Cleveland researchers used innovative balloon game to motivate participants through cycling sessions that showed measurable changes in neural connections.
Case Western Reserve University researcher and doctoral candidate Prajakta Joshi, right, speaks with a study participant prior to a cycling session that is part of a Parkinson’s disease study conducted at University Hospitals and the VA Northeast Ohio Healthcare System.
The study investigated whether exercise can restore brain signals in Parkinson’s patients.CLEVELAND, Ohio — Could pedaling a bike rewire the brain of someone with Parkinson’s disease, easing the tremors and muscle stiffness caused by the neurological condition? Past research studies suggested that exercise causes animal and human brains to forge new neurological connections. A local study jointly conducted by University Hospitals and the VA Northeast Ohio Healthcare System wanted to find out if the same was true for Parkinson’s patients. Implanted brain electrodes, veterans with Parkinson’s disease, electric smart bikes and a digital floating balloon all had a role in the $2 million study. Results suggested that yes, long-term exercise might lessen Parkinson’s symptoms. The disorder has no cure and worsens over time. The research suggests that increasingly challenging exercise led to more connections being formed within different parts of the brain, said UH and VA neurologistvice chair for research at UH and associate medical director of the Cleveland Functional Electric Stimulation Center, which focuses on the application of low-level electrical pulses to the nervous system to replace the actions of damaged neurons. “We can only speculate why the electrical activity changed,” Shaikh said. “We know that as the brain is exposed to different types of exercises, there is a release of growth factors . . . in the brain.”The collaboration between the two medical systems provided a pool of study participants that included military veterans, UH said. Scientists at Kent State and Case Western Reserve universities also assisted. The project received a boost because it recruited Parkinson’s patients who had deep brain stimulation devices implanted in their brains to treat movement problems.an electrode is placed inside the brain and attached to a very small neurostimulator, or electrical generator, implanted in the chest or abdomen. Electric current is delivered from the neurostimulator to the electrode in the targeted area of brain tissue responsible for symptoms, UH said. UH and VA investigators used data from patients’ deep brain stimulation devices to determine if exercise was re-activating brain connections damaged by the disease, UH said.“You should not be sitting on a couch watching TV all the time,” he said. “You should be doing something, thinking something, keeping your brain active. These are all very important things for brain health.”Over four weeks, about 50 participants took part in 12 cycling sessions ata nonprofit clinic in Beachwood that offers wellness programs for people with Parkinson’s disease. They hopped on stationary motorized bikes connected to a screen showing a floating balloon. Riders worked to maintain 80 rpm during a 30-minute session. The goal was to pedal fast enough to make their digital balloon float. The motorized bikes helped riders reach 80 rpm, but also added and reduced resistance depending on the rider’s effort. Researchers believe this push-and-pull mechanism is beneficial for treating Parkinson’s symptoms, Shaikh said. As a rider’s performance improved, the smart bike increased resistance, requiring more effort to keep the balloon from falling. The balloon game provided motivation to exercise and helped to fight the apathy that Parkinson’s patients often experience, Shaikh said. “Parkinson’s is not just a disease of movements, but it’s a disease of a mind also,” Shaikh said. “It also affects your mood. It can lead to anxiety and depression.” Signals were recorded from participants’ implanted brain devices before and after each exercise session, UH said. Brain signal changes were not immediately noticeable, but scientists detected a change in the brain signals used for motor control and movement after 12 exercise sessions, UH said. “We learned that if you keep doing the exercise over and over, it actually improves the way your brain is wired,” Shaikh said. The patients’ deep brain stimulation devices, recording from different areas of the brain, showed that certain parts of the brain changed in response to exercise, while the others did not.and subthalamus, showed larger changes than other portions of the brain, Shaikh said. “Our goal was to understand the immediate and long-term effects of the exercise in that region of the brain where the electrodes are implanted, which is also the same area where Parkinson’s pathology is evident,” Shaikh said. Next, UH and VA researchers will ask a different question. How do different types of electrical stimulation change the brain’s capacity to adapt? The research project looking into that question will involve a larger number of patients, and include some who were in the Parkinson’s exercise study, Shaikh said. I transferred to cleveland.com in 2020 after more than 30 years at the Plain Dealer. Previous beats include general assignment, home and garden, and entertainment. I was editor of the Friday! entertainment...
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