The <scp>T</scp>herapeutic <scp>P</scp>otential of <scp>E</scp>xercise to <scp>I</scp>mprove <scp>M</scp>ood, <scp>C</scp>ognition, and S<scp>l</scp>eep in <scp>P</scp>arkinson's <scp>D</scp>isease

Reynolds, Gretchen O.; Otto, Michael W.; Ellis, Terry; Cronin‐Golomb, Alice

doi:10.1002/mds.26484

Cited by 117 publications

(73 citation statements)

References 238 publications

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“…The BAI motor factor mediated the effect of PD on anxiety. Though PD is associated with greater anxiety disturbances than seen in the general population [1, 24], on the widely-used BAI the effect of PD was significantly influenced by their scores on motor items. BAI scores remained significantly higher for PD than NC even when accounting for motor items, however, indicating that the BAI does measure anxiety (apart from motor disturbances) in PD relative to a non-PD population.…”

Section: Discussionmentioning

confidence: 99%

The impact of motor symptoms on self-reported anxiety in Parkinson's disease

Salazar

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et al. 2017

Parkinsonism & Related Disorders

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Objective Anxiety is commonly endorsed in Parkinson’s disease (PD) and significantly affects quality of life. The Beck Anxiety Inventory (BAI) is often used but contains items that overlap with common PD motor symptoms (e.g., “hands trembling”). Because of these overlapping items, we hypothesized that PD motor symptoms would significantly affect BAI scores. Methods One hundred non-demented individuals with PD and 74 healthy control participants completed the BAI. PD motor symptoms were assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS). Factor analysis of the BAI assessed for a PD motor factor, and further analyses assessed how this factor affected BAI scores. Results BAI scores were significantly higher for PD than NC. A five-item PD motor factor correlated with UPDRS observer-rated motor severity and mediated the PD-control difference on BAI total scores. An interaction occurred, whereby removal of the PD motor factor resulted in a significant reduction in BAI scores for PD relative to NC. The correlation between the BAI and UPDRS significantly declined when controlling for the PD motor factor. Conclusions The results indicate that commonly endorsed BAI items may reflect motor symptoms such as tremor instead of, or in addition to, genuine mood symptoms. These findings highlight the importance of considering motor symptoms in the assessment of anxiety in PD and point to the need for selecting anxiety measures that are less subject to contamination by the motor effects of movement disorders.

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Section: Discussionmentioning

confidence: 99%

The impact of motor symptoms on self-reported anxiety in Parkinson's disease

Salazar

Neargarder

et al. 2017

Parkinsonism & Related Disorders

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“…A review based on seven studies concluded that physical exercise can improve motor symptoms and several NMS in PD 193 , possibly by improving perfusion, or by promoting growth hormone release or angiogenesis. In one relatively large study, 51 PD patients without dementia were randomly assigned to a progressive strengthening exercise training programme or to a simpler programme focusing on stretching, balance, breathing and non-progressive strengthening, administered twice a week for 24 months 194 .…”

Section: Managementmentioning

confidence: 99%

Cognitive decline in Parkinson disease

et al. 2017

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Dementia is a frequent problem encountered in advanced stages of Parkinson disease (PD). In recent years, research has focused on the pre-dementia stages of cognitive impairment in PD, including mild cognitive impairment (MCI). Several longitudinal studies have shown that MCI is a harbinger of dementia in PD, although the course is variable, and stabilization of cognition — or even reversal to normal cognition — is not uncommon. In addition to limbic and cortical spread of Lewy pathology, several other mechanisms are likely to contribute to cognitive decline in PD, and a variety of biomarker studies, some using novel structural and functional imaging techniques, have documented in vivo brain changes associated with cognitive impairment. The evidence consistently suggests that low cerebrospinal fluid levels of amyloid-β42, a marker of comorbid Alzheimer disease (AD), predict future cognitive decline and dementia in PD. Emerging genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms. Cognitive enhancing medications have some effect in PD dementia, but no convincing evidence that progression from MCI to dementia can be delayed or prevented is available, although cognitive training has shown promising results.

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“…Nevertheless, a beneficial effect of exercise on motor symptoms of PD as well as a general health benefit (physical fitness) seems likely from these studies. A beneficial effect on non-motor symptoms in PD is also conceivable, but not yet proven 2. To strengthen the evidence on symptomatic benefits, we need methodologically sound randomised controlled trials (RCTs) with large sample sizes, clinically relevant outcomes for both motor and non-motor signs, long-term interventions and prolonged follow-up 3.…”

Section: Introductionmentioning

confidence: 99%