selecting the most appropriate individualized therapy. The aim of this paper is to review the available therapeutic options and provide an overview of current research efforts, particularly those focusing on pharmacological treatments.
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Affiliation(s)
- Jon Rodríguez-Antigüedad
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Gonzalo Olmedo-Saura
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Javier Pagonabarraga
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Saül Martínez-Horta
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, Barcelona 08041, Spain
- Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Institut d’Investigacions Biomèdiques-Sant Pau (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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Tong S, Chen Y, Wu Z, Wang L, Wei Y, Wang X, Wu Y. Nerve injury induces pain hypersensitivity and anxiety-related behaviours and is associated with amygdala activation in male mice. PLoS One 2025; 20:e0323203. [PMID: 40334210 PMCID: PMC12058149 DOI: 10.1371/journal.pone.0323203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 04/03/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND Neuropathic pain is a common health problem, often accompanied by anxiety. The amygdala plays a crucial role in emotional processing and the basolateral amygdala (BLA) and the central amygdala (CeA) are primary components of the amygdala. The c-Fos is considered indicative of neuronal activation. We studied whether BLA and CeA are activated and their internal activation when chronic neuralgia occurs. METHODS The spared nerve injury (SNI) model was employed for this investigation. Mechanical paw withdrawal thresholds (PWTs) were utilized for assessing pain hypersensitivity, followed by observation of anxiety-like behaviors using the elevated plus maze test (EPMT) and the open field test (OFT). The c-Fos in BLA and CeA were measured by immunofluorescence staining. RESULTS We found that SNI mice exhibit pain hypersensitivity and anxiety-like behaviors. The expression of c-Fos in the BLA and CeA was upregulated in SNI mice. Besides, there were spatial differences in c-Fos expression between BLA and CeA. CONCLUSION The BLA and CeA showed activation in chronic pain and associated anxiety, and there were spatial differences in this activation. Targeting the amygdala may hold promise for treating chronic nerve pain with anxiety-like behaviors.
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Affiliation(s)
- Siyuan Tong
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuerong Chen
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zonglin Wu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Linbao Wang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuxin Wei
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xirui Wang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanyuan Wu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
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Lu F, Deng Z, Ji X, Li T, Yang W, Li G, Li X. Effects of mindfulness yoga during pregnancy on psychological and pregnancy outcomes in multiparous women of advanced maternal age. Complement Ther Clin Pract 2025; 59:101962. [PMID: 39987794 DOI: 10.1016/j.ctcp.2025.101962] [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: 07/12/2024] [Revised: 02/14/2025] [Accepted: 02/15/2025] [Indexed: 02/25/2025]
Abstract
BACKGROUND Multiparous women of advanced maternal age are more susceptible to psychological stress. OBJECTIVE This study examined the impact of mindfulness yoga on psychological well-being (anxiety and sleep quality) and pregnancy outcomes (Apgar scores and adverse perinatal events) in aging multiparous women. STUDY DESIGN Participants meeting the criteria were randomly assigned to a control or a mindfulness yoga intervention group. The Chinese version of the Childbirth Attitudes Questionnaire, the Chinese version of the Pregnancy-Related Anxiety Questionnaire, and the Self-Rating Scale of Sleep were utilized to assess fear of childbirth, anxiety levels, and sleep quality, respectively. Maternal and neonatal outcomes, including vaginal delivery rates, labor analgesic use, duration of labor, postpartum bleeding volume, fetal anomaly rates, and Apgar scores, were analyzed. RESULTS A total of 148 multiparous women of advanced maternal age participated in the study. No significant differences in baseline characteristics were observed between the two groups. Participants in the mindfulness yoga group exhibited significantly lower scores on the C-CAQ, PRAQ, and SRSS scales compared to those in the control group. Additionally, higher vaginal delivery rates, reduced analgesic use, and shorter durations across all three stages of labor were observed in the mindfulness yoga group, contributing to an overall reduction in total labor duration. Neonatal outcomes demonstrated notable differences, with higher Apgar scores and lower incidences of adverse perinatal events in the mindfulness yoga group. CONCLUSION Engagement in mindfulness yoga during pregnancy may contribute to improved psychological well-being and enhanced pregnancy outcomes in older multiparous women.
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Affiliation(s)
- Feifan Lu
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Naval Medical University (Changhai Hospital), Shanghai, 200000, China
| | - Zhizhi Deng
- The First Affiliated Hospital, Gynecology &Obstetrics and Reproductive Medical Center, Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Xinxin Ji
- Department of Gynaecology and Obstetrics, Qingdao Chengyang People's Hospital, Qingdao, 266000, China
| | - Tian Li
- Department of Gynaecology and Obstetrics, Qingdao Chengyang People's Hospital, Qingdao, 266000, China
| | - Weihao Yang
- Department of Gynaecology and Obstetrics, Qingdao Chengyang People's Hospital, Qingdao, 266000, China
| | - Guimei Li
- Department of Gynaecology and Obstetrics, Qingdao Chengyang People's Hospital, Qingdao, 266000, China
| | - Xia Li
- Department of Women's Health, Changzhou Maternal and Child Health Hospital, Changzhou, 213000, China.
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Goldman JG. Non-motor Symptoms and Treatments in Parkinson's Disease. Neurol Clin 2025; 43:291-317. [PMID: 40185523 DOI: 10.1016/j.ncl.2024.12.008] [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] [Indexed: 04/07/2025]
Abstract
SYNOPSIS Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. The non-motor features may precede the onset of motor symptoms and occur throughout all stages of PD. The non-motor symptoms reflect multisystem involvement of the central and peripheral nervous systems, multiple neurotransmitters, and multiple pathologies. PD management necessitates a comprehensive approach to address non-motor symptoms, including pharmacologic and non-pharmacological interventions and often multiple different disciplines or specialists in the PD care team. This review article discusses symptoms and treatments for the non-motor symptoms of PD including those affecting mood, cognition, behavior, sleep, autonomic function, and sensory systems.
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Affiliation(s)
- Jennifer G Goldman
- Barrow Neurological Institute, Phoenix, AZ, USA; JPG Enterprises LLC, Medical Division, Chicago, IL, USA.
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Duñabeitia I, González-Devesa D, Blanco-Martínez N, Ayán-Pérez C. The effects of stretching in Parkinson's disease: A systematic review of randomized controlled trials. Parkinsonism Relat Disord 2025; 134:107796. [PMID: 40122719 DOI: 10.1016/j.parkreldis.2025.107796] [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] [Received: 01/21/2025] [Revised: 03/09/2025] [Accepted: 03/18/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. While incurable, exercise has shown therapeutic benefits. Stretching, an accessible and low-cost modality, may improve mobility, balance, and flexibility, warranting systematic evaluation for managing PD symptoms. This systematic review aimed to examine and critically analyze scientific evidence on the effects of stretching in people with Parkinson's disease. METHODS A search was conducted in four electronic databases (Scopus, Web of Science, PEDro, and MEDLINE/PubMed) from inception to November 2024. The methodological quality of included studies was assessed using the PEDro scale. RESULTS Twelve randomized controlled trials were analyzed. Stretching programs lasted 4 weeks to 6 months. Positive effects were observed in motor symptoms and functional mobility for people with PD, although these were generally less pronounced compared to interventions like Tai Chi or WuQinXi Qigong. In contrast, mixed results to no significant improvements were observed for balance, gait, strength, cardiorespiratory fitness, mental health, neurocognitive function, sleep quality, physical activity levels, and fatigue. CONCLUSION Stretching improves motor symptoms and mobility in people with PD, but its benefits for gait, motor function, and mental health are limited compared to other exercises. Further studies are needed to assess its impact on motor and neurocognitive functions.
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Affiliation(s)
- Iratxe Duñabeitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Daniel González-Devesa
- Grupo de Investigación en Actividad Física, Educación, y Salud (GIAFES), Universidad Católica de Ávila, C/ Canteros, 05005, Ávila, Spain; Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310, Vigo, Spain
| | - Nerea Blanco-Martínez
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310, Vigo, Spain; Departamento de Didácticas Especiáis, Universidade de Vigo, 36310, Vigo, Spain.
| | - Carlos Ayán-Pérez
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310, Vigo, Spain; Departamento de Didácticas Especiáis, Universidade de Vigo, 36310, Vigo, Spain
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Moratelli JA, Corrêa CL, Andrade A, Lyra VB, Guimarães ACDA. Functional training and Mat Pilates have a positive effect on non-motor symptoms improving cognition, depressive symptoms, anxiety, and happiness in people with Parkinson's disease: a randomized controlled clinical trial with follow-up. Aging Ment Health 2025:1-10. [PMID: 40289666 DOI: 10.1080/13607863.2025.2496728] [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: 01/20/2024] [Accepted: 04/10/2025] [Indexed: 04/30/2025]
Abstract
OBJECTIVES To analyze the short-term (12-wk post-intervention) and long-term (6-month follow-up) effects of two exercise interventions (functional training or Mat Pilates) compared to a control group and a healthy reference group on non-motor symptoms in people with Parkinson's disease. METHOD 35 individuals with Parkinson's disease were randomized into three groups: functional training, Mat Pilates, and control group, along with 11 age- and sex-matched healthy individuals for the healthy reference group. The exercise groups received twice-weekly 60-min sessions for 12 wk. The control group and healthy reference group maintained routine activities and also received educational lectures during the 12-wk period. Outcome measures included cognition (MoCA), depressive symptoms (BDI), anxiety (BAI), mood (BRUMS), and aging perspective (Sheppard Inventory). RESULTS Short-term effects were observed for the functional training group in the short term for depressive symptoms (p = 0.010) and cognition (p = 0.040), and in the short and long term for anxiety (p = 0.007) and happiness (aging perspective) (p = 0.002). For the Mat Pilates group, effects were observed in cognition (p = 0.048) and confusion (p = 0.049) in the short term, and in depressive symptoms (p < 0.001), anxiety (p = 0.033), happiness (p < 0.001), and loneliness (aging perspective) (p = 0.017) in the short and long term. The control group showed worsening in depressive symptoms (p = 0.030) and confusion (p = 0.033). CONCLUSION Mat Pilates and functional training classes were effective in improving cognition, depressive symptoms, anxiety, and happiness. The control group and healthy reference group did not show significant effects in most studied variables. Both types of exercise can be recommended by professionals working with people with Parkinson's disease. REGISTRATION ReBEC - RBR-6ckggn.
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Affiliation(s)
- Jéssica Amaro Moratelli
- Human Movement, Sciences Center for Health and Sport Sciences, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Clynton Lourenço Corrêa
- Department of Physical Therapy, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Alexandro Andrade
- Department of Physical Education at the Health and Sport Sciences Center, State University of Santa Catarina, Florianópolis, SC, Brazil
| | - Vanessa Bellani Lyra
- Department of Physical Education, Estacio de Sa University, Florianópolis, SC, Brazil
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Some P, Majumdar V, N. K. M, Shetty K, Snigdha A. A Longitudinal Two-Armed Randomized Controlled Trial Protocol to Evaluate the Efficacy of Yoga on Progression of Disease in Early Parkinson's Disease. Ann Neurosci 2025; 32:99-107. [PMID: 40303506 PMCID: PMC12035283 DOI: 10.1177/09727531231198298] [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: 04/11/2023] [Accepted: 06/30/2023] [Indexed: 05/02/2025] Open
Abstract
Background Numerous studies have shown that yoga can aid patients with Parkinson's disease (PD) in managing their motor function, functional mobility, balance, anxiety, and overall quality of life. However, most of the reported research either needed more power or evaluated the results during or after the intervention. Due to the long-standing nature of PD, there are still few longitudinal studies investigating the potential of yoga to decrease the progression of the disease. Purpose We study whether sustained adjunct yoga intervention slows PD progression. Methods Over 18 months, this study will investigate the long-term benefits of yoga-based intervention in Parkinson's patients. The concept of "intention-to-treat (ITT)" will be employed. From the outpatient clinic of the Swami Vivekananda Yoga Anusandhana Samsthana in India, 160 patients with PD will be chosen. They will then be randomly assigned to either the interventional or control groups (1:1). The adjunct intervention group will participate in 21 daily contact yoga sessions (60 min) at the University Medical Center, followed by continued tele-supervised home practice and at-home self-practice. The effectiveness of the adjunct intervention will be evaluated at four different time points (baseline, 3-, 9-, 12-, and 18-month post-randomization). The primary endpoint will be the difference in the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part III score at baseline and after 18 months of intervention. Secondary outcomes will include subscores of MDS-UPDRS I, II, and IV, Parkinson's Disease Questionnaire (PDQ)-39 scores, treatment adherence, the PDQ-39, the Depression, Anxiety, and Stress Scale-21, and the Scales for Outcomes in PD-Sleep Scale (SCOPA-S). The primary outcome will be analyzed using mixed-effect models for repeated measures, adjusted for covariates as fixed effects. Results The protocol was conceptualized in October 2021 and approved by the Institutional Ethics Committee of SVYASA. Recruitment began in February 2022 and is underway with patient enrollment. Conclusion To our knowledge, this is the first controlled study to examine the long-term effects of yoga as an adjuvant therapy on the progression of PD. Key message This would be the first long-term trial to assess the potential of an adjunct yoga intervention to modulate disease progression in early Parkinson's patients.
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Affiliation(s)
- Parameshwar Some
- Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, India
| | - Vijaya Majumdar
- Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, India
| | - Manjunath N. K.
- Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, India
| | | | - Atmakur Snigdha
- Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, India
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van der Heide A, Wessel M, Papadopetraki D, Geurts DE, van Prooije TH, Gommans F, Bloem BR, Dirkx MF, Helmich RC. Propranolol Reduces Parkinson's Tremor and Inhibits Tremor-Related Activity in the Motor Cortex: A Placebo-Controlled Crossover Trial. Ann Neurol 2025; 97:741-752. [PMID: 39707791 PMCID: PMC11889531 DOI: 10.1002/ana.27159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 11/29/2024] [Accepted: 11/30/2024] [Indexed: 12/23/2024]
Abstract
OBJECTIVE Parkinson's disease (PD) resting tremor is thought to be initiated in the basal ganglia and amplified in the cerebello-thalamo-cortical circuit. Because stress worsens tremor, the noradrenergic system may play a role in amplifying tremor. We tested if and how propranolol, a non-selective beta-adrenergic receptor antagonist, reduces PD tremor and whether or not this effect is specific to stressful conditions. METHODS In a cross-over, double-blind intervention study, participants with PD resting tremor received propranolol (40 mg, single dose) or placebo (counter-balanced) on 2 different days. During both days, we assessed tremor severity (with accelerometry) and tremor-related brain activity (with functional magnetic resonance imaging), as well as heart rate and pupil diameter, while subjects performed a stressful cognitive load task that has been linked to the noradrenergic system. We tested for effects of drug (propranolol vs placebo) and stress (cognitive load vs rest) on tremor power and tremor-related brain activity. RESULTS We included 27 PD patients with prominent resting tremor. Tremor power significantly increased during cognitive load versus rest (F[1,19] = 13.8; p = 0.001;η p 2 = 0.42) and decreased by propranolol versus placebo (F[1,19] = 6.4; p = 0.02;η p 2 = 0.25), but there was no interaction. We observed task-related brain activity in a stress-sensitive cognitive control network and tremor power-related activity in the cerebello-thalamo-cortical circuit. Propranolol significantly reduced tremor-related activity in the motor cortex compared to placebo (F[1,21] = 5.3; p = 0.03;η p 2 = 0.20), irrespective of cognitive load. INTERPRETATION Our findings indicate that propranolol has a general, context-independent, tremor-reducing effect that may be implemented at the level of the primary motor cortex. ANN NEUROL 2025;97:741-752.
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Affiliation(s)
- Anouk van der Heide
- Department of Neurology, Centre of Expertise for Parkinson and Movement DisordersRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
| | - Maaike Wessel
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
| | - Danae Papadopetraki
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
| | - Dirk E.M. Geurts
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
| | - Teije H. van Prooije
- Department of Neurology, Centre of Expertise for Parkinson and Movement DisordersRadboud University Medical CentreNijmegenThe Netherlands
| | - Frank Gommans
- Department of Cardiology, Maxima Medical CentreVeldhovenThe Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Centre of Expertise for Parkinson and Movement DisordersRadboud University Medical CentreNijmegenThe Netherlands
| | - Michiel F. Dirkx
- Department of Neurology, Centre of Expertise for Parkinson and Movement DisordersRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
| | - Rick C. Helmich
- Department of Neurology, Centre of Expertise for Parkinson and Movement DisordersRadboud University Medical CentreNijmegenThe Netherlands
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive NeuroimagingRadboud University NijmegenNijmegenThe Netherlands
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Meliani AAG, Lima AG, Moratelli JA, da Silveira J, Saraiva PSDS, Gil PR, Guimarães ACDA. Can Dance and Yoga Help With the Non-Motor Symptoms of People With Parkinson's? A Systematic Review With Meta-Analysis. J Appl Gerontol 2025:7334648251328441. [PMID: 40105264 DOI: 10.1177/07334648251328441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2025] Open
Abstract
Objective: To assess the effectiveness of randomized clinical trials that utilized dance and yoga as interventions for individuals with Parkinson's disease in relation to anxiety, self-esteem, cognition, depressive symptoms, and fecal and urinary incontinence. Method: Five databases (Embase, PubMed, ScienceDirect, Scopus, and Web of Science) were consulted following PRISMA guidelines and registered in PROSPERO. Results: Seven studies were included in the meta-analysis, showing low risk of bias and high heterogeneity (I2 = 91%; p < .001). Yoga was effective for anxiety (I2 = 97%; p < .001) and dance showed positive effects on cognition, albeit with high variability (I2 = 90%; p < .001). Both interventions were beneficial for depressive symptoms (I2 = 75%; p < .001). Conclusion: Dance and yoga are promising interventions for anxiety and depressive symptoms in Parkinson's disease patients. Record: Prospero CRD42024533561.
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Affiliation(s)
- Audrey Alcantara Garcia Meliani
- Master student of the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Alicia Garcia Lima
- Master student of the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Jéssica Amaro Moratelli
- PhD from the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Juliana da Silveira
- Doctoral students of the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Patricia Severo Dos Santos Saraiva
- Master's degree from the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Priscila Rodrigues Gil
- Doctoral students of the Postgraduate Program in Human Movement Sciences (PPGCMH), State University of Santa Catarina (UDESC), Florianopolis, Brazil
| | - Adriana Coutinho de Azevedo Guimarães
- Department of Physical Education and the Postgraduate Program in Human Movement Sciences at the State University of Santa Catarina (UDESC), Florianopolis, Brazil
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11
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Wang ZY, Deng YL, Zhou TY, Jiang ZY, Liu Y, Liu BF, Cao Y. The effects of exercise interventions on depressive symptoms in stroke patients: a systematic review and meta-analysis. Front Physiol 2025; 16:1492221. [PMID: 40166715 PMCID: PMC11955706 DOI: 10.3389/fphys.2025.1492221] [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: 09/06/2024] [Accepted: 02/07/2025] [Indexed: 04/02/2025] Open
Abstract
Purpose This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on depressive symptoms in stroke patients. Methods Following PRISMA guidelines, We conducted searches in PubMed, Embase, CENTRAL, and Web of Science. The topic was the effect of exercise on depression levels in stroke patients. Patient's performance on depression scales after exercise was assessed using standardized mean difference (SMD) and 95% confidence intervals (95% CI). A random effects model (RE) was used to conduct a meta-analysis and compare the results between subgroups conducted based on adherence to ACSM guidelines and the length of exercise interventions. Results The analysis included 24 randomized controlled trials (RCTs) involving 1,757 participants. The meta-analysis revealed that exercise interventions had a significant positive effect on reducing depressive symptoms in stroke patients, with a standardized mean difference (SMD) of -0.43 (95% CI: 0.65, -0.21). Subgroup analysis indicated that high compliance with ACSM guidelines resulted in a more substantial reduction in depressive symptoms (SMD = -0.79, 95% CI: 1.10, -0.49), compared with low or uncertain compliance (SMD = -0.03, 95% CI: 0.16, 0.10). Longer exercise intervention was associated with greater mitigation of depressive symptoms. The differences between intervention groups of different lengths were statistically significant (p < 0.05). Conclusion These findings support the integration of tailored exercise programs into post-stroke care to optimize mental health outcomes. Compliance to ACSM-recommended exercise dosages significantly ameliorate depression levels in stroke patients. Further research is warranted to explore standardized exercise regimens in larger, multicenter trials. Systematic Review Registration https://www.crd.york.ac.uk/prospero/#recordDetails, identifier PROSPERO(CRD42024579095).
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Affiliation(s)
- Zhi-Yuan Wang
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ya-Lu Deng
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ting-Yuan Zhou
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, Sichuan, China
| | - Zi-Yang Jiang
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Liu
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo-Fu Liu
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Cao
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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12
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Raggi A, Serretti A, Ferri R. Treatment options for depression in Parkinson's disease: a mini-review. Int Clin Psychopharmacol 2025:00004850-990000000-00165. [PMID: 40071596 DOI: 10.1097/yic.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2025]
Abstract
Depression is a common comorbidity in Parkinson's disease (PD), significantly reducing patients' quality of life. This mini-review examines pharmacological and nonpharmacological therapies for managing depression in PD, analyzing their benefits, and limitations. Pharmacological options include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), levodopa, dopaminergic agonists, and monoamine oxidase B inhibitors. Nonpharmacological strategies involve brief psychodynamic therapy, cognitive-behavioral therapy (CBT), physical exercise, phytomedicine, massage therapy, music therapy, phototherapy, yoga, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, electroconvulsive therapy (ECT), and deep brain stimulation. SSRIs, SNRIs, and some dopamine agonists have shown effectiveness and good tolerability, especially when combined with CBT or rTMS. For severe or refractory cases, ECT remains a viable option. Although many of these therapies show promise, the limited number and scale of studies for each treatment restrict the strength of current evidence. Further large-scale, multicenter randomized-controlled trials are essential to validate these preliminary findings and establish evidence-based guidelines. In addition, the potential benefits of social support and brief psychodynamic therapy in the context of PD-related depression require further exploration to provide holistic care strategies for this population.
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Affiliation(s)
- Alberto Raggi
- Unit of Neurology, G.B. Morgagni - L. Pierantoni Hospital, Forlì
| | - Alessandro Serretti
- Department of Medicine and Surgery, Kore University of Enna, Enna
- Oasi Research Institute - IRCCS, Troina, Italy
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13
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Wang K, Wang P, Li Y, Wang C, Veldheer S, Wang F, Na M, Sun L, Gao X. Association between yoga and multimorbidity: a nationwide study of 279,885 middle-aged and older adults. BMC Public Health 2025; 25:888. [PMID: 40050815 PMCID: PMC11884150 DOI: 10.1186/s12889-025-22035-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 02/20/2025] [Indexed: 03/10/2025] Open
Abstract
BACKGROUND The health benefits of exercise have been well-established, but the specific role of yoga in multimorbidity was less understood. This study aimed to examine the association between yoga and multimorbidity in comparison with other exercises or non-exercise. METHODS This cross-sectional study pooled nationally representative surveys from Behavioral Risk Factor Surveillance System (BRFSS) (2015, 2017, and 2019), and classified 279,885 participants aged 45 + years as yoga practitioners, other exercisers, and non-exercisers. Multinominal and binary logistic regressions were separately used for association of yoga with multimorbidity (coexistence of ≥ 2 conditions) and individual chronic conditions. Potential effect modification by age, sex, education level, and race/ethnicity was examined. We further assessed the dose-response association of duration and frequency of yoga practice with multimorbidity. RESULTS The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for yoga practitioners (n = 5081) vs. other exercisers (n = 192,718) were 0.69 (95% CI 0.55-0.86) for coexistence of two conditions, and 0.72 (95%CI 0.58-0.89) for coexistence of ≥ 3 conditions. The associations were stronger (ORs ranged from 0.43 to 0.52; P < 0.0001 for all) when comparing yoga practitioners with non-exercisers (n = 82,086), which were more pronounced in women relative to men (P-interaction < 0.05). Increased duration or frequency of yoga practice was associated with lower odds of multimorbidity in a dose-response manner (P for trend<0.0001 for all). Similar inverse associations were observed between yoga and individual chronic conditions. CONCLUSION Yoga was associated with lower odds of multimorbidity in middle-aged and older adults, relative to other exercises or non-exercise.
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Affiliation(s)
- Kaiyue Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Peilu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Yaqi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Chen Wang
- Shanghai Research Institute of Sports Science, Shanghai, 200030, China
| | - Susan Veldheer
- Departments of Family and Community Medicine and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Feifei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, 200032, China.
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14
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Liu X, Su J, Zhang J, Li Z, Huang K, Lin D, Tao E. Effects of MAO‑B inhibitors in life quality of Parkinson's disease patients: A systematic review and meta‑analysis. Behav Brain Res 2025; 480:115410. [PMID: 39732440 DOI: 10.1016/j.bbr.2024.115410] [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: 10/03/2024] [Revised: 12/20/2024] [Accepted: 12/23/2024] [Indexed: 12/30/2024]
Abstract
INTRODUCTION Monoamine oxidase-B (MAO-B) inhibitors, as an add-on therapy to levodopa, are widely used in Parkinson's disease (PD). The effects of MAO-B inhibitors on quality of life remain unclear, and the aim of this systematic review and meta-analysis was to assess the efficacy and safety of MAO-B inhibitors on quality of life in different domains. METHODS We searched PubMed, Embass, and Cochrane Library databases for randomized controlled trials of PD patients who were administered MAO-B inhibitors. Outcomes were the change from baseline in the total score of life quality scales, change from baseline in domains of the Parkinson's Disease Questionnaire-39 (PDQ-39), and incidence of treatment-associated adverse events (TAEs). RESULTS Sixteen studies covering 4734 PD patients were included in the study. The PDQ-39 scores were lower with MAO-B inhibitors than with placebo (SMD: -0.26, 95 % CI: [-0.49, -0.04], P = 0.02). The European Quality of Life Questionnaire-5D (EQ-5D) scores were higher in the MAO-B inhibitor group. Patients treated with MAO-B inhibitors had better performance in the domains of mobility, activities of daily living, emotional well-being, stigma, communication, and bodily discomfort, except for social support and cognition. The incidence of TAEs was slightly higher in patients treated with MAO-B inhibitors. CONCLUSIONS Evidence has shown that MAO-B inhibitors, especially safinamide, are effective in improving the quality of life of PD patients, although with a slightly higher incidence of TAEs. The domains of quality of life were improved, except for cognition and social support, compared with placebo. Further studies are warranted to evaluate the effects of other MAO-B inhibitors on quality of life.
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Affiliation(s)
- Xiaohuan Liu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jiehua Su
- Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China
| | - Jieli Zhang
- Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China
| | - Zhonggui Li
- Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China
| | - Kaixun Huang
- Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China
| | - Danyu Lin
- Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China
| | - Enxiang Tao
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-sen University, Sun Yat-Sen University, Shenzhen, China.
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15
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Li J, Liu T, Xian M, Zhou K, Wei J. The Power of Exercise: Unlocking the Biological Mysteries of Peripheral-Central Crosstalk in Parkinson's Disease. J Adv Res 2025:S2090-1232(25)00143-2. [PMID: 40049515 DOI: 10.1016/j.jare.2025.03.001] [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: 07/23/2024] [Revised: 01/06/2025] [Accepted: 03/01/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND Exercise is a widely recognized non-pharmacological treatment for Parkinson's Disease (PD). The bidirectional regulation between the brain and peripheral organs has emerged as a promising area of research, with the mechanisms by which exercise impacts PD closely linked to the interplay between peripheral signals and the central nervous system. AIM OF REVIEW This review aims to summarize the mechanisms by which exercise influences peripheral-central crosstalk to improve PD, discuss the molecular processes mediating these interactions, elucidate the pathways through which exercise may modulate PD pathophysiology, and identify directions for future research. KEY SCIENTIFIC CONCEPTS OF REVIEW This review examines how exercise-induced cytokine release promotes neuroprotection in PD. It discusses how exercise can stimulate cytokine secretion through various pathways, including the gut-brain, muscle-brain, liver-brain, adipose-brain, and bone-brain axes, thereby alleviating PD symptoms. Additionally, the potential contributions of the heart-brain, lung-brain, and spleen-brain axes, as well as multi-axis crosstalk-such as the brain-gut-muscle and brain-gut-bone axes-are explored in the context of exercise therapy. The study highlights the need for further research into peripheral-central crosstalk and outlines future directions to address challenges in clinical PD therapy.
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Affiliation(s)
- Jingwen Li
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng, Henan, 475004, China
| | - Tingting Liu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, Henan, 475004, China
| | - Meiyan Xian
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, Henan, 475004, China
| | - Ke Zhou
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng, Henan, 475004, China.
| | - Jianshe Wei
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng, Henan, 475004, China; Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, Henan, 475004, China.
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16
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Pandey S, Pandey AC, Kotecha VR. Yoga-A complementary and traditional medicine for human health. JOURNAL OF INTEGRATIVE MEDICINE 2025; 23:93-105. [PMID: 39855918 DOI: 10.1016/j.joim.2025.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/07/2024] [Indexed: 01/27/2025]
Abstract
Yoga is a therapeutic practice renowned for its multifaceted benefits across the body's systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body's various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga's effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers. Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga-A complementary and traditional medicine for human health. J Integr Med. 2025; 23(2): 93-105.
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Affiliation(s)
- Saurabh Pandey
- Inter University Centre for Yogic Science, Aruna Asaf Ali Marg, New Delhi 110067, India; Ministry of Ayush, Ayush Bhawan, New Delhi 110023, India.
| | - Avinash C Pandey
- Inter University Centre for Yogic Science, Aruna Asaf Ali Marg, New Delhi 110067, India
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Kwok JYY, Chan LML, Lai CA, Ho PWL, Choi ZYK, Auyeung M, Pang SYY, Choi EPH, Fong DYT, Yu DSF, Lin CC, Walker R, Wong SYS, Ho RTH. Effects of Meditation and Yoga on Anxiety, Depression and Chronic Inflammation in Patients with Parkinson's Disease: A Randomized Clinical Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2025; 94:101-118. [PMID: 40024243 PMCID: PMC11965853 DOI: 10.1159/000543457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 01/02/2025] [Indexed: 03/04/2025]
Abstract
INTRODUCTION Clinical guidelines recommend a holistic approach to Parkinson's disease (PD) care, yet randomized trials examining mindfulness-based interventions in this context are scarce. This study investigated the effects of two mindfulness practices - meditation and yoga - on biopsychosocial outcomes in PD patients, including anxiety symptoms, depressive symptoms, motor/nonmotor symptoms, health-related quality-of-life (HRQOL), mindfulness, and stress and inflammation biomarkers, compared to usual care. METHODS 159 participants with a clinical diagnosis of idiopathic PD and a Hoehn and Yahr stage of 1, 2, and 3, were randomized into meditation (n = 53), yoga (n = 52), and control (n = 54). Meditation and yoga were delivered in 90-min groups for 8 weeks. Primary outcomes included anxiety symptoms and depressive symptoms. Secondary outcomes included motor and nonmotor symptoms, HRQOL, mindfulness, and serum levels of interleukin-6, cortisol and TNF-alpha. Assessments were done at baseline (T0), 2 months (T1), and 6 months (T2). Linear mixed models were conducted following intention-to-treat principle. RESULTS Compared to control, both meditation, and yoga groups had significant improvements in anxiety symptoms (meditation: mean difference [MD] = -1.36, 95% CI: -2.46 to-0.26; yoga: MD = -1.61, CI: -2.70 to -0.52), motor symptoms (meditation: MD = -5.35, CI: -8.61 to-2.09; yoga: MD = -6.59, CI: -9.82 to-3.36), HRQOL (meditation: MD = -2.01, CI: -3.41 to-0.62; yoga: MD = -1.45, CI: -2.83 to-0.08), and describing skills (meditation: MD = 0.97, CI: 0.04-1.89; yoga: MD = 0.92, CI: 0.01-1.84) at T1, and significant reductions in serum interleukin-6 levels (meditation: MD = -1.14, CI: -2.18 to-0.10; yoga: MD = -1.11, CI: -2.09 to-0.13) at T2. Only meditation significantly reduced depression (MD = -1.44, CI: -2.57 to-0.30) at T1 and sustained the motor and HRQOL improvements at T2. CONCLUSION Meditation and yoga significantly improved anxiety symptoms, chronic inflammation, motor symptoms, mindfulness-describing facet, and HRQOL in PD patients. Meditation provided additional benefits in reducing depressive symptoms and sustaining motor and HRQOL improvements. INTRODUCTION Clinical guidelines recommend a holistic approach to Parkinson's disease (PD) care, yet randomized trials examining mindfulness-based interventions in this context are scarce. This study investigated the effects of two mindfulness practices - meditation and yoga - on biopsychosocial outcomes in PD patients, including anxiety symptoms, depressive symptoms, motor/nonmotor symptoms, health-related quality-of-life (HRQOL), mindfulness, and stress and inflammation biomarkers, compared to usual care. METHODS 159 participants with a clinical diagnosis of idiopathic PD and a Hoehn and Yahr stage of 1, 2, and 3, were randomized into meditation (n = 53), yoga (n = 52), and control (n = 54). Meditation and yoga were delivered in 90-min groups for 8 weeks. Primary outcomes included anxiety symptoms and depressive symptoms. Secondary outcomes included motor and nonmotor symptoms, HRQOL, mindfulness, and serum levels of interleukin-6, cortisol and TNF-alpha. Assessments were done at baseline (T0), 2 months (T1), and 6 months (T2). Linear mixed models were conducted following intention-to-treat principle. RESULTS Compared to control, both meditation, and yoga groups had significant improvements in anxiety symptoms (meditation: mean difference [MD] = -1.36, 95% CI: -2.46 to-0.26; yoga: MD = -1.61, CI: -2.70 to -0.52), motor symptoms (meditation: MD = -5.35, CI: -8.61 to-2.09; yoga: MD = -6.59, CI: -9.82 to-3.36), HRQOL (meditation: MD = -2.01, CI: -3.41 to-0.62; yoga: MD = -1.45, CI: -2.83 to-0.08), and describing skills (meditation: MD = 0.97, CI: 0.04-1.89; yoga: MD = 0.92, CI: 0.01-1.84) at T1, and significant reductions in serum interleukin-6 levels (meditation: MD = -1.14, CI: -2.18 to-0.10; yoga: MD = -1.11, CI: -2.09 to-0.13) at T2. Only meditation significantly reduced depression (MD = -1.44, CI: -2.57 to-0.30) at T1 and sustained the motor and HRQOL improvements at T2. CONCLUSION Meditation and yoga significantly improved anxiety symptoms, chronic inflammation, motor symptoms, mindfulness-describing facet, and HRQOL in PD patients. Meditation provided additional benefits in reducing depressive symptoms and sustaining motor and HRQOL improvements.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
- Center on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Lily Man Lee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China,
| | - Charis Ann Lai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Philip Wing Lok Ho
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hum, Hong Kong, China
- Mental Health Research Centre, PolyU Academy for Interdisciplinary Research, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
- China State Key Laboratory of Marine Pollution and Department of Chemistry, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Zoe Yuen-Kiu Choi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hum, Hong Kong, China
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China
| | | | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Samuel Yeung Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, CUHK Thomas Jing Centre for Mindfulness Research and Training, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Rainbow Tin Hung Ho
- Center on Behavioral Health, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
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18
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Spee BTM, de Vries NM, Zeggio S, Plijnaer M, Koksma JJ, Duits AA, Stap T, Pasman G, Haeyen S, Darweesh S, Crone J, Bloem BR, Pelowski M. Unleashing creativity in people with Parkinson's disease: a pilot study of a co-designed creative arts therapy. J Neurol 2025; 272:161. [PMID: 39849173 PMCID: PMC11758163 DOI: 10.1007/s00415-024-12878-0] [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: 09/12/2024] [Revised: 12/18/2024] [Accepted: 12/20/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Conventional medical management, while essential, cannot address all multifaceted consequences of Parkinson's disease (PD). This pilot study explores the potential of a co-designed creative arts therapy on health-related quality of life, well-being, and pertinent non-motor symptoms. METHODS We conducted an exploratory pilot study with a pre-post design using validated questionnaires. Eight individuals with PD participated in the program. The investigated intervention was a 10-week creative arts therapy with weekly 90-120-min sessions, guided by three creative therapists. Participants were allowed to autonomously select from multiple creative media based on their personal preferences. Explored co-primary outcomes included health-related quality of life (PDQ-39), well-being (ICECAP-A), anxiety/depression (HADS), executive functioning (BRIEF-A), resilience/mental flexibility (FIT-60), and self-efficacy (GSES). We used paired sample t tests for pre-post analysis of the co-primary outcomes and Wilcoxon signed-rank tests for PDQ-39 sub-scores. We also included aesthetic responsiveness (AReA) and healthcare consumption (IMCQ adapted for PD) questionnaires reported as descriptive statistics. RESULTS The results showed a significant reduction in anxiety and an increase in well-being. We also observed a slight improvement in cognitive functioning. Finally, we noted a reduction in healthcare consumption (fewer visits at neurologists, specialized PD nurses, and allied healthcare professionals). CONCLUSION These findings cautiously suggest that our co-designed, multi-media creative arts therapy has the potential to increase well-being and reduce anxiety, while reducing healthcare consumption. These preliminary findings support the need for a larger, randomized controlled trial to explore the therapeutic potential of creative arts therapy in PD care.
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Affiliation(s)
- Blanca T M Spee
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria.
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Nienke M de Vries
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Sara Zeggio
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Marjoke Plijnaer
- Art Unbound, collaboration partner of Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan-Jurjen Koksma
- Radboud University Medical Center Health Academy, Nijmegen, the Netherlands
| | - Annelien A Duits
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Medical Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Thieme Stap
- Radboud University Medical Center Health Academy, Nijmegen, the Netherlands
- Fontys University of Applied Sciences, Research Group Professional Workplaces, Eindhoven, The Netherlands
| | - Gert Pasman
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Suzanne Haeyen
- GGNet, Centre of Expertise for Personality Disorders Apeldoorn, Centre for Mental Health, PO Box 2003, Scelta, 7230 GC, Warnsveld, the Netherlands
- Research Group Arts & Psychomotor Therapies in Health Care, Academy of Health & Vitality, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, the Netherlands
| | - Sirwan Darweesh
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Julia Crone
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Matthew Pelowski
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Luo Z, Chen J, Liu Y, Dai Y, Gao H, Zhang B, Ou H, So KF, Wei JA, Zhang L. Treadmill exercise prevents stress-induced anxiety-like behaviors via enhancing the excitatory input from the primary motor cortex to the thalamocortical circuit. Nat Commun 2025; 16:939. [PMID: 39843934 PMCID: PMC11754434 DOI: 10.1038/s41467-025-56258-2] [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: 05/16/2023] [Accepted: 01/10/2025] [Indexed: 01/24/2025] Open
Abstract
Physical exercise effectively prevents anxiety disorders caused by environmental stress. The neural circuitry mechanism, however, remains incomplete. Here, we identified a previously unrecognized pathway originating from the primary motor cortex (M1) to medial prefrontal cortex (mPFC) via the ventromedial thalamic (VM) nuclei in male mice. Besides anatomical evidence, both ex vivo and in vivo recordings showed enhanced excitability of M1-VM inputs to the prelimbic (PrL) region of mPFC upon 14-day treadmill exercise on a chronic restraint stress (CRS) mouse model. Further functional interrogations demonstrated that the activation of this neural circuit is both necessary and sufficient to direct the anxiolytic effect of exercise training in CRS mice. Our findings provide more insights into the neural circuits connecting motor and mental regions under exercise paradigm and implicate potential targets for neuromodulation in treating anxiety disorders.
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Affiliation(s)
- Zhihua Luo
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
- Songjiang Research Institute, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junlin Chen
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Yuchu Liu
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Yelin Dai
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Hui Gao
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Borui Zhang
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Haibin Ou
- College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Kwok-Fai So
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China.
- State Key Laboratory of Brain and Cognitive Science, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Ji-An Wei
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China.
| | - Li Zhang
- Key Laboratory of CNS Regeneration (Ministry of Education), Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China.
- Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao, China.
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China.
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20
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Mailankody P, Kamble N, Bhattacharya A, Shubha Bhat GS, Arumugam T, Thennarasu K, Arasappa R, Varambally S, Yadav R, Pal PK. Yoga as an Add-on Therapy in Parkinson's Disease: A Single Group Open-label Trial. Can J Neurol Sci 2025; 52:102-109. [PMID: 38525880 DOI: 10.1017/cjn.2024.43] [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] [Indexed: 03/26/2024]
Abstract
OBJECTIVE We aimed to evaluate the effect of yoga on motor and non-motor symptoms and cortical excitability in patients with Parkinson's disease (PD). METHODS We prospectively evaluated 17 patients with PD at baseline, after one month of conventional care, and after one month of supervised yoga sessions. The motor and non-motor symptoms were evaluated using the Unified Parkinson's disease Rating Scale (motor part III), Hoehn and Yahr stage, Montreal Cognitive Assessment, Hamilton depression rating scale, Hamilton anxiety rating scale, non-motor symptoms questionnaire and World Health Organization quality of life questionnaire. Transcranial magnetic stimulation was used to record resting motor threshold, central motor conduction time, ipsilateral silent period (iSP), contralateral silent period (cSP), short interval intracortical inhibition (SICI), and intracortical facilitation. RESULTS The mean age of the patients was 55.5 ± 10.8 years, with a mean duration of illness of 4.0 ± 2.5 years. The postural stability of the patients significantly improved following yoga (0.59 ± 0.5 to 0.18 ± 0.4, p = 0.039). There was a significant reduction in the cSP from baseline (138.07 ± 27.5 ms) to 4 weeks of yoga therapy (116.94 ± 18.2 ms, p = 0.004). In addition, a significant reduction in SICI was observed after four weeks of yoga therapy (0.22 ± 0.10) to (0.46 ± 0.23), p = 0.004). CONCLUSION Yoga intervention can significantly improve postural stability in patients with PD. A significant reduction of cSP and SICI suggests a reduction in GABAergic neurotransmission following yoga therapy that may underlie the improvement observed in postural stability. CLINICALTRIALSGOV IDENTIFIER CTRI/2019/02/017564.
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Affiliation(s)
- Pooja Mailankody
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - G S Shubha Bhat
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Thamodharan Arumugam
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - K Thennarasu
- Department of Biostatistics, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Rashmi Arasappa
- Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
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21
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Lyu FF, Ramoo V, Chui PL, Ng CG. Adaptation, Validation, and Feasibility Evaluation of Mindful Standing Yoga Combined with Baduanjin for Older Patients with Primary Osteoporosis. West J Nurs Res 2025; 47:33-46. [PMID: 39559966 DOI: 10.1177/01939459241301295] [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] [Indexed: 11/20/2024]
Abstract
OBJECTIVE This study aimed to adapt, validate, and evaluate the feasibility of a mindful exercise program (Mindful Standing Yoga combined with Baduanjin) for older patients with primary osteoporosis. METHODS The study was conducted in 3 stages. Stage 1 involved a qualitative focus group discussion with 6 experts to gather perspectives on modifying the exercise program. Stage 2 used a Delphi approach with another 6 experts to validate the program. In Stage 3, a feasibility study was conducted with 20 eligible patients (out of 23 initially enrolled) at a traditional Chinese medicine hospital, using a single-group pre- and posttest design. The strenuousness of the adapted exercise was assessed through heart rate (HR) and rating of perceived exertion (RPE). Its effects were measured using the Global Pain Scale (GPS), the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), the Tampa Kinesiophobia-11 Scale, and the Timed Up and Go test. Patient satisfaction and feedback were also collected. RESULTS The modified program, consisting of 9 movements and taking 30 min to complete, was validated by experts as suitable, safe, and effective for practice. HR and RPE measurements confirmed it as a low-intensity exercise and not strenuous for the study population. The program significantly improved back pain and mindfulness in the feasibility study, with most participants expressing satisfaction with the protocol. CONCLUSION Experts and participants affirmed that the program was appropriate and satisfactory for older patients with primary osteoporosis, particularly those with back pain. Further high-quality randomized controlled trials are needed to validate its effectiveness.
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Affiliation(s)
- Fang Fei Lyu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Vimala Ramoo
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Adjunct Faculty, Manipal College of Nursing, Manipal Academic of Higher Education, Manipal, Karnataka, India
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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22
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Yao M, Qu Y, Zheng Y, Guo H. The effect of exercise on depression and gut microbiota: Possible mechanisms. Brain Res Bull 2025; 220:111130. [PMID: 39557221 DOI: 10.1016/j.brainresbull.2024.111130] [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: 08/31/2024] [Revised: 11/09/2024] [Accepted: 11/12/2024] [Indexed: 11/20/2024]
Abstract
Exercise can effectively prevent and treat depression and anxiety, with gut microbiota playing a crucial role in this process. Studies have shown that exercise can influence the diversity and composition of gut microbiota, which in turn affects depression through immune, endocrine, and neural pathways in the gut-brain axis. The effectiveness of exercise varies based on its type, intensity, and duration, largely due to the different changes in gut microbiota. This article summarizes the possible mechanisms by which exercise affects gut microbiota and how gut microbiota influences depression. Additionally, we reviewed literature on the effects of exercise on depression at different intensities, types, and durations to provide a reference for future exercise-based therapies for depression.
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Affiliation(s)
- Mingchen Yao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yaqi Qu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yalin Zheng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Hao Guo
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
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23
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Wu YT, Chen MY, Huang YC, Liu CY. Effectiveness of Applying the Theory of Planned Behavior with Yoga Program on the Physical Activity and Mental Health of the Prefrailty Older Adults. Int J Yoga 2025; 18:27-37. [PMID: 40365368 PMCID: PMC12068459 DOI: 10.4103/ijoy.ijoy_190_24] [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: 09/03/2024] [Revised: 11/30/2024] [Accepted: 12/19/2024] [Indexed: 05/15/2025] Open
Abstract
Objectives Grounded in the theory of planned behavior (TPB), this study evaluated the effectiveness of a yoga program intervention on the physical functioning and mental health in older adults. Materials and Methods This was a quasi-experimental two-group, pre- and posttest, single-blind study. The participants were older adults above 65 years of age and in the early stage of frailty. The intervention for the experimental group was a twice weekly 60-min yoga session for 12 weeks; the control group received physical activity lectures in the 1st and 8th weeks. Pretest is conducted before the intervention, posttest one is conducted in the 8th week, and posttest two is conducted in the 12th week. Outcome indicators include physical activity level, body balance, flexibility, lower limb muscle strength, mental health (Brief Symptom Rating Scale [BSRS]), exercise behavior questionnaire, etc. Results After 12-week silver yoga intervention, there were 31 participants in the experimental group with a loss of 9% (29% loss rate), whereas there were 29 participants in the control group with a loss of 6% (20% loss rate). Results from generalized estimating equations that grip strength index (P = 0.000), right lower limb muscle strength (P = 0.000), left lower limb muscle strength (P = 0.000) were significant between groups for both experimental and control groups, whereas other outcome indicators such as physical activity level, balance, flexibility, and mental health were not significant between groups. However, experimental within-group mean differences at week 12 for grip strength (P = 0.000), BSRS (P = 0.016), physical activity level (P = 0.000), right lower limb muscle strength (P = 0.000), left lower limb muscle strength (P = 0.000), simple physical function assessment (P = 0.000), single-leg standing (P = 0.000), upper limb flexibility (P = 0.000), lower limb flexibility (P = 0.000), exercise behavior evaluation attitude (P = 0.000), and exercise behavior evaluation perceived behavioral control (P = 0.000) were all significant. Conclusions This study uses Ajzen's TPB as a basis to explore the behavioral intention after silver yoga intervention. This theory believes that an individual's specific behavior is affected by his or her behavioral intention, and the behavioral intention depends on the actor's attitude and subjective attitude toward the behavior. Norms perceived behavioral control. The research results show that yoga intervention attitude has the highest impact on behavioral intention, followed by perceived behavioral control and finally subjective norms. The experimental group has changed their attitudes and cognitions to increase their behavioral intentions. They have a deeper understanding of yoga asanas. They have broken through the difficult limb bending and kneeling postures seen in the past, which has increased their participation in yoga activities and confidence in their perceived behaviors. It also enhances behavioral intention, which means that the attitude and personal behavior of the research subjects after the intervention increase the elder's exercise intention, making the elder more clearly aware that yoga asanas are competent, thereby increasing the regularity of activity participation.
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Affiliation(s)
- Ya Ting Wu
- Department of Nursing, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Miao Yen Chen
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yung Cheng Huang
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chieh Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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24
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He J, Liu F, Xu P, Xu T, Yu H, Wu B, Wang H, Chen J, Zhang K, Zhang J, Meng K, Yan X, Yang Q, Zhang X, Sun D, Chen X. Aerobic Exercise Improves the Overall Outcome of Type 2 Diabetes Mellitus Among People With Mental Disorders. Depress Anxiety 2024; 2024:6651804. [PMID: 40226688 PMCID: PMC11918971 DOI: 10.1155/da/6651804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/09/2024] [Indexed: 04/15/2025] Open
Abstract
The escalating global prevalence of type 2 diabetes mellitus (T2DM) and mental disorder (MD) including schizophrenia, bipolar disorder, major depressive disorder, and anxiety highlights the urgency for comprehensive therapeutic strategies. Aerobic exercise (AE) is a viable adjunct therapy, providing significant benefits for individuals dealing with both T2DM and MD. This review consolidates evidence on AE's role in alleviating the physiological and psychological effects of these comorbid conditions. It delves into the pathophysiological connections between T2DM and various MD, including depression, schizophrenia, anxiety, and bipolar disorder-emphasizing their reciprocal exacerbation. Key neurophysiological mechanisms through which AE confers benefits are explored, including neuroinflammation modulation, brain structure and neuroplasticity enhancement, growth factor expression regulation, and hypothalamic-pituitary-adrenal (HPA)/microbiota-gut-brain (MGB) axis normalization. Clinical results indicate that AE significantly improves both metabolic and psychological parameters in patients with T2DM and MD, providing a substantial argument for integrating AE into comprehensive treatment plans. Future research should aim to establish detailed, personalized exercise prescriptions and explore the long-term benefits of AE in this population. This review underscores the potential of AE to complement existing therapeutic modalities and enhance the management of patients with T2DM and MD.
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Affiliation(s)
- Jiaxuan He
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Fan Liu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Peiye Xu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Ting Xu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Haiyang Yu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Baihui Wu
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Hanbing Wang
- Department of Biotechnology, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Jia Chen
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611100, China
| | - Kun Zhang
- Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Junbei Zhang
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Kaikai Meng
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Xiaoqing Yan
- The Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou 325035, China
| | - Qinsi Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
| | - Xingxing Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Da Sun
- Institute of Life Sciences and Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
| | - Xia Chen
- Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu 322000, China
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Yuping Z, Tianbi L, Wentao S, Yun L, Guodong Z. The Optimal Type and Dose of Exercise for Elevating Brain-Derived Neurotrophic Factor Levels in Patients With Depression: A Systematic Review With Pairwise, Network, and Dose-Response Meta-Analyses. Depress Anxiety 2024; 2024:5716755. [PMID: 40226670 PMCID: PMC11919060 DOI: 10.1155/da/5716755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 11/28/2024] [Indexed: 04/15/2025] Open
Abstract
Background: Reduced brain-derived neurotrophic factor (BDNF) levels have been linked to increased depression risk. While physical exercise is known to alleviate depressive symptoms and elevate BDNF levels, the effects of different exercise modalities and doses, along with their dose-response relationships, remain unclear. Objective: This study aims to systematically evaluate the effects of various exercise types and doses on BDNF levels in patients with depression through pairwise meta-analysis, network meta-analysis (NMA), and dose-response NMA and to provide personalized exercise prescription recommendations. Methods: A comprehensive search identified randomized controlled trials (RCTs) examining exercise's impact on BDNF levels in depression. Pairwise and NMA compared six exercise modalities: continuous aerobic exercise (CAE), resistance exercise (RE), combined aerobic and resistance exercise (AERE), yoga, Qigong, and mindfulness. Dose-response NMA was used to assess the relationships between exercise dose and BDNF levels. Results: Thirty-six RCTs with 2515 participants were included. The pairwise meta-analysis indicated that all exercise interventions significantly elevated BDNF levels in patients with depression, with AERE, RE, and yoga demonstrating the most substantial effects. NMA rankings suggested that AERE was the most effective intervention, followed by RE, yoga, Qigong, mindfulness, and CAE. Dose-response NMA revealed a positive nonlinear dose-response relationship between total exercise volume and BDNF levels, with an optimal effective dose identified at ~610 METs-min/week. Beyond 1000 metabolic equivalent of tasks (METs)-min/week, increases in BDNF levels appeared to plateau. Moreover, each exercise type had distinct dose-response patterns, with RE and AERE having relatively higher optimal effective dose ranges, while CAE, yoga, Qigong, and mindfulness exhibited lower optimal ranges. Conclusions: AERE, RE, and yoga are effective interventions for enhancing BDNF levels in patients with depression, with Qigong, mindfulness, and CAE being comparatively less effective. A positive nonlinear dose-response relationship between exercise volume and BDNF levels was observed. Further research is needed to refine dose-response relationships in this population.
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Affiliation(s)
- Zhu Yuping
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing 400715, China
| | - Lei Tianbi
- Department of Physical Education, Sichuan Province Science City Chunlei School, Chengdu 621054, China
| | - Shi Wentao
- College of Physical Education, Southwest University, Chongqing, China
- International College, Krirk University, Bangkok 226002, Thailand
| | - Li Yun
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing 400715, China
| | - Zhang Guodong
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing 400715, China
- International College, Krirk University, Bangkok 226002, Thailand
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26
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Rao P, Agarwal D, Rohatgi S, Chaturvedi S. Pranayama (yogic breathing practices) in Parkinson's disease: protocol for a scoping review of literature. BMJ Open 2024; 14:e092315. [PMID: 39806643 PMCID: PMC11667350 DOI: 10.1136/bmjopen-2024-092315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Accepted: 11/12/2024] [Indexed: 01/16/2025] Open
Abstract
INTRODUCTION Parkinson's disease is a neurodegenerative disorder that presents with motor symptoms such as tremors, slowness and gait difficulties, in addition to various non-motor symptoms such as anxiety, depression and autonomic and sleep disturbances. Pranayama (yogic breathing practices) has been studied as a part of yoga interventions in Parkinson's disease. Previous systematic reviews and meta-analyses have not detailed the pranayama practices used in clinical studies, and there is no clarity on the pranayama practices that would be most beneficial for Parkinson's disease. This scoping review aims to map the available scientific evidence on the effect of pranayama interventions for Parkinson's disease and identify the potential gaps in the literature. METHODS AND ANALYSIS A literature search will be conducted in major databases (JBI evidence synthesis, MEDLINE, Cochrane Library, including Cochrane Complimentary Medicine, and Scopus) from 1990 to date. Relevant grey literature will be searched. Two independent reviewers will initially review the extracted articles and will be further adjudicated by two independent reviewers. Data management will be done using Rayyan software throughout the review. Data extracted will include specific details of the population, concept, context and study methods specific to the scoping review objectives. The extracted data will be presented in tabular/diagrammatic form, reporting on items aligning with the review objectives, such as details of the pranayama intervention and its clinical outcomes. A narrative summary will accompany the tabulated results, identifying the gaps in evidence and areas for future research. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review. The findings will be disseminated through publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER Protocol Registration in Open Science Framework - https://osf.io/jdwga/?view_only=82aa5afd46974416a402fa1a0ac39fce.
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Affiliation(s)
- Prajwal Rao
- Neurology, Dr D Y Patil Vidyapeeth, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
| | - Dhiraj Agarwal
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Shalesh Rohatgi
- Neurology, Dr D Y Patil Vidyapeeth, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
| | - Sarika Chaturvedi
- Dr D Y Patil Vidyapeeth, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
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27
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Guo X, Le Y. The triangular relationship of physical activity, depression, and inflammatory markers: A large cross-sectional analysis with NHANES data. J Affect Disord 2024; 367:589-597. [PMID: 39236891 DOI: 10.1016/j.jad.2024.09.008] [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] [Received: 03/06/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 09/07/2024]
Abstract
Depression is a major public health problem worldwide and is closely related with systemic inflammatory responses. Additionly, physical activity (PA) is thought to be associated with lower levels of depression and inflammatory markers. This study aimed to elucidate the complex interactions between PA, depression, and inflammatory markers. Based on the National Health and Nutrition Examination Survey (NHANES), various logistic regression were applied to analyze the pairwise correlations among the three. Restrictive cubic splines were constructed to explore the nonlinear relationship between PA and depression. Mediation models were used to identify the mediating role of inflammatory markers. The findings revealed a positive link between depression and inflammatory marker, whereas PA was inversely correlated with both inflammatory marker and depression. Particularly, we noticed the greatest reduction in the risk of depression when the level of PA was between 1200 and 1722 MET-min/week. Besides, we demonstrated that inflammatory markers mediate the potential effects of physical inactivity on depression, ranging from 1.72 % to 6.25 %. In conclusion, PA appear to protect against depression, in which inflammatory markers may play a mediating role. Moreover, we determined the optimal dosage of PA to minimize the likelihood of depression, thereby offering valuable guidance for managing depression.
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Affiliation(s)
- Xinrong Guo
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, No.138, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Yuan Le
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, No.138, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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Zhu B, Liu Q, Jia S, Wang X, Man Q. The relationship between physical exercise and depressive symptoms in college students: the mediating role of rumination. Front Psychiatry 2024; 15:1501996. [PMID: 39703454 PMCID: PMC11655475 DOI: 10.3389/fpsyt.2024.1501996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 11/12/2024] [Indexed: 12/21/2024] Open
Abstract
Objective This study aims to explore the correlation between physical exercise, rumination, and depressive symptoms in college students, as well as to investigate the potential pathways through which physical exercise may impact depressive symptoms. This exploration offers valuable insights for the development of clinical exercise interventions. Methods A cross-sectional study design was employed, with 2,902 participants recruited via convenience sampling. Structural equation modeling was utilized to explore the relationship between physical exercise and depressive symptoms in college students. Results 1) Statistically significant differences were observed between depressed and non-depressed college students in terms of rumination, symptom rumination, reflective pondering, and compulsive meditation (all P < 0.05); 2) Physical exercise was found to negatively predict symptom rumination (B=-0.083, P<0.001), compulsive thinking (B=0.034, P>0.05), reflective pondering (B=-0.038, P<0.01), and BDI-II scores (B=-0.103, P<0.001). Symptom rumination positively predicted BDI-II scores (B=0.648, P<0.001), while compulsive thinking and reflective pondering were found to predict BDI-II scores positively (B=0.028, P>0.05) and negatively (B=-0.041, P>0.05), respectively. 3) Physical exercise exerted a direct effect of 59.09% on BDI-II scores (B: -0.065, 95% CI -0.104, -0.028), indicating that higher levels of physical exercise were associated with lower BDI-II scores. The coefficients for duration, intensity, and frequency were statistically significant (all P < 0.05), with intensity and frequency exhibiting higher path coefficients. Rumination, as a latent variable, mediated 40.91% of the indirect effect (B: -0.045, 95% CI -0.077, -0.015), with symptom rumination emerging as a statistically significant pathway (P < 0.05). Conclusion Rumination may mediate the relationship between physical exercise and depressive symptoms, with varying mediating effects across different dimensions of rumination. The intensity and duration of physical exercise exert a stronger influence.
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Affiliation(s)
- Bei Zhu
- China College of teacher education, East China Normal University, Shanghai, China
| | - Qing Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Shuqi Jia
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Xing Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Qin Man
- School of Sports and Health, Shanghai Linxin Accounting and Finance University, Shanghai, China
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Costa V, Prati JM, de Oliveira Barreto Suassuna A, Souza Silva Brito T, Frigo da Rocha T, Gianlorenço AC. Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis. J Geriatr Psychiatry Neurol 2024; 37:415-435. [PMID: 38445606 DOI: 10.1177/08919887241237223] [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: 03/07/2024]
Abstract
BACKGROUND Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD. METHODS Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate. RESULTS Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety. CONCLUSION Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.
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Affiliation(s)
- Valton Costa
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - José Mario Prati
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Alice de Oliveira Barreto Suassuna
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Federal University of Uberlandia, Uberlandia, Brazil
| | - Thanielle Souza Silva Brito
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Thalita Frigo da Rocha
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Anna Carolyna Gianlorenço
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
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Sripunya P, Wongpakaran T, Wongpakaran N. The Relationship Between Feelings of Emptiness and Self-Harm Among Thai Patients Exhibiting Borderline Personality Disorder Symptoms: The Mediating Role of the Inner Strengths. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1776. [PMID: 39596961 PMCID: PMC11596335 DOI: 10.3390/medicina60111776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/25/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024]
Abstract
Background and Objectives: Fifty percent of individuals with borderline personality disorder (BPD) experience self-harm. One of the crucial factors related to self-harm is feelings of emptiness. While inner strengths, such as the Five Precepts, meditation, and equanimity, have been identified as potential buffers against negative mental health outcomes in BPD, their role in mediating the relationship between feelings of emptiness and self-harm is not well-documented. This study aimed to explore how these inner strengths mediate the relationship between feelings of emptiness and self-harm in individuals exhibiting BPD symptoms. Materials and Methods: A total of 302 Thai participants exhibiting BPD symptoms completed several assessments: the SCID-II Personality Disorder Questionnaire for BPD to assess feelings of emptiness and self-harm, the Inner-Strength-Based Inventory (i-SBI) to evaluate the Five Precepts, meditation, and equanimity, and the Outcome Inventory Depression (OI-Depression) to assess depression. Mean and standard deviation were used for continuous variables, such as age and OI-Depression. A t-test assessed mean differences in continuous variables between the self-harm group and the non-self-harm group. Chi-square tests examined differences in categorical variables with three or more levels, such as education. Pearson's correlation and linear regression analyzed relationships between continuous variables, including i-SBI and OI-Depression scores. Mediation analysis was performed using IBM SPSS and AMOS, with self-harm as the outcome variable, feelings of emptiness as the predictor, and inner strengths as mediators. Results: The participants had a mean age of 36.56, with 65.4% being female. The analysis showed that the Five Precepts, meditation, and equanimity significantly mediated the relationship between feelings of emptiness and self-harm, with a standardized coefficient of β = 0.534 (95% CI = 0.417 to 0.647, p < 0.001). The indirect effect of feelings of emptiness through these inner strengths was significant (β = 0.034, 95% CI = 0.009 to 0.075, p = 0.005). The mediation model explained 38% of the variance in self-harm with a 3% increase, albeit small but significant. Conclusions: This study highlights that inner strengths negatively mediate the relationship between feelings of emptiness and self-harm, indicating that as these inner strengths increase, the direct impact of feelings of emptiness on self-harm decreases. These findings suggest that targeting inner strengths as protective factors could be a valuable strategy in developing interventions aimed at reducing self-harm by addressing the underlying emotional challenges associated with BPD.
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Affiliation(s)
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (P.S.); (N.W.)
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Fishel SC, Hotchkiss ME, McNamara CA, Sevilla KM, Brown SA. Effect of group virtual exercise on people with Parkinson's disease: A randomized controlled trial. Physiother Theory Pract 2024:1-11. [PMID: 39462296 DOI: 10.1080/09593985.2024.2420015] [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: 06/21/2024] [Revised: 10/04/2024] [Accepted: 10/04/2024] [Indexed: 10/29/2024]
Abstract
BACKGROUND For people with Parkinson's disease (PwPD), high-intensity exercise in individual or group format can improve function and quality of life (QoL). Individualized virtual exercise programs have been effective for people with PD, but the feasibility and impact of group exercise in the virtual format has not been investigated. PURPOSE To compare the effect of individual and group virtual exercise on functional mobility and QoL for PwPD. METHODS Twenty PwPD were randomized to individualized (n = 10) or group (n = 10) virtual exercise 2 times per week for 8 weeks. Exercises were multi-dimensional, and intensity was monitored with a wrist-worn heart rate (HR) monitor. Outcomes were assessed before and after the program, including standing balance, gait speed, gait endurance, motor function, QoL, and self-efficacy. Within-and between-group changes were analyzed using a mixed model analysis of variance (ANOVA) and nonparametric tests were used for analysis. RESULTS Participants attended over 75% of scheduled sessions. Within-group analysis showed statistically significant improvements in Five Times Sit-to-Stand (p < .01), mini-BESTest (p = .03), comfortable (p < .01) and fast gait speeds (p = .02), and gait endurance (p < .01) with large effect sizes (partial eta squared > 0.25). There were no statistically significant differences between groups on any outcomes (p > .09). In more than 70% of sessions, participants reached an exercise intensity ≥ 65% HR maximum. CONCLUSION This high-intensity, virtual exercise program was safe and effective at improving balance and functional mobility for community-dwelling PwPD in individual and group format. Virtual exercise programs, either in an individual or group format, can increase access to high-quality programs for PwPD.
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Affiliation(s)
- Sarah C Fishel
- Department of Physical Therapy, Ithaca College, Ithaca, NY, USA
- Department of Health Sciences, Rocky Mountain University of Health Professions, Provo, UT, USA
| | | | | | - Kaitlyn M Sevilla
- Department of Physical Therapy and Rehabilitation, Rochester Regional Health at Unity Hospital, Rochester, NY, USA
| | - Samantha A Brown
- Department of Physical Therapy, Sargent College, Boston University, Boston, MA, USA
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Chen X, Chen L, Chen X, Ye Q, Cai G, Zeng Y. Assessing the impact of immersive virtual reality technology on the psychological recovery of patients with Parkinson's disease depression: study protocol of a randomized controlled trial. Trials 2024; 25:715. [PMID: 39456018 PMCID: PMC11515453 DOI: 10.1186/s13063-024-08552-5] [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: 01/30/2024] [Accepted: 10/14/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND AND AIM Depression in Parkinson's disease (DPD) has a high incidence rate among patients with Parkinson's disease (PD). It is a common nonmotor symptom of PD that seriously affects the quality of life of patients. Thus, improving DPD is important for improving the quality of life of patients. Psychotherapy for depression is limited for many reasons, and only a few patients are able to benefit from this therapy. Several studies have demonstrated that relaxation therapy, playing, and exercise therapy are effective treatments for depression. In recent years, virtual reality (VR) has rapidly developed as a form of rehabilitation due to its immersive characteristics and accessibility. It has also been applied in the psychological treatment of phobia and anxiety. However, no relevant research on the treatment of DPD has been conducted using VR. This study aims to assess the effects of immersive VR-assisted training on patients with DPD. METHODS This single-blind randomized controlled trial will recruit 74 patients with DPD. The patients will then be randomly allocated into two groups. The patients in the VR group (n = 37) will receive VR-assisted training (40 min) three times a week for 8 weeks. The patients in the non-VR training group (n = 37) will receive treatment as usual. The outcome measures will be assessed before intervention, and after 8 weeks, 3 months, and 6 months of the intervention. The primary outcomes will include the Hamilton Depression Scale-24. The secondary outcomes will include the 36-Item Short-Form Health Survey questionnaire, neuroinflammation factors (brain-derived neurotrophic factor, interleukin-6, and C-reactive protein), and functional magnetic resonance imaging. DISCUSSION The traditional treatment of depression has limited resources and requires a lot of time and energy. It is not suitable for patients with PD having mobility difficulties and residing in remote areas. VR can make up for limitations in traditional treatment methods. An advantage of VR is that it makes patients more invested in active participation. This study may provide an improved method for the clinical treatment of patients with DPD, which is suitable for clinical decision-making and future practice. TRIAL REGISTRATION The study has been registered in the Chinese Clinical Trial Registry ChiCTR2200065843, November 16, 2022. https://www.chictr.org.cn/showproj.html?proj=174551 {2a and 2b}.
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Affiliation(s)
- Xinyan Chen
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
- Department of Neurology Nursing, Fujian Medecal University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
| | - Lina Chen
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
| | - Xiaochun Chen
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
| | - Qinyong Ye
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China
| | - Guoen Cai
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
| | - Yuqi Zeng
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
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Blard F, Erraud J, Bonnet M, Auzou N, Tison F. Mindfulness in Parkinson's disease: A French national survey and a pilot intervention feasibility trial using the MBSR program (M-Park). Rev Neurol (Paris) 2024; 180:777-790. [PMID: 38749789 DOI: 10.1016/j.neurol.2024.03.013] [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: 07/04/2023] [Revised: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 10/15/2024]
Abstract
BACKGROUND Non-pharmacological complementary interventions, particularly mind-body practices, are of growing importance in the management of Parkinson's disease (PD). Among these, mindfulness meditation seems particularly effective, especially on anxiety and depression symptoms. However, current knowledge on mindfulness standardized programs in PD is still limited, particularly in France. Aiming at improving this knowledge we designed the M-PARK study in two phases. Phase 1 consisted in a French national survey to explore expectations, needs and initiatives for mindfulness meditation for PD patients. Phase 2 was a clinical trial with objectives to assess feasibility, acceptability and effects of a mindfulness (MBSR) program proposed to PD patients. METHODS In phase 1, online questionnaires were addressed to members of a French PD patient's association (France Parkinson) and French MBSR qualified instructors. In Phase 2, a clinical trial involving 30 PD patients consisted of a standard MBSR program with two additional evaluation visits one month before and after the program. Data collection included a global clinical evaluation, assessment of depression and anxiety symptoms, sleep, pain and quality of life and a face-to-face interview for qualitative assessment of the acceptability and lived experience during the program. Three MBSR programs were proposed to three groups of ten patients: two were online due to the pandemic situation, one proposed to patients with no or minor fluctuations (group 1) and one for patients with slight to moderate fluctuations (group 2), and the last one face-to-face for patients with no or minor fluctuations (group 3). RESULTS French survey: 209 responses were collected for the questionnaire sent to the members of the association France Parkinson; and 68 for the questionnaire sent to the instructors. Two-thirds of patients surveyed had heard of mindfulness meditation (66%), but were unaware of what this approach really consisted and how it could really help them. Few instructors (29%) had had to deal with patients with PD in their current practice. Yet 90% of patients surveyed indicated they were in favor of introducing this type of approach into their care. CLINICAL TRIAL The results indicated that the program is feasible and acceptable both online and face-to-face for patients with PD. Among the 30 patients enrolled, 25 completed the program. No unwanted effects related to mindfulness meditation practice were observed. The results showed a statistically significant reduction in anxiety symptoms, depressive symptoms, and improvement in quality of life. Furthermore, no statistically significant change was measured for pain or sleep quality. There was no striking difference in results observed between the patient groups. For the qualitative analysis, major themes highlighted were in relation with: (i) the lived experience during program; (ii) changes in the daily life; and (iii) disease-related changes. A large majority of patients who completed the program (24/25) described their participation as positive or very positive. They reported better management of stress and emotions, as well as greater autonomy in implementing new behavioral strategies, particularly in terms of self-care, acceptance, and de-identification from the disease. CONCLUSION Despite high expectations, PD patients are poorly informed about available mindfulness programs. This study however shows that these programs, whether offered online or face-to-face, are particularly beneficial, especially for anxiety and depressive symptoms, at least in mild-to-moderate stages of the disease.
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Affiliation(s)
- F Blard
- Institut des Maladies Neurodégénératives, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France; Institut de Médecine Intégrative et Complémentaire, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - J Erraud
- Institut des Maladies Neurodégénératives, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France; Centre d'Excellence sur les Maladies Neurodégénératives "Bordeaux Initiative for Neurodegenerative Disorders", CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - M Bonnet
- Institut des Maladies Neurodégénératives, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - N Auzou
- Institut des Maladies Neurodégénératives, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - F Tison
- Institut des Maladies Neurodégénératives, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France; Institut de Médecine Intégrative et Complémentaire, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France; Centre d'Excellence sur les Maladies Neurodégénératives "Bordeaux Initiative for Neurodegenerative Disorders", CHU de Bordeaux, Université de Bordeaux, Bordeaux, France.
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Tian J, Kong Q, Yu H, Liu P, Shen L, Luo Y. Comparative Efficacy of Acute Exercise Intervention on Anxiety in Adolescents and Young Adults: A Network Meta-Analysis. Scand J Med Sci Sports 2024; 34:e14735. [PMID: 39317982 DOI: 10.1111/sms.14735] [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: 11/17/2023] [Revised: 09/02/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024]
Abstract
Acute exercise is a promising non-pharmacological therapy for alleviating anxiety. However, the effects of different types of acute exercise on anxiety in adolescents and young adults remain unclear. Therefore, our study aims to conduct a network meta-analysis to compare the effectiveness of various exercise interventions in improving anxiety in adolescents and young adults. We conducted an online literature search in five databases: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO. The search was conducted from inception to March 1, 2023, and was limited to English-language publications. Pairwise and network meta-analyses were performed using random-effects models. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was applied to rate the certainty of evidence. A total of 33 studies involving 1121 participants were included. The network meta-analysis results revealed that mind-body exercise was the most effective intervention for reducing anxiety in adolescents and young adults (SMD = -0.36, 95% CI: -0.70, -0.03, moderate certainty). Additionally, aerobic exercise (SMD = -0.16, 95% CI: -0.28, -0.03, high certainty) showed significant reduction in anxiety, while resistance exercise (SMD = -0.09, 95% CI: -0.33, 0.14, moderate certainty) and multicomponent exercise (SMD = -0.01, 95% CI: -0.59, 0.57, moderate certainty) did not show significant reduction in anxiety. Moderate certainty evidence suggests that acute mind-body exercise may be the most effective type of exercise for reducing anxiety in adolescents and young adults. Future research should focus on conducting more multi-arm randomized controlled trials to provide more direct evidence on the relative effectiveness of different exercise interventions.
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Affiliation(s)
- Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Qingtao Kong
- Department of Physical Education and Sports, Shanghai Ocean University, Shanghai, China
| | - Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Peifeng Liu
- Department of Physical Education, Central South University, Changsha, China
| | - Liqun Shen
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Luo
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Wu X, Shi M, Lian Y, Zhang H. Cognitive behavioral therapy approaches to the improvement of mental health in Parkinson's disease patients: a systematic review and meta-analysis. BMC Neurol 2024; 24:352. [PMID: 39300337 PMCID: PMC11411832 DOI: 10.1186/s12883-024-03859-x] [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: 02/25/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Non-motor symptoms (NMS) such as impaired cognition, anxiety, and depression can have a strong adverse effect on the quality of life (QoL) of Parkinson's disease (PD) patients. The clinical application of cognitive behavioral therapy (CBT) offers an opportunity to improve cognitive function, mental health, and overall QoL for these patients. OBJECTIVE CBT is frequently applied as a treatment option aimed at benefiting the mental health of PD patients, but the relative utility of CBT in this patient population has yet to be rigorously assessed. The present review was thus conducted with the goal of examining the relative safety and efficacy of CBT as a treatment option for PD patients suffering from cognitive impairment, anxiety, and depression, with a particular focus on the impact of CBT on PD patient QoL. METHODS The PubMed, Embase, Medline, and Cochrane Library databases were searched for all studies published from their inception to present using keywords including "cognitive behavioral therapy" and "Parkinson's disease". Two reviewers independently screened these published studies and extracted relevant data from studies that met with defined inclusion/exclusion criteria, in addition to assessing the risk of bias. Those randomized controlled trials (RCTs) assessing the impact of CBT on older PD patients were eligible for study inclusion. In total, 22 articles incorporating 1,053 patients were included in this meta-analysis. Study quality was examined as per the Cochrane risk of bias framework. Heterogeneity and associated outcomes were assessed based on mean difference (MD), I2, and 95% confidence interval (95%CI) values. RESULTS In total, 22 RCTs were ultimately found to be eligible for inclusion in the present meta-analysis. The results of this meta-analysis indicated that CBT significantly impacted cognition as compared to other treatment options (including placebo treatment, clinical monitoring, clinic-based treatment, psychoeducation, physical activity training, health enhancement) (I2 = 49%, MD = 0.23, 95%CI: 0.03-0.44, P = 0.03). CBT was also associated with significant improvements in PD patient QoL (I2 = 0%, MD = 3.45, 95%CI: 1.13-5.57, P = 0.04), anxiety symptoms (I2 = 57%, MD = -2.01, 95%CI: -4.01-0.01, P = 0.05), and depression symptoms (I2 = 74%, MD = -3.94, 95%CI: -6.47 to -1.42, P = 0.04). CONCLUSIONS These results reveal that CBT can have beneficial effects on PD patient cognitive status and QoL. Notably, CBT represents an effective option for treating NMS such as anxiety and depression in PD patients. These results offer strong evidence in favor of applying CBT as a means of enhancing the mental health, cognition, and QoL of individuals with PD. However, additional high-quality large-scale studies will be essential to confirm and expand upon these results.
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Affiliation(s)
- Xiaoke Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Mengmeng Shi
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
| | - Haifeng Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
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HongFei Z, Li Z, Liang L, Ru GW, Yi HL, Zhen W. Current interventional model for movement in Parkinson's disease: network meta-analysis based on the improvement of motor ability. Front Aging Neurosci 2024; 16:1431277. [PMID: 39318860 PMCID: PMC11419980 DOI: 10.3389/fnagi.2024.1431277] [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: 05/11/2024] [Accepted: 08/26/2024] [Indexed: 09/26/2024] Open
Abstract
Aim To identify optimally therapeutic exercise interventions for improving motor ability among patients with Parkinson's disease (PD), we conducted a network meta-analysis (NMA) of randomized controlled trials comparing different exercise regimens. Methods Relevant RCTs were retrieved by searching PubMed, Embase, Cochrane, Web of Science, CINAHL, CBM, China National Knowledge Infrastructure (CNKI), Wan fang, VIP, and other databases from inception to July 9, 2023 is available in English as the primary language. Exercise outcomes as measured by Movement Disorder Society- Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) score change were evaluated and ranked using STATA software version 18.0. All included studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Results The final NMA included 71 studies involving 3,732 participants, 87 intervention experiments, and 27distinct interventions. Although most exercise interventions showed some efficacy (reducing MDS-UPDRS-III score), cumulative ranking probability surface (SUCRA) values indicated that the best exercise interventions for motor function improvement were archery (95.6%), riding a bicycle (80.9%), and binary rhythm dance (80.8%). Conclusion An exercise intervention comprising archery, cycling, and(or) binary rhythm dance may yield superior improvements in motor function among patients with Parkinson's disease.
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Affiliation(s)
- Zhao HongFei
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Zhang Li
- Xiamen Medical College, Xiamen, China
| | - Li Liang
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Guo Wan Ru
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Huang Lan Yi
- School of Psychology, Shanghai Sport University, Shanghai, China
| | - Wang Zhen
- Wushu College, Shanghai Sport University, Shanghai, China
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Zhao H, Zhang L, Yang J, Guo W, Sun C, Shi R, Wang Z. Parkinson's disease motor intervention patterns: a network meta-analysis based on patient motor function. Front Neurol 2024; 15:1432256. [PMID: 39314864 PMCID: PMC11418397 DOI: 10.3389/fneur.2024.1432256] [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: 05/13/2024] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Background Parkinson's disease is characterized by symptoms such as bradykinesia and rigidity, which worsen as the disease progresses, significantly impacting patients' independence and quality of life. This study utilizes a network meta-analysis approach to quantify information gathered from randomized controlled trials (RCTs) regarding motor interventions that effectively improve the motor function of Parkinson's disease patients, aiming to provide evidence for selecting appropriate exercise intervention strategies for patients. Methods A systematic search strategy for randomized controlled trials (RCTs) restricted to English was constructed based on multiple biomedical databases. Databases searched included PubMed, Embase, Cochrane, Web of Science, CINAHL, CBM, China National Knowledge Infrastructure (CNKI), Wan fang, VIP, etc., with searches conducted from inception to July 9, 2023. Two authors screened all studies, extracted data, and used frequency domain analysis methods. Network meta-analysis was performed using STATA software version 18.0 to compare and rank exercises that could effectively improve the motor function of Parkinson's disease patients (measured by indicators such as MDS-UPDRS-III, TUG, BBS, Mini-BES Test, 6MWT scores). Additionally, a series of analyses and evaluations were conducted, such as assessing the methodological quality of included studies using the Cochrane risk of bias tool. Results The network meta-analysis included a total of 111 studies involving 5,358 participants, 133 intervention experiments, and 31 intervention measures. Although most exercise interventions showed effectiveness, cumulative ranking curves under the surface (SUCRA) values showed that archery exercise significantly improved patients' MDS-UPDRS-III scores (SUCRA = 95.6%), significantly superior to routine care [standardized mean difference (SMD = 16.92, 95%CI = -28.97, -4.87)]. High-intensity and agility exercise (High strength and agility) referred to as high-intensity exercise or agility training or a combination of both, collectively termed as high-intensity agility training, significantly improved patients' completion time for the time-up-and-go test (SUCRA = 99.7%), (SMD = -7.88, 95%CI = -9.47, -6.28). Dance and Tai Chi exercises significantly improved patients' balance abilities: Mini-Balance Evaluation Systems Test (SUCRA = 77.9%), (SMD = 5.25, 95%CI = -0.42, 10.92) for dance intervention and Berg Balance Scale (SUCRA = 94.7%), (SMD = 11.22, 95%CI = 3.26, 19.18) for Tai Chi intervention. Dance also significantly improved patients' walking ability in the 6-min walk test (SUCRA = 80.5%), (SMD = 71.31, 95%CI = 13.77, 128.84). Conclusion Compared to other exercises, archery, dance, Tai Chi, and high-intensity agility exercises demonstrate superior efficacy in improving the motor function of Parkinson's disease patients.
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Affiliation(s)
- Hongfei Zhao
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Li Zhang
- Xiamen Medical College, Xiamen, Fujian, China
| | - Jingling Yang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wanru Guo
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Chunyang Sun
- School of Exercise and Health, Shanghai Sport University, Shanghai, China
| | - Runbo Shi
- Wushu College, Shanghai Sport University, Shanghai, China
| | - Zhen Wang
- Wushu College, Shanghai Sport University, Shanghai, China
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Li D, Mohanty S, Mavathur R, Vageesh VY, Jain A, Gopi A, Raghuram N. Study Protocol for Mindfulness-Based Yoga Versus Physical Exercise on the Psychological Well-Being in Students With Early Visual Impairment: A Three-Armed, Multi-Centered, Randomized Controlled Trial. Cureus 2024; 16:e69240. [PMID: 39398856 PMCID: PMC11470265 DOI: 10.7759/cureus.69240] [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] [Accepted: 09/11/2024] [Indexed: 10/15/2024] Open
Abstract
Background People with visual impairment (VI) tend to face more psychological distress than normally sighted individuals due to mobility restrictions, fear of falling, and sleep disturbances. However, research to address these problems is rare. This study aims to investigate the effect of mindfulness-based yoga versus physical exercise on the psychological well-being of individuals with VI. Methods This study will be a single-blinded, three-armed, multicentered, randomized controlled trial (RCT). A total of 132 participants with VI (ages 15-25) will be recruited in the study and will be randomly assigned to either group 1 (mindfulness-based yoga), group 2 (physical exercise), or group 3 (wait-list control). Groups 1 and 2 will receive intervention for 40 hours (eight weeks, weekly five days, one hour/day), whereas group 3 will continue their daily activities as usual. The intervention will take place in the afternoon from Monday to Friday. The timing varies between 4-5 pm according to the different time schedules of the institutions of the blind. Three times, assessments will be conducted at T0 (baseline), T1 (eighth week at the completion of the intervention), and T2 (sixth month following the completion of the intervention). ANOVA will be used to find out the differences between groups; repeated measures ANOVA will be used to check within-group changes. Trial status The study was first screened in December 2021. The recruitment of participants has been completed in two centers covering 62 individuals with VI, and intervention started in August 2022. The data collection is still ongoing due to the nature of the study design, a specific demographic, complex logistics, and administrative bottlenecks. The study incorporates three different groups and a substantial sample size (n=132). The specific demographic, people with visual impairments, are rare and difficult to locate. In addition, a six-month follow-up assessment contributes to complex procedures while coordinating between various institutions and securing necessary authorizations. Discussion This study will be the first comprehensive RCT to investigate the psychological well-being of the VI population with various psychophysiological and hormonal parameters in multiple centers. The presence of physical exercise and a wait-list control group will further elucidate the potential mechanism of Mindfulness-based yoga. Mindfulness-based yoga can be integrated into educational and rehabilitation systems to enhance the well-being of individuals with VI.
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Affiliation(s)
- Danqing Li
- Yoga and Humanity Division, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Bangalore, IND
| | - Soubhagyalaxmi Mohanty
- Yoga and Humanity Division, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Bangalore, IND
| | - Ramesh Mavathur
- Yoga and Life Science Division, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Bangalore, IND
| | - Vijaya Y Vageesh
- Physiology, Jagadguru Sri Shivarathreeshwara (JSS) Medical College and Hospital, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research, Mysore, IND
| | - Anup Jain
- Yoga and Humanity Division, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Bangalore, IND
| | - Arun Gopi
- Community Medicine, Jagadguru Sri Shivarathreeshwara (JSS) Medical College and Hospital, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research, Mysore, IND
| | - Nagarathna Raghuram
- Preventive Medicine, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Bangalore, IND
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Li Y, Luo X, Zhang A, Ying F, Wang J, Huang G. The potential of arts therapies in Parkinson's disease rehabilitation: A comprehensive review. Heliyon 2024; 10:e35765. [PMID: 39229526 PMCID: PMC11369473 DOI: 10.1016/j.heliyon.2024.e35765] [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: 04/22/2024] [Revised: 07/02/2024] [Accepted: 08/02/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND AND PURPOSE Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies. METHODS This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD. RESULTS From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively. CONCLUSION The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities.
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Affiliation(s)
- Yiyuan Li
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Aijia Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Fangtian Ying
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Zhejiang University, Hangzhou, 310027, China
| | - Jue Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, Guangdong, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Zhuhai M.U.S.T. Science and Technology Research Institute, Zhuhai, Guangdong, China
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Nakayama N, Kono A, Moriwaki Y, Niihara M, Aizawa R, Ookabe S, Kita E, Kaneko H. Improved Sympathetic Activity With Short-Term Effects of Yoga in Young Adults. Holist Nurs Pract 2024:00004650-990000000-00047. [PMID: 39212538 DOI: 10.1097/hnp.0000000000000675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
The purpose of this study was to clarify the heart rate variability (HRV) transition after a single yoga program. Participants were 22 females who were healthy university students and had never practiced yoga before. They practiced yoga while recording their HRV. Heart rate (HR), high frequency (HF; 0.15-0.4 Hz) as parasympathetic and low frequency (LF; 0.04-0.15 Hz) components were extracted, and then the LF/HF ratio as sympathetic and normalized units of HF HFnu = HF/(LF + HF) as parasympathetic modulation in autonomic activity were calculated. HR and HRV indices after yoga were divided into four 5-minute periods (after 5, 10, 15, and 20 minutes) and compared before yoga. HR and LF/HF at all periods after yoga were significantly lower than before yoga (P < .01, all). HF after yoga was not significantly changed, but HFnu after 5, 10, and 15 minutes was significantly higher than before yoga (P < .01, <.01, and =.02, respectively). The short-term effects of yoga on HRV implied a decrease in sympathetic modulation and a relative increase in parasympathetic modulation. Therefore, yoga may be used as a fast-acting alternative therapy to significantly improve sympathetic activity.
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Affiliation(s)
- Natsuki Nakayama
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan (Dr Nakayama, Ms Kono, Ms Moriwaki, Ms Niihara, and Mr Ookabe); Department of Nursing, Nagoya University Hospital, Nagoya, Japan (Ms Aizawa); Department of Nursing, Mie University, Tsu, Japan (Ms Kita); and Department of Internal Medicine, Hosigaoka Maternity Hospital, Nagoya, Japan (Dr Kaneko)
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Li W, Liu Y, Deng J, Wang T. Influence of aerobic exercise on depression in young people: a meta-analysis. BMC Psychiatry 2024; 24:571. [PMID: 39164715 PMCID: PMC11337568 DOI: 10.1186/s12888-024-06013-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 08/09/2024] [Indexed: 08/22/2024] Open
Abstract
OBJECTIVE To investigate the influence of aerobic exercise on depression among the young people. DATA SOURCES PubMed, Web of science, Embase, Cochrane, EBSCO were searched from inception to November 2023. STUDY SELECTION RCT studies, assessing the use of aerobic exercise in young people aged 6-35 years and then determining the development of depression in young people (aged 6-35 years), were selected, and mean ± SD values adjusted for the presence of baseline depression were extracted. DATA EXTRACTION AND SYNTHESIS Study quality was assessed using the Review manager 5.4.1 and Cochrane 5.1 item on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES The included studies evaluated the relationship between aerobic exercise and depression at various time points among young individuals, and provided corresponding mean ± SD values. Depression diagnosis in the selected studies was conducted using the Depression Correlation Scale. RESULTS After screening 2296 articles, 163 articles were selected for full-text review, and 8 of those were further reviewed. Ultimately, 12 studies, involving 658 individuals, were included in the meta-analysis. The results of the meta-analysis indicated that aerobic exercise could effectively improve depression in young people (d = -1.33, 95%CI: -1.78 ~ -0.87, P < 0.05). Subgroup analysis demonstrated that aerobic exercise was beneficial for both depression (d = -2.68, 95%CI: -3.87 ~ -1.48, P < 0.05) and non-depression (d = -0.85, 95%CI: -1.20 ~ -0.51, P < 0.05) conditions, as well as for low intensity (d = -0.93, 95%CI: -1.29 ~ 0.58, P < 0.05) and moderate intensity (d = -2.08,95%CI:-2.88 ~ -1.27, P < 0.05) exercises. Additionally, aerobic exercise was found to significantly alleviate depression in young people when performed for 40 min or less (d = -2.00,95%CI: -2.96 ~ -1.04, P < 0.05), whereas durations exceeding 40 min showed a lesser effect (d = -0.85,95%CI:-1.47 ~ -0.24, P < 0.05). Furthermore, the duration-based analysis revealed that aerobic exercise improved depression levels in young people regardless of duration, whether it was for less than 6 weeks (d = -1.27,95%CI: 2.12 ~ 0.14, P < 0.05), 6 to 11 weeks (d = 1.55, 95% CI: 2.16 ~ 0.94, P < 0.05), or more than 12 weeks (d = 1.00, 95% CI: -1.76 ~ -0.24,P < 0.05). Overall, these findings suggest that aerobic exercise is a promising intervention for alleviating depression in young individuals. CONCLUSIONS Both short (less than 40 min) and long (more than 40 min) periods of aerobic exercise were effective in improving depressive symptoms. However, the optimal duration of aerobic exercise may vary depending on the specific population and individual factors studied, such as age, health status, and exercise tolerance. Therefore, this study concluded that the most effective exercise regimen, 40 min of moderate-intensity aerobic exercise three times a week for 6 to 11 weeks, showed more significant improvement in depression indicators in individuals with depressive symptoms.
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Affiliation(s)
- Weicheng Li
- School of Sports Training, Chengdu Sport University, Chengdu, 610041, Sichuan, China
| | - Yongfeng Liu
- School of Sports Training, Chengdu Sport University, Chengdu, 610041, Sichuan, China.
| | - Jiaxin Deng
- School of Sports Training, Chengdu Sport University, Chengdu, 610041, Sichuan, China
| | - Tong Wang
- School of Sports Training, Chengdu Sport University, Chengdu, 610041, Sichuan, China
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Kim R, Choi S, Kang N, Park K, Shin H, Lee H, Lee H, Jun JS, Jeon B, Byun K. Effects of high-intensity interval training and moderate-intensity continuous training on non-motor symptoms in patients with Parkinson's disease: a randomised pilot trial. J Neurol Neurosurg Psychiatry 2024; 95:886-888. [PMID: 38548325 DOI: 10.1136/jnnp-2023-331990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 03/20/2024] [Indexed: 04/07/2024]
Affiliation(s)
- Ryul Kim
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Seohee Choi
- Department of Neurology, Inha University Hospital, Incheon, Korea (the Republic of)
| | - Nyeonju Kang
- Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
| | - Kiwon Park
- Department of Biomedical and Robotics Engineering, Incheon National University, Incheon, Korea (the Republic of)
| | - Heehyun Shin
- Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
| | - Hanall Lee
- Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
| | - Hyungwoo Lee
- Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea (the Republic of)
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Kyeongho Byun
- Division of Sport Science, Incheon National University, Incheon, Korea (the Republic of)
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Li X, Qu X, Shi K, Yang Y, Sun J. Physical exercise for brain plasticity promotion an overview of the underlying oscillatory mechanism. Front Neurosci 2024; 18:1440975. [PMID: 39176382 PMCID: PMC11338794 DOI: 10.3389/fnins.2024.1440975] [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: 05/30/2024] [Accepted: 07/26/2024] [Indexed: 08/24/2024] Open
Abstract
The global recognition of the importance of physical exercise (PE) for human health has resulted in increased research on its effects on cortical activity. Neural oscillations, which are prominent features of brain activity, serve as crucial indicators for studying the effects of PE on brain function. Existing studies support the idea that PE modifies various types of neural oscillations. While EEG-related literature in exercise science exists, a comprehensive review of the effects of exercise specifically in healthy populations has not yet been conducted. Given the demonstrated influence of exercise on neural plasticity, particularly cortical oscillatory activity, it is imperative to consolidate research on this phenomenon. Therefore, this review aims to summarize numerous PE studies on neuromodulatory mechanisms in the brain over the past decade, covering (1) effects of resistance and aerobic training on brain health via neural oscillations; (2) how mind-body exercise affects human neural activity and cognitive functioning; (3) age-Related effects of PE on brain health and neurodegenerative disease rehabilitation via neural oscillation mechanisms; and (4) conclusion and future direction. In conclusion, the effect of PE on cortical activity is a multifaceted process, and this review seeks to comprehensively examine and summarize existing studies' understanding of how PE regulates neural activity in the brain, providing a more scientific theoretical foundation for the development of personalized PE programs and further research.
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Affiliation(s)
| | | | - Kaixuan Shi
- Physical Education Department, China University of Geosciences Beijing, Beijing, China
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Sadek AT, Djerdjour L, Reyes RA, Adams GP, Logan CH, Smith MA, Biddle SG, Wiles TS, Urrea-Mendoza E, McConnell TM, Revilla FJ, Trilk JL. The Feasibility and Efficacy of a Virtual Reality Tandem Cycling Program for Persons with Parkinson's Disease and Their Care Partners. Neurol Ther 2024; 13:1237-1257. [PMID: 38878129 PMCID: PMC11263444 DOI: 10.1007/s40120-024-00636-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 05/30/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health. METHODS Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05. RESULTS Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04). CONCLUSION Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
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Affiliation(s)
- Alia T Sadek
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA.
| | - Leila Djerdjour
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Ryan A Reyes
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Greggory P Adams
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Cara H Logan
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Margaret A Smith
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | - Sara G Biddle
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
| | | | - Enrique Urrea-Mendoza
- Department of Clinical Science/TMH Physicians Partners, Medical School, Florida State University, Tallahassee, FL, USA
| | - Tracie M McConnell
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Fredy J Revilla
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
- Neuroscience Associates, Prisma Health-Upstate, Greenville, SC, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA
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Bispo DPCF, Lins CCSA, Hawkes KL, Tripp S, Khoo TK. The Positive Effects of Physical Activity on Quality of Life in Parkinson's Disease: A Systematic Review. Geriatrics (Basel) 2024; 9:94. [PMID: 39051258 PMCID: PMC11270410 DOI: 10.3390/geriatrics9040094] [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: 06/02/2024] [Revised: 07/06/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Physical activity can have positive effects on motor and non-motor symptoms in Parkinson's disease, but its benefits in terms of quality of life and function are uncertain and vary based on the specific forms of activities and interventions. OBJECTIVE We sought to assess the current evidence on the positive effects of physical activity in people with Parkinson's disease and more specifically in relation to its potential benefits for quality of life. METHODS This systematic review was conducted between January and April 2024 via the PubMed, Medline, and Scopus databases. Predetermined search criteria were used that included the following terms: "Parkinson's disease", "quality of life" and "physical activity". RESULTS A total of 1669 articles were identified. After utilizing predetermined criteria, a total of fifteen articles met the selection criteria. Statistically significant improvements in quality of life were found in seven studies. Seven studies demonstrated a significant improvement in non-motor symptoms, while nine studies showed an improvement in motor symptoms. CONCLUSIONS Despite heterogeneity in the study designs, interventions and clinical assessments, the articles identified in this review yielded mostly positive results in relation to physical activities. The findings reflect an improvement in motor and non-motor symptoms may translate to a better quality of life in people with Parkinson's disease.
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Affiliation(s)
- Dharah P. C. F. Bispo
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
- Neuropsychiatry and Behavioural Sciences Department, Health Sciences Centre, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
- Gerontology Department, Health Sciences Centre, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
| | - Carla C. S. A. Lins
- Gerontology Department, Health Sciences Centre, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
- Anatomy Department, Health Sciences Centre, Federal University of Pernambuco, Recife 50670-901, PE, Brazil
| | - Kelly L. Hawkes
- Northern New South Wales Local Health District, Ballina, NSW 2478, Australia
| | - Shae Tripp
- Northern New South Wales Local Health District, Ballina, NSW 2478, Australia
| | - Tien K. Khoo
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
- Northern New South Wales Local Health District, Ballina, NSW 2478, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
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Liu L, Wang D, Wu W, Xiang M, Li X, Zhao Y, Wang J, Wang A. Effectiveness of a self-determination theory-based intervention for nursing home residents with depression: A randomized controlled trial. Heliyon 2024; 10:e33818. [PMID: 39027615 PMCID: PMC11255488 DOI: 10.1016/j.heliyon.2024.e33818] [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: 07/13/2023] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
Objective and rationale The prevalence of depression among older adults residing in nursing homes has risen. While physical activity interventions based on the self-determination theory have been shown to reduce depressive symptoms among students and middle-aged adults, research in nursing home residents is scarce. This study aimed to investigate whether physical activity can alleviate depressive symptoms in nursing home residents over an extended period. Methods Between September 2020 and August 2021, 46 nursing home residents in Shenyang were randomly assigned to either a control group (n = 23) or an intervention group (n = 23). The control group followed a standard physical activity programme, whereas the intervention group underwent a programme based on self-determination theory. Both groups were monitored for 24 weeks post-intervention. Depression scores were assessed using the Geriatric Depression Scale, sociodemographic data collected via a self-designed questionnaire, cognitive function evaluated using the Mini-Mental State Examination, and weight and body fat measured using the Omron KARADA Scan Body Composition and Scale. Results Depression scores were measured at five time points: baseline (T0), weeks 12 (T1), and 24 (T2) of the intervention, and weeks 12 (T3) and 24 (T4) during follow-up. Both groups exhibited a trend of decline by more than five points. The intervention group demonstrated more favourable pre-to-post changes in depression scores compared to the control group. Conclusions A physical activity intervention based on self-determination conceptual framework has been proven to be effective for nursing home residents with depressive symptoms, also aiding in the maintenance of their physical activity levels. This study offers a theoretical foundation for the development of intervention programmes by researchers and identifies potential intervention strategies for caregivers in nursing homes. Trial Registration The Chinese Clinical Trial Registry (ChiCTR2200060598) (June 5, 2022).
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Affiliation(s)
- Lei Liu
- Nursing Teaching and Research Department, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Daqiu Wang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Wei Wu
- Institute of Humanitites and Social Sciences, Shenyang University, Shenyang, 110044, Liaoning, China
| | - Mingqiang Xiang
- School of Sport and Health & Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Guangzhou Sport University, Guangzhou, 510500, Guangdong, China
| | - Xiaoxue Li
- School of Nursing, Chinese Academy of Medical Science & Peking Union Medical College, 100144, Beijing, China
| | - Yudan Zhao
- Science and Technology Department, Shenyang Medical College, Shenyang, 110034, Liaoning, China
| | - Jiayu Wang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Aiping Wang
- Nursing Teaching and Research Department, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China
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van der Heide A, Goltz F, de Vries NM, Bloem BR, Speckens AE, Helmich RC. Study protocol for the MIND-PD study: a randomized controlled trial to investigate clinical and biological effects of mindfulness-based cognitive therapy in people with Parkinson's disease. BMC Neurol 2024; 24:219. [PMID: 38918695 PMCID: PMC11197298 DOI: 10.1186/s12883-024-03736-7] [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: 06/04/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND People with Parkinson's disease (PD) are very sensitive to the effects of stress. The prevalence of stress-related neuropsychiatric symptoms is high, and acute stress worsens motor symptoms. Animal studies suggest that chronic stress may accelerate disease progression, but evidence for this in humans is lacking. Mindfulness-based interventions (MBIs) train participants to focus on the present moment, on purpose and without judgement. Previous studies suggest that MBIs may alleviate stress and reduce depression and anxiety in PD. We aim to demonstrate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) as a non-pharmacologic treatment strategy for neuropsychiatric (and motor) symptoms in PD, and to identify the mechanisms underlying stress and stress reduction in PD. METHODS In a prospective randomized controlled trial (RCT), we investigate whether 8 weeks of MBCT, as compared to care as usual, can reduce symptoms of anxiety and depression in people with PD. We aim to include 124 PD patients, who experience mild-moderate symptoms of anxiety and depression, are eligible for magnetic resonance imaging (MRI) and naïve to mindfulness, and who have a disease duration ≤ 10 years. Every participant is followed for 12 months. Clinical and biochemical assessments take place at baseline (T0), after 2 months (T1), and after 12 months (T2); MRI assessments take place at T0 and T2. Our primary outcome is the total score on the Hospital Anxiety and Depression Scale (HADS) at T1, while correcting for the HADS score at T0, age, and gender. Beyond testing the effects of MBCT on symptoms of anxiety and depression in PD, we explore whether MBCT: (1) has an effect on motor symptom severity, (2) influences cerebral and biochemical markers of stress, and (3) leads to a change in biomarkers of PD progression. DISCUSSION MIND-PD is one of the first RCTs with a 1-year follow-up to investigate the effects of MBCT on symptoms of anxiety and depression in PD, and to explore possible mechanisms underlying stress and stress reduction in PD. Insight into these mechanisms can pave the way to new treatment methods in the future. TRIAL REGISTRATION ClinicalTrials.gov, NCT05779137. Registered on 12 January 2023.
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Affiliation(s)
- Anouk van der Heide
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Neurology department, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Franziska Goltz
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands.
- Neurology department, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Nienke M de Vries
- Neurology department, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Neurology department, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anne E Speckens
- Radboud University Medical Centre, Psychiatry department, Nijmegen, The Netherlands
| | - Rick C Helmich
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, P.O. Box 9101, Nijmegen, 6500 HB, The Netherlands
- Neurology department, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
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Yuan Y, Wang J, Wang G, Wang T, Zhang H, Fu X, Wu L, Chen X, Xia R, Zhang L, Lin SC, Yang Y. Optimal dosage ranges of various exercise types for enhancing timed up and go performance in Parkinson's disease patients: a systematic review and Bayesian network meta-analysis. Front Aging Neurosci 2024; 16:1399175. [PMID: 38988329 PMCID: PMC11234838 DOI: 10.3389/fnagi.2024.1399175] [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: 03/11/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To examine the dose-response relationship between specific types of exercise for alleviating Timed up and Go (TUG) in Parkinson's disease PD. Design Systematic review and Bayesian network meta-analysis. Data sources PubMed, Medline, Embase, PsycINFO, Cochrane Library, and Web of Science were searched from inception until February 5th, 2024. Study analysis Data analysis was conducted using R software with the MBNMA package. Effect sizes of outcome indicators were expressed as mean deviation (MD) and 95% confidence intervals (95% CrI). The risk of bias in the network was evaluated independently by two reviewers using ROB2. Results A total of 73 studies involving 3,354 PD patients. The text discusses dose-response relationships in improving TUG performance among PD patients across various exercise types. Notably, Aquatic (AQE), Mix Exercise (Mul_C), Sensory Exercise (SE), and Resistance Training (RT) demonstrate effective dose ranges, with AQE optimal at 1500 METs-min/week (MD: -8.359, 95% CI: -1.398 to -2.648), Mul_C at 1000 METs-min/week (MD: -4.551, 95% CI: -8.083 to -0.946), SE at 1200 METs-min/week (MD: -5.145, 95% CI: -9.643 to -0.472), and RT at 610 METs-min/week (MD: -2.187, 95% CI: -3.161 to -1.278), respectively. However, no effective doses are found for Aerobic Exercise (AE), Balance Gait Training (BGT), Dance, and Treadmill Training (TT). Mind-body exercise (MBE) shows promise with an effective range of 130 to 750 METs-min/week and an optimal dose of 750 METs-min/week (MD: -2.822, 95% CI: -4.604 to -0.996). According to the GRADE system, the included studies' overall quality of the evidence was identified moderate level. Conclusion This study identifies specific exercise modalities and dosages that significantly enhance TUG performance in PD patients. AQE emerges as the most effective modality, with an optimal dosage of 1,500 METs-min/week. MBE shows significant benefits at lower dosages, catering to patients with varying exercise capacities. RT exhibits a nuanced "U-shaped" dose-response relationship, suggesting an optimal range balancing efficacy and the risk of overtraining. These findings advocate for tailored exercise programs in PD management, emphasizing personalized prescriptions to maximize outcomes.Systematic Review Registration: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024506968).
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Affiliation(s)
- Yuan Yuan
- Department of Physical Education, Kunsan National University, Gunsan-si, Jeollabuk-do, Republic of Korea
| | - JunYu Wang
- The School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - GuoTuan Wang
- Institute of Physical Education, Henan University, Kaifeng, China
- School of Physical Education and Health, Krasnoyarsk State Pedagogical University named after V.P., Krasnoyarsk City, Russia
| | - Tao Wang
- College of Physical Education and Health, Southwest University of Science and Technology, Mianyang, China
| | - HaoYang Zhang
- Institute of Physical Education, Henan University, Kaifeng, China
| | - XueYing Fu
- Institute of Physical Education, Henan University, Kaifeng, China
| | - LiHua Wu
- The Seventh Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - XiaoTian Chen
- Second Clinical Medical College, Wenzhou Medical University, Zhejiang, China
| | - Rui Xia
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, China
| | - Lin Zhang
- Department of Rehabilitation, West China Hospital Sichuan University Jintang Hospital, Chengdu, China
| | - Shu-Cheng Lin
- Department of Sport, Leisure and Health Management, Tainan University of Technology, Tainan City, Taiwan
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, China
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Mylius V, Zenev E, Brook CS, Brugger F, Maetzler W, Gonzenbach R, Paraschiv-Ionescu A. Imbalance and Falls in Patients with Parkinson's Disease: Causes and Recent Developments in Training and Sensor-Based Assessment. Brain Sci 2024; 14:625. [PMID: 39061366 PMCID: PMC11274436 DOI: 10.3390/brainsci14070625] [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: 04/22/2024] [Revised: 05/16/2024] [Accepted: 05/28/2024] [Indexed: 07/28/2024] Open
Abstract
Imbalance and falls in patients with Parkinson's disease (PD) do not only reduce their quality of life but also their life expectancy. Aging-related symptoms as well as disease-specific motor and non-motor symptoms contribute to these conditions and should be treated when appropriate. In addition to an active lifestyle, advanced exercise training is useful and effective, especially for less medically responsive symptoms such as freezing of gait and postural instability at advanced stages. As treadmill training in non-immersive virtual reality, including dual tasks, significantly reduced the number of falls in PD patients, the mechanism(s) explaining this effect should be further investigated. Such research could help to select the most suitable patients and develop the most effective training protocols based on this novel technology. Real-life digital surrogate markers of mobility, such as those describing aspects of endurance, performance, and the complexity of specific movements, can further improve the quality of mobility assessment using wearables.
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Affiliation(s)
- Veit Mylius
- Department of Neurology, Center for Neurorehabilitation, 7317 Valens, Switzerland; (E.Z.); (C.S.B.); (R.G.)
- Department of Neurology, Philipps University, 35043 Marburg, Germany
| | - Elisabeth Zenev
- Department of Neurology, Center for Neurorehabilitation, 7317 Valens, Switzerland; (E.Z.); (C.S.B.); (R.G.)
| | - Caroline S. Brook
- Department of Neurology, Center for Neurorehabilitation, 7317 Valens, Switzerland; (E.Z.); (C.S.B.); (R.G.)
- Department of Neurology, University of Bern, Inselspital Bern, 3010 Bern, Switzerland
| | - Florian Brugger
- Department of Neurology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland;
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, 24105 Kiel, Germany;
| | - Roman Gonzenbach
- Department of Neurology, Center for Neurorehabilitation, 7317 Valens, Switzerland; (E.Z.); (C.S.B.); (R.G.)
| | - Anisoara Paraschiv-Ionescu
- Signal Processing Laboratory 5, Ecole Polytechnique Federale de Lausanne (EPFL), 1015 Lausanne, Switzerland;
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James Vibin A, Niharika N, Valliappan V, Lamo P, Parajuli N, Jat M, Lama S, Agarwal A, Sagar R, Sharma G. Effect of Integrated Yoga as an add-on therapy in adults with clinical depression - A randomized controlled trial. Int J Soc Psychiatry 2024; 70:709-719. [PMID: 38279599 DOI: 10.1177/00207640231223431] [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: 01/28/2024]
Abstract
BACKGROUND Depression is a leading cause of disability and the conventional management has several limitations. Recent studies demonstrated the benefits of yoga in psychological disorders. AIMS To evaluate the efficacy of the Integrated Yoga Module (IYM) to standard care with added yogic education on lifestyle modification (YELM) in patients with clinical depression. METHODS A PROBE trial was conducted at a single tertiary care hospital in India. Adults aged 18 to 64 with clinical depression were randomized to either an IYM or an active control group using a computer-generated mixed block randomization sequence. Both groups received YELM in addition to standard care and the intervention group practiced IYM, for 8 weeks. The primary outcome was the reduction in depression symptoms assessed using the Beck Depression Inventory (BDI-II), and secondary outcomes involved self-compassion, brief resilience, positive and negative experiences, and quality of life, evaluated at 8 weeks. RESULTS The mean ± SD age of participants was 32.2 ± 10.0 and 54.3% were females. The IYM group showed statistically significant improvements in BDI-II scores β = -6.7 (95% CI [-10.8, -2.5]; p = .001), resilience β = 0.4 (95% CI [0.02, 0.80]; p = .037), physical health domain of WHOQOL - BREF β = 10.1 (95% CI [0.7, 19.5]; p = .035) and negative emotions (SPANE-N) β = 2.8 (95% CI [0.1, 5.4]; p = .037). However, no significant differences were found in SCS-SF β = -0.3 (95% CI [-0.7, 0.0]; p = .053). CONCLUSIONS IYM as an adjunct is superior to conventional medical management in reducing symptoms and improving positive psychological resources in clinical depression.
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Affiliation(s)
- Anu James Vibin
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Niharika Niharika
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Varun Valliappan
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Pasang Lamo
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Niranjan Parajuli
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mansingh Jat
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sudha Lama
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Aman Agarwal
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Sharma
- Centre for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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