Dr. Angela Ridgel consults with Parkinson’s study participant Brad Hoover during a motorized exercise biking routine in her laboratory in the Kent State University Gym Annex. Photo: Courtesy Kent State University, Jeff Glidden, University Photographer.

Parkinson’s Research Update

Post readers are requesting an update on Parkinson’s disease (PD) research findings. Here’s promising news about exercise and genetics from the International Congress of Parkinson’s Disease and Movement Disorders.

A surprising observation by friends on a tandem bike is now an active focus of research: Can forcing someone with Parkinson’s to exercise harder than (s)he normally would somehow counteract the uncontrollable leg and arm movements that are characteristics of the disease?

Preliminary research says yes—and ongoing studies are teasing out the specifics of how much exercise is best. Discovery of why it works awaits future investigation.

In a study presented at the June 11-17 conference in Paris, France, researchers at Cleveland Clinic report that forced-exercise helps relieve symptoms as well taking levodopa, a standard drug prescribed for PD.

Participants showed a 35 percent to 40 percent improvement after a single ride on a stationary tandem bicycle with a healthy partner pedaling at a steady pace of 80 to 90 revolutions per minute (rpm). PD patients typically perform about 40 to 60 rpm on their own.

Researchers think that exceeding the nervous system’s usual limits may lead to chemical changes in the body that help improve motor functioning.

“Exercise is part of a healthy lifestyle in general, and, if it has specific effects in PD, that is all for the better,” commented Dr. Mark Hallet of the National Institute of Neurological Disorders and Stroke. “The current abstract deals with the mechanism of a short-term benefit. Using neuroimaging, the authors find a similar pattern of changes as are induced with levodopa. This is certainly interesting and may indicate that exercise, in the short run, causes dopa release. Whether this effect is relevant to more long-term effects remain to be demonstrated.”

Dr. Angela Ridgel and her team at Kent State University are testing a motorized stationary bike that has been customized by its German manufacturers to reach speeds of 90 rpm. In the recently completed study, 21 people with Parkinson’s disease strapped themselves to the bike’s pedals for three 40-minute sessions.

“First we had study participants perform a basic fitness test,” Dr. Ridgel explained to the Post. “Then they came for sessions at 60, 70, or 80 rpm, and we compared their ability to move between each workout. This is passive exercise—we asked them not to help, but to let the motor do the work. We’re analyzing the data right now, but really seems as if we are getting an effect.”

The next step is to compare the benefit of passive versus active exercise.

“The same bike allows active exercise,” Ridgel says. “We will continue to look at specific rates, but we’re going to see if we get an even more dramatic effect when people are helping.

“The goal of our current research is not to make specific recommendations,” she concludes. “Of course, exercise is good for everyone. For people with Parkinson’s who want to exercise by cycling, I suggest lightening the resistance and maximizing the speed of their leg movement. Having Parkinson’s makes it somewhat more tricky for them, but that is what I’m suggesting to people who ask me.”

For more information about the research and to receive the study upon publication, e-mail Dr. Ridgel at aridgel@kent.edu.

Gene Research

Investigators say that variations within one gene may play a role in developing Parkinson’s disease and essential tremor (ET). Data presented at the Movement Disorder Society’s 13th International Congress reveal that the LINGO1 gene may be the “missing link” between the two most common movement disorders. PD and ET are characterized by different types of tremors and treatments. The finding provides the first firm evidence that connects these disorders and offers hope for new therapies in the future.

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June 27, 2009