Abstract
BackgroundTai Chi has been shown to improve motor symptoms in Parkinson’s disease (PD), but its long-term effects and the related mechanisms remain to be elucidated. In this study, we investigated the effects of long-term Tai Chi training on motor symptoms in PD and the underlying mechanisms.MethodsNinety-five early-stage PD patients were enrolled and randomly divided into Tai Chi (n = 32), brisk walking (n = 31) and no-exercise (n = 32) groups. At baseline, 6 months and 12 months during one-year intervention, all participants underwent motor symptom evaluation by Berg balance scale (BBS), Unified PD rating-scale (UPDRS), Timed Up and Go test (TUG) and 3D gait analysis, functional magnetic resonance imaging (fMRI), plasma cytokine and metabolomics analysis, and blood Huntingtin interaction protein 2 (HIP2) mRNA level analysis. Longitudinal self-changes were calculated using repeated measures ANOVA. GEE (generalized estimating equations) was used to assess factors associated with the longitudinal data of rating scales. Switch rates were used for fMRI analysis. False discovery rate correction was used for multiple correction.ResultsParticipants in the Tai Chi group had better performance in BBS, UPDRS, TUG and step width. Besides, Tai Chi was advantageous over brisk walking in improving BBS and step width. The improved BBS was correlated with enhanced visual network function and downregulation of interleukin-1β. The improvements in UPDRS were associated with enhanced default mode network function, decreased L-malic acid and 3-phosphoglyceric acid, and increased adenosine and HIP2 mRNA levels. In addition, arginine biosynthesis, urea cycle, tricarboxylic acid cycle and beta oxidation of very-long-chain fatty acids were also improved by Tai Chi training.ConclusionsLong-term Tai Chi training improves motor function, especially gait and balance, in PD. The underlying mechanisms may include enhanced brain network function, reduced inflammation, improved amino acid metabolism, energy metabolism and neurotransmitter metabolism, and decreased vulnerability to dopaminergic degeneration.Trial registration This study has been registered at Chinese Clinical Trial Registry (Registration number: ChiCTR2000036036; Registration date: August 22, 2020).
Highlights
Tai Chi has been shown to improve motor symptoms in Parkinson’s disease (PD), but its long-term effects and the related mechanisms remain to be elucidated
We found that the differences in Unified PD rating-scale (UPDRS) total score and UPDRS-III score were associated with the change of Huntingtin interaction protein 2 (HIP2) mRNA level after Bonferroni correction (P < 0.005)
Compared to the control group, the HIP2 mRNA level was elevated after Tai Chi training for 6 months (P < 0.001) and Discussion In this study, we found long-term beneficial effects of Tai Chi in improving balance and other motor symptoms in PD
Summary
Tai Chi has been shown to improve motor symptoms in Parkinson’s disease (PD), but its long-term effects and the related mechanisms remain to be elucidated. We investigated the effects of long-term Tai Chi training on motor symptoms in PD and the underlying mechanisms. With progression of the disease, patients lose postural stability and have difficulty in gait and balance, causing frequent falls and disability in daily living [2]. Evidence from randomized controlled trials by Fuzhong Li et al shows improvement of maximal excursion, direction control, gait velocity and quality of life after 6-month Tai Chi training in PD patients [6, 11]. Previous studies focusing on Tai Chi training only showed shortterm (up to 6 months) benefits for PD patients. Owing to the progressive nature of PD, the long-term effects of such interventions should be concerned
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