| New podcast episode!
Today marks the return of our expert interview series, the first episode of this particular type in a year.
Dr. Giselle Petzinger, an associate professor of Neurology at the University of Southern California and today’s guest, studies the extensive effects of how different types of exercise, in particular skill-based exercise, can affect the clinical outcome for people with Parkinson’s disease.
WATCH THE FULL INTERVIEW NOW
This conversation is an important one because it bridges two topics very near and dear to me – exercise and neurodegenerative disease. In particular, Parkinson’s disease.
Parkinson’s disease is a progressive neurodegenerative disorder with no known cure.
Parkinson’s disease is caused by the destruction of neurons that produce dopamine, a neurotransmitter best known for its role in motor, motivation, and pleasure control. And yet, Parkinson’s disease does not start with the loss of just one dopamine-producing neuron. By the best estimates, we may have to lose 50 percent or more of these neurons before we develop the clinically obvious motor features of the disorder, including the hallmark tremor. (See “dopamine threshold” at 00:05:41 in the episode.)
As the disease progresses, through some sort of circuit-shifting compensatory mechanism, deftly described in this interview by Dr. Giselle Petzinger, people with Parkinson’s disease begin to lose the automaticity of movement while temporarily retaining their ability to move through an increase in effortful cognitive control.
“They have to think about it.”
Exercise and skill-based exercise may help restore some of the automaticity of movement to Parkinson’s patients.
One of the benefits of certain types of skill-based exercise championed by Dr. Giselle Petzinger, including Tai chi, yoga, and Rock Steady Boxing, but probably also activities like tango dancing and even skateboarding, is that they help people with Parkinson’s achieve the “sweet spot” cross-section between being difficult enough to challenge the participant, intense enough to create a sweat, and complex enough to engage the mind.
In particular, Dr. Petzinger emphasizes it is the motor complexity and challenge that often gives a special therapeutic benefit of these sorts of activities.
While the causes of Parkinson’s disease remain complex and are still under investigation, exercise offers affected people an opportunity to tap into built-in mechanisms of repair and resilience.
One of the most powerful tools we have in our toolset to support neuronal and synaptic health is the neurotrophic growth factor known as brain-derived neurotrophic factor or BDNF.
It is here where exercise intensity may be an important mediating factor. Whether we’re talking about using useful rules of thumb like working ourselves until the point of sweating and flushness in the cheeks — or more hard and fast measures like achieving 80 percent maximum heart rate for 40 minutes several times per week from aerobic exercise — intense, challenging exercise can help us achieve robust, likely clinically relevant, neurotrophic support at the molecular level.
In fact, research has shown eight weeks of intensive treadmill training three times a week can increase the expression of dopamine receptors in the basal ganglia by 80 to 90 percent in Parkinson’s disease patients.
In a six-month-long study, patients performing high-intensity exercise showed no disease progression, while non-exercisers experienced a 15 percent worsening of their motor symptoms.
In addition to exercise, in this podcast Dr. Giselle Petzinger and I discuss…
- 00:03:03 – What is Parkinson’s disease?
- 00:08:03 – How symptoms of Parkinson’s disease generally only appear when ~50% of dopamine-secreting neurons in substantia nigra are lost. 1
- 00:11:03 – How other circuits in the brain can compensate for the loss of function of the substantia nigra.
- 00:14:43 – Prevalence and hereditary risk factors of Parkinson’s disease.
- 00:17:31 – How epidemiological studies have linked increased Parkinson’s disease risk with exposure to pesticides, herbicides, solvents, and certain heavy metals such as manganese. 1
- 00:23:03 – How exercise can lower the risk of developing Parkinson’s disease. 1 2 3
- 00:31:44 – How skill-based exercise, such as yoga, Tai chi, boxing, tango or skateboarding may play a special role in ameliorating some of the effects of the disease by driving circuit-specific effects, by creating top-down cognitive challenge for skills involved in a patient’s movement through space.
- 00:43:55 – How serum BDNF significantly increases in Parkinson’s patients after 1 month of treadmill exercise and why this might mean better cognitive function. 1 2
- 00:54:39 – How treadmill exercise with heart rate 80-85% maximum for at least 3x per week slowed the progression of Parkinson’s disease symptoms. 1
- 00:57:37 – Why exercise may not fully replace the use of medications.
- 01:06:04 – How the omega-3 fatty acid DHA has some preclinical evidence suggesting it may reduce motor-symptoms and dyskinesia in Parkinson’s disease. 1 2 3 4
- 01:08:18 – How patients with Parkinson’s disease have higher levels of inflammatory biomarkers and how this might contribute to the disease. 1
In conclusion
While Parkinson’s disease has no known cure, we do know that exercise – probably a combination of both factors of skill-based and high-intensity – can forestall progression of this devastating disease and offer therapeutically beneficial opportunities, something not promised by medication alone.
Follow the work of Dr. Giselle Petzinger via Twitter at @gpetzinger. Her academic profile at the University of Southern California can be found by clicking here.
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Thanks for listening and watching!
Rhonda and team
P.S. As a premium member, you have access to the Google Presentation which summarizes all of the graphics in the episode. This episode has over 100 slides! Click here to access that now. Thanks so much for being a member! |
