How does “motor reserve” change after the onset of Parkinson’s disease?
Kyoto University announced on January 5 that daily exercise habits and proper nadopamine supplementation therapy can improve “motor reserve” and focus on suppressing the progression of Parkinson’s disease symptoms. This research was carried out by a research group including Lecturer Kazuto Tsukita (and Teikyo University Specially Appointed Researcher) of the same university’s Graduate School of Medicine, Professor Riki Matsumoto, and Professor Ryosuke Takahashi of the Research Promotion Headquarters. The research results are published online in Neurology.
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Parkinson’s disease is a neurodegenerative disease in which the number of dopamine neurons in the substantia nigra of the brain gradually decreases, resulting in slow motor symptoms. It has become possible to quantitatively evaluate functional decline.
Individual differences in symptoms are due to the ability to flexibly understand various neural networks in the brain and compensate for dopaminergic nerve disorders.This adaptive ability is known as the “reserve ability” (exercise).However, until now, not enough research has been done to understand how this reserve ability for exercise changes when it develops, and what lifestyle habits and treatments should be focused on maintaining and strengthening it.
Analyzing changes in motor reserve after onset and related factors using large-scale data
The research group used data from the PPMI (Parkinson’s Progression Markers Initiative), an international multicenter observational study, to calculate motor reserve using the discrepancy between “deterioration of function of dopamine nerve terminals assessed by brain imaging” and “actual severity of motor symptoms” over the years since the onset of symptoms, and analyzed longitudinal changes and factors.
Reserve capacity fluctuates depending on disease status and lifestyle habits, and maintenance and improvement are recommended through exercise and drug treatment.
The results revealed that the motor reserve capacity in Parkinson’s disease is a “dynamically changing adaptive capacity of the brain” that fluctuates greatly depending on the course of the disease and lifestyle habits.
Of particular note is that patients who regularly exercise at the time of onset not only show high motor reserve from the early stage of disease onset, but also show that their motor reserve increases further by increasing the amount of exercise they do after diagnosis.
It is known that there is a relationship between motor reserve capacity at the early stage of onset and the risk of severe movement disorders.
Furthermore, patients who had a high motor reserve during the early years of disease had a cautiously low risk of developing a sufficiently severe motor disability (Hoehn & Yahr stage 4 or higher) that is useful for daily life, even after 10 years.
These results are important findings that indicate that maintaining a high motor reserve capacity in the early stages of onset is a key to long-term disease stability.
Expectations for building treatment programs suitable for individual patients
This study shows that increasing motor reserve capacity through exercise habits and proper dopamine replacement therapy from the early stage of onset of symptoms has a significant impact on long-term stability of the disease. This suggests that it could be a therapeutic strategy to support work function and halt the progression of the disease. The results of this research are expected to greatly contribute to the establishment of future treatment strategies, as they suggest a direction toward inhibiting the progression of Parkinson’s disease symptoms.
“In the future, we plan to further examine what type, frequency, and intensity of exercise most effectively increases motor reserve capacity, and which type of exercise is most appropriate for drug therapy depending on the patient’s age, stage of disease, and comorbidities.