Register for updates

 
 

Medicine & Health
RSS Feed
Dual Virtual Reality/Treadmill Exercises Promote Brain Plasticity in Parkinson's Patients
Tuesday, November 28, 2017 9:00:00 AM

Therapy effective even in later stages of the disease, TAU researchers say

A new Tel Aviv University study suggests that a therapy that combines Virtual Reality and treadmill exercise dramatically lowers the incidence of falling among Parkinson's patients by changing the brain's behavior and promoting beneficial brain plasticity, even in patients with neurodegenerative disease.

Patients with Parkinson's disease experience gradual neuronal loss, leading to cognitive and motor impairments that damage their ability to walk and cause debilitating, often fatal, falls. The new study shows that fall rates are reduced in response to treadmill training with Virtual Reality. The number of neurons activated in the pre-frontal cortex is also reduced in response to the same combination. This reduction likely reflects enhancements in motor control and greater automaticity of cognitively demanding tasks.

The research underlines the importance of combining cognitive rehabilitation with the motor rehabilitation of Parkinson's disease patients.

The study was conducted by Prof. Jeff Hausdorff of TAU's Sackler School of Medicine and Tel Aviv Medical Center along with colleagues Dr. Inbal Maidan of Tel Aviv Medical Center and Dr. Anat Mirelman and Prof. Nir Giladi, both of TAU's Sackler School of Medicine and Tel Aviv Medical Center. The findings were recently published in the journal Neurology.

"In previous research, we showed that patients with Parkinson's disease use cognitive function, which is reflected in activation of the pre-frontal cortex of the brain, to compensate for impaired motor function," Prof. Hausdorff says. “We also showed that a specific form of exercise targeting the cognitive control of gait — combined treadmill training with a Virtual Reality representation of obstacles in a path — leads to a significantly lower fall rate in Parkinson's patients.

"The Virtual Reality gait program, in which patients must avoid obstacles, enhances the patient's cognitive performance and thus reduces the requirement for prefrontal brain activity," Prof. Hausdorff continues.

Seventeen subjects in two groups, one which combined treadmill training with Virtual Reality and one which used treadmill training alone, underwent a six-week intervention, exercising three times a week for about an hour each time. The Virtual Reality group played a "game" in which they viewed their feet walking in a city or park environment. Through the game, they implicitly learned how to deal with obstacles in the virtual environment, how to plan ahead and how to do two things at once — that is, address cognitive challenges related to safe ambulation.

The other group just walked on a treadmill without the VR components or cognitive challenges. Before and after the subjects participated in the exercise programs, the researchers used functional MRI imagery to evaluate the patients' brain activation patterns.

"The study's findings reinforce the hypothesis that training improves motor and cognitive performance through improved neuroplasticity — more so than that seen with treadmill training alone," Prof. Hausdorff explains. "Interestingly, the benefits of treadmill training with VR were specifically seen during walking conditions that require cognitive input (i.e., obstacle negotiation and dual tasking), conditions associated with falls in everyday environments. In these conditions, fewer neurons were needed after training with VR, while no change was seen in the group that trained by walking on a treadmill without VR."

Previous research conducted on mouse models of Parkinson's disease suggested the importance of task-specific exercises on the brain. However, the new TAU study is the first to show such findings in people with Parkinson's disease.

"Exercise that focuses on motor components promotes plasticity in brain areas associated with sensory-motor integration and coordination," Prof. Hausdorff says. "But exercise incorporating cognitive components also stimulates changes in brain regions related to cognition. It may therefore have a greater impact on compensatory brain function and the cognitive functions related to safe ambulation (i.e., walking without falling)."

"The takeaway here is that even relatively late in the disease, when 60-80 percent of dopaminergic neurons have died, there is still an opportunity to promote plasticity in the brain," Prof. Hausdorff concludes. "Moreover, to induce specific brain changes, exercise should be personalized and targeted to a specific clinical problem."




Latest News

Brain Arousal Compound Noradrenaline Plays Critical Role in Sensory Perception

Discovery paves way for detecting situations of dangerous lapses and for improving anesthesia protocols, TAU researchers say.

Compounds Found in Green Tea and Wine May Block Formation of Toxic Metabolites

Discovery may pave the way for therapies to treat inborn congenital metabolic disorders, TAU researchers say.

2018 Tel Aviv International Student Film Festival Celebrates Women in Cinema

Twentieth edition of festival draws film students and distinguished Israeli and international directors.

Smart Probe Detecting Cancer Cells May Improve Survival Rates

Fluorescent tags of injected polymers are "turned on" by an enzyme overproduced in cancer cells, TAU researchers say.

The Steinhardt Museum of Natural History at TAU to Open July 2018

New museum displays thousands of items that tell the story of biodiversity in Israel and the Middle East.

Modern Laser Science Brightened by 2,300-Year-Old Technology

Archimedes' screw inspires TAU researchers to devise a novel particle-trapping laser beam.

Neuronal Activity Sheds Light on the Origin of Consciousness

Electrodes in patients with epilepsy register neuronal activity underlying emergence of conscious experience, TAU researchers say.

Philadelphia Orchestra Performs with TAU Students, Israel Philharmonic in Packed Concert

Orchestra's trip to Israel is the third visit to the country by a major U.S. symphony orchestra.

TAU Student Film Wows at Cannes Film Festival

Rubber Dolphin written and directed by Steve Tisch School of Film and Television graduate.

Changes to Specific MicroRNA Involved in Development of Lou Gehrig's Disease

Mechanism involving specific microRNA and muscle molecules plays role in amyotrophic lateral sclerosis, TAU researchers say.

contentSecondary
c

© 2018 American Friends of Tel Aviv University
39 Broadway, Suite 1510 | New York, NY 10006 | 212.742.9070 | info@aftau.org
Privacy policy | Tel Aviv University