Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease
For the management of Parkinson’s disease (PD), the concept of forced exercise (FE) has drawn interest. In PD subjects, the FE executed with lower limbs has been shown to lessen symptoms and to promote brain adaptive changes. Our study is aimed to investigate the effect of an upper-limb exercise, co...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-10-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fnhum.2019.00350/full |
| _version_ | 1818159179405197312 |
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| author | Luca Valerio Messa Federica Ginanneschi Davide Momi Davide Momi Lucia Monti Carla Battisti David Cioncoloni Barbara Pucci Emiliano Santarnecchi Emiliano Santarnecchi Emiliano Santarnecchi Alessandro Rossi |
| author_facet | Luca Valerio Messa Federica Ginanneschi Davide Momi Davide Momi Lucia Monti Carla Battisti David Cioncoloni Barbara Pucci Emiliano Santarnecchi Emiliano Santarnecchi Emiliano Santarnecchi Alessandro Rossi |
| author_sort | Luca Valerio Messa |
| collection | DOAJ |
| description | For the management of Parkinson’s disease (PD), the concept of forced exercise (FE) has drawn interest. In PD subjects, the FE executed with lower limbs has been shown to lessen symptoms and to promote brain adaptive changes. Our study is aimed to investigate the effect of an upper-limb exercise, conceptually comparable with the FE, in PD. Upper-limb exercise was achieved in a sitting position by using a specially designed device (Angel’s Wings®). Clinical data, computerized dynamic posturography, magnetic resonance imaging (MRI) (resting-state MRI and arterial spin labeling), and neuropsychological tests were used before and after 2 months’ exercise training. We found a significant long-lasting improvement in Unified Parkinson Disease Rating Scale (UPDRS)-III and cognitive scales, along with improvement in balance and postural control (better alignment of the gravity center and improvement in weight symmetry and in anticipatory motor strategies). Computerized dynamic posturography pointed out an enhanced central ability to integrate the vestibular signals with afferents from other sensory systems. Neuroimaging analyses after 2 months’ exercise training showed, with respect to pretraining condition, many changes. An increase of the cerebral blood flow was evident in the left primary motor cortex (M1), left supplementary motor cortical area, and left cerebellar cortex. The bilateral globus pallidus showed an increased functional connectivity to the right central operculum, right posterior cingulate gyrus, and left sensorimotor cortex. Seed-to-voxel analysis demonstrated a functional connectivity between M1 and the left superior frontal gyrus. Left crus II showed strengthened connections with the left pre-rolandic area, left post-rolandic area, and left supramarginal area. These findings likely reflect compensatory mechanisms to the neuropathological hallmark of PD. Overall, our results show that this upper-limb exercise model, conceptually comparable with the FE already tested in the lower limbs, leads to a global improvement (involving non-exercised limbs) likely consistent with the functional changes observed in the central nervous system. |
| first_indexed | 2024-12-11T15:41:52Z |
| format | Article |
| id | doaj.art-0a03fec718394d4eb028e6e334efcacf |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-12-11T15:41:52Z |
| publishDate | 2019-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-0a03fec718394d4eb028e6e334efcacf2022-12-22T00:59:47ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612019-10-011310.3389/fnhum.2019.00350474349Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s DiseaseLuca Valerio Messa0Federica Ginanneschi1Davide Momi2Davide Momi3Lucia Monti4Carla Battisti5David Cioncoloni6Barbara Pucci7Emiliano Santarnecchi8Emiliano Santarnecchi9Emiliano Santarnecchi10Alessandro Rossi11Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalySiena Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neurological Sciences, University of Siena, Siena, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, ItalyUnit of Neuroimaging and Neurointervention, Department of Neurological and Neurosensorial Sciences, Azienda Ospedaliera Universitaria Senese, Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalyU.O.P. Professioni della Riabilitazione, Azienda Ospedaliera Universitaria Senese, Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalyBerenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United StatesThe Center for Complex Network Research, Department of Physics, Northeastern University, Boston, MA, United StatesDepartment of Medical, Surgical and Neurological Sciences, University of Siena, Siena, ItalyFor the management of Parkinson’s disease (PD), the concept of forced exercise (FE) has drawn interest. In PD subjects, the FE executed with lower limbs has been shown to lessen symptoms and to promote brain adaptive changes. Our study is aimed to investigate the effect of an upper-limb exercise, conceptually comparable with the FE, in PD. Upper-limb exercise was achieved in a sitting position by using a specially designed device (Angel’s Wings®). Clinical data, computerized dynamic posturography, magnetic resonance imaging (MRI) (resting-state MRI and arterial spin labeling), and neuropsychological tests were used before and after 2 months’ exercise training. We found a significant long-lasting improvement in Unified Parkinson Disease Rating Scale (UPDRS)-III and cognitive scales, along with improvement in balance and postural control (better alignment of the gravity center and improvement in weight symmetry and in anticipatory motor strategies). Computerized dynamic posturography pointed out an enhanced central ability to integrate the vestibular signals with afferents from other sensory systems. Neuroimaging analyses after 2 months’ exercise training showed, with respect to pretraining condition, many changes. An increase of the cerebral blood flow was evident in the left primary motor cortex (M1), left supplementary motor cortical area, and left cerebellar cortex. The bilateral globus pallidus showed an increased functional connectivity to the right central operculum, right posterior cingulate gyrus, and left sensorimotor cortex. Seed-to-voxel analysis demonstrated a functional connectivity between M1 and the left superior frontal gyrus. Left crus II showed strengthened connections with the left pre-rolandic area, left post-rolandic area, and left supramarginal area. These findings likely reflect compensatory mechanisms to the neuropathological hallmark of PD. Overall, our results show that this upper-limb exercise model, conceptually comparable with the FE already tested in the lower limbs, leads to a global improvement (involving non-exercised limbs) likely consistent with the functional changes observed in the central nervous system.https://www.frontiersin.org/article/10.3389/fnhum.2019.00350/fullASLEquiTestforced exercisefMRIresting-state fMRIParkinson’s disease |
| spellingShingle | Luca Valerio Messa Federica Ginanneschi Davide Momi Davide Momi Lucia Monti Carla Battisti David Cioncoloni Barbara Pucci Emiliano Santarnecchi Emiliano Santarnecchi Emiliano Santarnecchi Alessandro Rossi Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease Frontiers in Human Neuroscience ASL EquiTest forced exercise fMRI resting-state fMRI Parkinson’s disease |
| title | Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease |
| title_full | Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease |
| title_fullStr | Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease |
| title_full_unstemmed | Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease |
| title_short | Functional and Brain Activation Changes Following Specialized Upper-Limb Exercise in Parkinson’s Disease |
| title_sort | functional and brain activation changes following specialized upper limb exercise in parkinson s disease |
| topic | ASL EquiTest forced exercise fMRI resting-state fMRI Parkinson’s disease |
| url | https://www.frontiersin.org/article/10.3389/fnhum.2019.00350/full |
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