Tuesday, November 7, 2017

Running reversed MPTP-Parkinson's in mice.

In the MPTP-mouse model of Parkinson's disease, eight weeks of running improved balance, reduced the amount of a bad protein in the brain, reduced neuroinflammation and slowed cell death.

Neuropotective effects of endurance exercise against neuroinflammation in MPTP-induced Parkinson's disease mice. (Jang et al., 2017).
Parkinson's disease mouse.  Mice were injected with a toxin called MPTP to cause Parkinson's disease.  Three groups of mice were studied: 1. no MPTP injection; 2. MPTP injection; 3. MPTP injection plus exercise.
Endurance exercise (EE): Running five days per week for 1 hour for 8 weeks.
Eight weeks of EE restored motor performance. 
alpaha-synuclein levels were suppressed to non PD levels.
EE reversed PD neuro-inflammation which leads to cell death.
Gradually add endurance exercise to your exercise program.  
Shake it Off and Step Up.

Click the links throughout this post to learn more about some related topics.

What is MPTP?  In the late 1970s a young chemistry student was trying to make synthetic opioids for illicit use.  He accidentally made MPTP which causes permanent Parkinson's symptoms.  Currently, MPTP injected animals provide the best research model to study Parkinson's disease.

Mobility tests:  How do you test the motor ability of mice?  See this Rotarod test video.  The cellular and molecular measures in this paper are very interesting.  However, the story would have been less complete if the researchers did not also study motor function.  In this paper (Figure 1B) the Parkinson's mice that exercised for 8-weeks (ME group) stayed balanced on the rod just as long as the non-PD mice.  

What is alpha-Synuclein?  This is a protein that accumulates in excess in the Parkinson's brain. In this paper (see Figure 1D) this protein was restored to the normal levels in the Parkinson's mice who did 8-weeks of endurance exercise (ME).

Neuroinflammation is seen in multiple neurodegenerative diseases.  This is a link to a scientifically 'heavy' paper.  In the abstract, you will find a long list of neurodegenerative diseases that involve neuroinflammation.  The scientific progress we make with Parkinson's disease benefits other conditions like Alzheimer's disease and visa versa.   Neuroinflammation is part of the pathway to cell death or apoptosis.  In Figure 3F of our selected paper, the bar graph shows the normal amount of neuronal apoptotic cells in the PD mice that exercised.  The PD mice that did not exercise had about 300% more cells that were dying.

Exercise Prescription: Running for an hour, five times per week, for eight weeks might seem out of reach.  But you shouldn't ignore the amazing potential of some amount of endurance exercise in your life.  Five days of running was used in this study because it is a standard in this type of research. No information in this study suggests that five days of running is the minimal effective dose. You are likely to benefit even if you do less than this amount. We know for sure that you will not get these benefits if you don't exercise.  If you already do endurance exercise several days per week - fantastic!  Keep it up and be sure to also pursue other aspects of fitness like functional strength and balance.

Type: If running is not enjoyable or possible, consider other types of exercise like hiking, cycling, swimming or stationary exercise equipment (Ellipticals, rowing machines…). 

The First Step for Beginning Exercise

Historically, fast, high intensity or high power exercise strategies have not been recommended for older adults and patients.  These exercises have been avoided mainly to minimize cardiovascular and musculoskeletal risks.  We are beginning to understand the benefits of high power and high intensity exercise in various patient groups but we still need to apply such exercise strategies with caution.  In 2015, the American College of Sports Medicine (ACSM) updated its approach to Pre-Participation Health Screening to minimize the risks of exercise without creating unnecessary barriers to exercise participation.  Click here if you are interested in best-practices for screening.

Before you begin an exercise program, take a fitness test, or substantially increase your level of activity, make sure to answer the following questions. This physical activity readiness questionnaire (PAR-Q) will help determine if you’re ready to begin an exercise routine or program.
  • Has your doctor ever said that you have a heart condition or that you should participate in physical activity only as recommended by a doctor?
  • Do you feel pain in your chest during physical activity?
  • In the past month, have you had chest pain when you were not doing physical activity?
  • Do you lose your balance from dizziness? Do you ever lose consciousness?
  • Do you have a bone or joint problem that could be made worse by a change in your physical activity?
  • Is your doctor currently prescribing drugs for your blood pressure or a heart condition?
  • Do you know of any reason you should not participate in physical activity?
If you answered yes to one or more questions, if you are over 40 years of age and have recently been inactive, or if you are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity. If you answered no to each question, then it’s likely that you can safely begin exercising, according to these guidelines provided by the ACSM.

What are the Side Effects of exercise?

Some people with PD have momentary drops in their blood pressure.  Be careful when you rise from the bike after exercise.  Take it slow.  Other than this, exercise sometimes comes with some reversible fatigue and some soreness.  If you keep taking this wonderful medicine called exercise, these side effects will likely diminish.  Then there are all the good side-effects of exercise: improved heart health, reduced depression and anxiety, improved bone health and more.  The side effects of exercise, if you want to think of them that way, are mostly good.