Then now next
The impact of aerobic exercise on improving motor function and slowing the progression of Parkinson’s disease is the focus of an NIH-funded clinical trial conducted by Dr. Jay Alberts of Cleveland Clinic.
Thankfully, early therapeutic Parkinson’s disease treatments such as bloodletting followed by vesicatories that blistered the skin to divert blood and inflammatory pressure away from the brain and spinal cord are no longer used. By the mid-1800s, neurologists noticed a decrease in symptoms after long carriage, train or horseback rides and recommended vibratory therapy.
There are two general approaches to treatment—improving symptoms with medications such as levodopa, developed in the 1960s and still considered the gold standard, and engaging in physical therapy and exercise.
Jay Alberts, PhD, Vice Chair of Innovation in the Neurological Institute and a staff member in the Cleveland Clinic Lerner Research Institute Department of Biomedical Engineering, recently received a $3 million National Institutes of Health grant to conduct a multisite clinical trial to study the long-term effects of aerobic exercise on improving motor function and slowing the disease’s progression, using indoor cycling bikes from fitness technology company Peloton.
Cleveland Clinic, designated by the Parkinson’s Foundation as a Center of Excellence, offers another option: deep brain stimulation (DBS), a surgical treatment that involves implanting electrodes in the brain, like a pacemaker for your gray matter. Electrical impulses delivered by the electrodes disrupt abnormal activity that causes movement symptoms.
In 2018, 83% of Cleveland Clinic Parkinson’s patients who underwent DBS rated their condition as improved.
Dr. Alberts, who holds the Edward F. and Barbara A. Bell Family Endowed Chair, says physicians in the near future will assess patients remotely using consumer-friendly telemedicine technology such as the Microsoft HoloLens, a mixed-reality device that allows users to see and interact with three-dimensional holograms. The HoloLens will enable physicians to simultaneously evaluate motor skills and cognitive skills, helping to generate better treatment recommendations and outcomes for patients while connecting every part of the country with the expertise of Cleveland Clinic. The collected data also will help enable predictive analytics for other patients.