High-intensity interval training (HIIT) can be of great benefit to patients with Parkinson’s disease. In addition to the neuroprotective effect that prevents the death of dopaminergic neurons, which is so characteristic of this individual, this type of activity also inhibits systemic inflammation, which affects the rate of disease progression.
The team of Paulina Małczyńska-Sims from the Institute of Psychiatry and Neuroscience in Warsaw investigated the effect of 12 weeks of HIIT training on the level of inflammatory factors and antioxidant capacity in 15 people with Parkinson’s disease (PD). The findings and conclusions drawn from them are described by the scientists in the journal Aging Clinical and Experimental Research (http://dx.doi.org/10.1007/s40520-022-02153-5).
Extraordinary relationship: training and nerves
Where did the idea of finding the association between seemingly unrelated items like exercise and Parkinson’s disease come from?
says Paulina Małczyńska-Sims, who conducted the study as part of her PhD thesis. This gave us the idea of using HIIT in Parkinson’s disease. At the moment, we do not have a drug that normally acts as a neuroprotector, that is, protects neurons from death. Even levodopa (the most effective drug currently used in this disease), although it helps patients by replenishing dopamine levels, which are greatly reduced in patients, does not protect neurons from neurodegeneration.
In addition, the researcher adds that in Parkinson’s disease there are movement disorders, muscle stiffness and sluggishness, so one of the elements of treatment is to improve these parameters through different types of exercises.
“So we decided to investigate whether the process of training, that is, prolonged exercise, could modulate the inflammation that always accompanies Parkinson’s disease,” he says.
Although the exact mechanisms of neurodegeneration in Parkinson’s are not yet fully understood, there is increasing talk about the importance of inflammation in this process. Chronic inflammation and neuritis occur in the bodies of patients with the disease discussed. Meanwhile, previous studies have shown that interval training can have a beneficial effect in reducing inflammation.
“When I began to explore the topic, it turned out that there were several reports that although short-term intense interval training in healthy young men might slightly increase inflammation, when used long-term, it might reduce the pathogenesis of adaptive changes. In the body. It has been proven, for example, in people suffering from obesity or type 2 diabetes “- says the researcher.
He also adds, since inflammation is constantly present in patients with Parkinson’s disease: in the brain, and over time also in the periphery, microglia are activated, stimulating astrocytes, which in turn damages the connections between individual neurons. These processes are accompanied by increased oxidative stress, all of which lead to the death of dopaminergic neurons.
“We don’t have a cure for it. Levodopa does not cause cells to stop dying. This process continues. So it is important to find a method that effectively but gently helps reduce inflammation and oxidative stress “- says the author of the publication.
“There have been studies showing that NSAIDs reduce the risk of Parkinson’s disease, but we found that we didn’t want to treat patients with more drugs because they were taking too much of them anyway. So, we decided to check how intense exercise would affect them, because research has shown That short-term, low-intensity exercise doesn’t cause adaptive changes in the body. We wanted to know if we’d get an improvement or a deterioration in our performance, and maybe it wouldn’t make any difference.”
HIIT is a real hit
28 people diagnosed with Parkinson’s disease were included in the study. For 12 weeks (3 times per week) 15 of them performed HIIT exercises on a circular thermometer, and the remainder formed a non-exercise control group. Blood samples were taken from the participants multiple times to measure levels of inflammatory markers and antioxidants.
“We studied about 60 people, women and men. They were all in good general condition with Parkinson’s disease in its early to intermediate stages. They moved independently, were mostly professionally active and could cycle. We chose them so that there are no former high-performance athletes among them. But they were people like most of us: recreational physical activity, participation in various organized activities for people with cerebral palsy, such as dancing, playing table tennis or boxing “- says the researcher from the Institute of Psychiatry and Neuroscience.
After completing the experiment, it turned out that in the training group there was a clear decrease in the level of pro-inflammatory cytokines, which was accompanied by a decrease in the number of neutrophils, the ratio of neutrophils to lymphocytes and the ratio of neutrophils to monocytes. This means that systemic inflammation is reduced and antioxidant capacity is improved, which may be an important factor in slowing disease progression.
“After these three months, we have noticed that the introduction of physical exertion in the treatment of patients with Parkinson’s disease can achieve good results” – concludes Paulina Mawczyzka Sims.
The researcher adds that the type of training is very important. He cites several publications comparing low, medium, and high intensity exercises, proving that continuous vigorous exercise produces the best results and that high intensity interval training is more enjoyable and easier to perform for people with Parkinson’s than continuous high intensity exercise. “And believe me, it was a really very difficult training. I traveled with our patients, I support them in it, and we had to do our best there. Every week the workload was increasing, but the performance of the participants also improved, ”confirms Paulina Mauchska Sims.
A HIIT session is one of the stressors on the body. After its implementation, the level of reactive oxygen species, pro-inflammatory factors, increases sharply. However, studies in animals and humans show that if such sessions are repeated over a long period of time, elevated pro-inflammatory factors begin to activate anti-inflammatory factors that suppress inflammation, and more importantly they act that way for a prolonged period. “Therefore, adaptive changes and anti-inflammatory processes are activated in the body that eliminate the inflammatory processes caused by individual training sessions” – explains the author of the study.
At the same time, she emphasized that although the results analyzed by her team were based only on the study of the level of selected factors in the blood samples, that is, completely objective criteria, the subjective feelings of the participants, not included in this study, were very promising. “I have spoken to patients and they have all noticed the change in themselves. They have felt much better: both mentally and physically. Based on this, I can doubt that if we had investigated any other factors, the results would have been more promising. However, our grant was very small and its budget very limited. “.
effort for health
Finally, the author emphasizes that the use of HIIT may benefit not only Parkinson’s disease, but other neurodegenerative diseases as well.
By reducing inflammation while increasing anti-inflammatory processes, and the long-term persistence of the changes HIIT causes, it can help improve the quality of life for people with many chronic diseases in which inflammation plays an important role.
The team from the Institute of Psychiatry and Neuroscience hopes that other researchers will “choose the subject” and that the results obtained will be verifiable in much larger groups. “Our experiment was kind of a prelude. Promising, but still a precursor. Will it be possible to translate these results into a larger population – we’ll see over time,” he says.
“I myself would like to explore this topic further, because this is a great opportunity for people with Parkinson’s disease. A new drug for this disease will not appear soon, and in the next few years we have no prospects of developing any innovative method with neuroprotective effects. And something like that, Provided that its validity is confirmed in a large population, it is immediately available to all ”- he summarizes.
As for the mechanism by which intense training positively affects the condition of patients with Parkinson’s disease, another publication by the same research group is due soon, further increasing the role of microRNA in the whole process.
PAP – Science in Poland, Katarzyna Czechowicz
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