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Parkinson's

Regular exercise ‘could help slow onset of Parkinson’s’

As little as four hours of moderate exercise a week may make a difference to early-onset Parkinson’s, a new study finds

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People with early-stage Parkinson’s disease who maintain a routine comprising one to two hours of exercise twice a week may have greater ability to balance, walk and carry out daily activities later, a new study suggests. 

Research has found that those who exercised frequently over five years – doing activities including walking or household tasks like gardening – performed better in cognitive tests and had slower progression of the disease in several aspects.

“Our results are exciting, because they suggest it may never be too late for someone with Parkinson’s to start an exercise programme to improve the course of their disease,” said study author Dr Kazuto Tsukita, of Kyoto University in Japan and a member of the American Academy of Neurology. 

“That’s because we found that to slow progression of the disease, it was more important for people with Parkinson’s to maintain an exercise programme than it was to be active at the beginning of the disease.”

The study looked at 237 people with early-stage Parkinson’s. They had an average age of 63 and were followed by researchers for up to six years.

Participants’ exercise levels at the start of the study were determined using a questionnaire that measured time and intensity during the previous week of leisure activity, like walking and biking; household activity, like gardening; and occupational activity, like taking care of others. 

Common cognitive tests were used to measure people’s verbal and memory skills and how much time it took to complete mental tasks.

Researchers found that people’s physical activity level at the start of the study was not associated with the progression of their Parkinson’s later on. Instead, they found it was more important to maintain physical activity over time.

People who got at least at least four hours per week of moderate to vigorous exercise like walking or dancing had slower decline in balancing and walking five years later, compared to those who did not get that much exercise. 

Researchers used a common test to rate each person’s Parkinson’s symptoms on a scale of zero to four, with higher scores indicating more severe impairment. 

People who got below average levels of moderate to vigorous exercise, or less than one to two hours, once or twice a week, increased from an average score of 1.4 to 3.7 over six years. 

That compares with those who got above average levels of moderate to vigorous exercise, who on average increased from a score of 1.4 to 3.0 during that time.

One cognitive test researchers used was a common paper-and-pencil test used to measure mental processing speed. The test gives the participant 90 seconds to match numbers with geometric figures and  has a maximum possible score of 110. 

People who did less than 15.5 hours of work per week, on average, dropped from a 44 to a 40 on the test six years later. That compares to an average drop from a score of 44 to 43 for those who did more than 15.5 hours of work over the same period.

“Although medications can provide people with Parkinson’s some symptom relief, they haven’t been shown to slow the progression of the disease,” Dr Tsukita said. 

“We found that regular physical activity, including household tasks and moderate exercise, may actually improve the course of the disease over the long run. Best of all, exercise is low cost and has few side effects.”

Dementia

Can brain sensors help spot dementia?

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New highly sensitive quantum sensors for the brain may be able to identify brain diseases such as dementia, MND and Parkinson’s, by spotting a slowing in the speed at which signals travel across the brain. 

The quantum scanners currently being developed by scientists can detect the magnetic fields generated when neurons fire.  

Measuring moment-to-moment changes in the brain, they track the speed at which signals move across the brain.  

This time element means a patient could be scanned twice several months apart to check whether the activity in their brain is slowing down. 

Such slowing can be a sign of Alzheimer’s or other diseases of the brain.

The research was led by University of Sussex quantum physicists. 

Aikaterini Gialopsou, a doctoral researcher in the School of Mathematical and Physical Sciences at the University of Sussex and Brighton and Sussex Medical School is the lead author on the paper.

“We’ve shown for the first time that quantum sensors can produce highly accurate results in terms of both space and time,” she says.

“While other teams have shown the benefits in terms of locating signals in the brain, this is the first time that quantum sensors have proved to be so accurate in terms of the timing of signals too.

“This could be really significant for doctors and patients concerned with the development of brain disorders.”

These quantum sensors are believed to be much more accurate than either EEG or fMRI scanners, due in part to the fact that the sensors can get closer to the skull.  

The closer proximity of the sensors to the brain can not only improve the spatial, but also the temporal resolution of the results. 

This double improvement of both time and space accuracy is highly significant as it means brain signals can be tracked in ways that are inaccessible to other types of sensors.

“It’s the quantum technology which makes these sensors so accurate”, explains Professor Peter Kruger, who leads the Quantum Systems and Devices lab at the University of Sussex.

“The sensors contain a gas of rubidium atoms. Beams of laser light are shone at the atoms, and when the atoms experience changes in a magnetic field, they emit light differently.  

“Fluctuations in the emitted light reveal changes in the magnetic activity in the brain. The quantum sensors are accurate within milliseconds, and within several millimetres.”

The technology behind the scanners is magnetoencephalography (MEG). Combining MEG with these new quantum sensors has developed a non-invasive way to probe activity in the brain. 

Unlike existing brain scanners – which send a signal into the brain and record what come back – MEG passively measures what is occurring inside from the outside, eliminating the health risks currently associated for some patients with invasive scanners.

Currently MEG scanners are expensive and bulky, making them challenging to use in clinical practice. 

This development of quantum sensor technology could be crucial for transferring the scanners from highly controlled laboratory environments into real-world clinical settings.

“It’s our hope with this development that in discovering this enhanced function of quantum brain scanners the door is opened to further developments that could bring about a quantum revolution in neuroscience,” adds Gialopsou. 

“This matters because, although the scanners are in their infancy, it has implications for future developments that could lead to crucial early diagnosis of brain diseases, such as ALS, MS and even Alzheimer’s. That’s what motivates us as a team.”

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Parkinson's

Motor cortex role in Parkinson’s disease becomes clearer

The finding supports a new line of research around the origins of changes in the motor cortex and its role during PD

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The motor cortex could have a larger role in Parkinson’s disease than recognised to date, a new study has revealed. 

The role of neuron and dopamine loss in Parkinson’s disease (PD) has long been recognised by neuroscientists. However, how dopaminergic modulation affects brain regions involved in the control of voluntary movement remains a subject of investigation. 

Researchers at Stony Brook University have now used an experimental model to demonstrate that a loss of midbrain dopaminergic centres impairs the ability of the primary motor cortex neurons to transform inputs into appropriate output. 

The finding supports a new line of research regarding the origins of changes in the motor cortex and its role during PD.

Patients with PD show abnormal activity in the motor cortex, which to date remains difficult to explain. 

Scientists have proposed that motor cortex dysfunction in PD may come from loss of direct dopaminergic innervation of the cortex, or, alternatively, it could arise as a consequence of basal ganglia pathology.

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“Our study shows that the changes in excitability of motor cortex neurons very likely are due to basal ganglia pathology and not loss of direct dopaminergic innervation of the motor cortex,” says Professor Arianna Maffei, a professor of Neurobiology and Behavior. 

“The results we showed support the idea that changes in motor cortex activity due to loss of dopamine are very important for the pathophysiology of PD. This adds to our current knowledge and points to the motor cortex as a potential novel site for intervention.”

The research team assessed how the loss of dopamine affects the input/output function of neurons in the motor cortex. 

They tested three different ways to reduce dopamine signalling to ask how motor cortex dysfunction may arise:

  • Used pharmacology to block the receptors selectively in the motor cortex 
  • Injected a toxin that kills dopaminergic neurons in the midbrain to induce basal ganglia pathology 
  • Used the same toxin to eliminate dopamine neuron axons in the motor cortex to test the possibility that loss of dopaminergic input to the motor cortex may be responsible for its dysfunction.

Professor Maffei explains that the idea behind these approaches was to dissect out the circuit mechanisms underlying loss of function in the motor cortex and possibly use these data to better understand PD pathophysiology.

Overall, the research demonstrated that diminished dopamine signalling, whether acute or chronic, has profound effects on the excitability of primary motor cortex neurons.

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Community rehab

Virtual exercise group committed to neuro patients wins award

Neuro Heroes has been acknowledged for its engaging exercise provision and building of a UK-wide community

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An online exercise group which offers specially-devised classes for people with neurological conditions has marked its first anniversary by winning national recognition for its work. 

Neuro Heroes was launched in October last year to enable people to continue to challenge themselves through physio-led exercise despite lockdown, and has since grown into a UK-wide community. 

The group initially focused on delivering high-intensity exercise classes for people with Parkinson’s disease – building a clientele spanning younger people with Young Onset Parkinson’s Disease through to older people wanting to push themselves – but has since broadened its reach to deliver MS and Cerebral Palsy specific sessions, as well as general neuro classes. 

In recognition of its contribution to supporting people with neurological conditions and its new and refreshing take on exercise, which positively challenges participants – based on both clinical experience and evidence-based guidance – Neuro Heroes has been named as a winner in the UK Parkinson’s Excellence Network Awards. 

The group, run by neurophysiotherapists Laura Douglas and Anna Kharin, won the Person-Centred Approach Award, which recognises its work in supporting people living with Parkinson’s, both through exercise and the building of a UK-wide virtual community. 

“We’re really proud to have been recognised, it’s a big achievement for us, and is so good to know we have created a service people engage with and value,” says Laura. 

“We were nominated by one of the people who attend our sessions, which brings it back to the fact we are person-centred and our approach is working.

“Our high-intensity approach has been really welcomed, people have been really keen to engage with us, but we’ve listened to the feedback as we have gone and evolved as a result. We want to give people what they want. 

“Parkinson’s was what we initially focused on when we launched, and our PD Power session – the first we ever held – is now so popular we have had to add a second session each week. But we’ve been able to expand that to cover other conditions, which has been brilliant.” 

Neuro Heroes now offers classes specific to people living with MS and has partnered with a number of branches of the MS Society in London to offer free sessions to their members and has also formed its first partnership with an NHS Trust to offer MS sessions. 

Cerebral Palsy is also a new condition for the group, with its six-week CP Empower course proving particularly popular. 

“There is a lot of education and discussion in there, and our physio Bex has wanted to do something like this for a while, so it’s great to be able to offer this – and the feedback is really important too, as that will help with other Empower classes in future,” says Laura. 

“We see a lot of young adults coming to us who are already in the problem zone, resources are so limited after paediatric Cerebral Palsy services, there is a real lack in the transition to adult services, so this course addresses many of the secondary problems they may be experiencing.”

But as well as the benefits delivered through its exercise offering, Neuro Heroes has also discovered its role at the heart of a growing community of people with neurological conditions throughout the UK. 

“We now have a Facebook members’ group so people can share photos and videos of their successes and achievements, there is a great support network there and people are really keen to interact virtually,” says Laura. 

“We’ve done a lot in a year and we’re really proud of where we are now and what we’ve created. But we’re always trying to raise awareness of Neuro Heroes and get bigger – the bigger we are, the more we can offer, and that’s the main goal of what we are doing.” 

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