Treadmill in Parkinson’s: influence on gait, balance, BDNF and Reduced Glutathione

Abstract Introduction: Parkinson’s disease (PD) is characterized by nigrostriatal degeneration, with dopaminergic depletion, and inflammatory and oxidative changes in the brain, leading to movement and coordination disorders. Recent studies have shown that treadmill training can be beneficial for these patients, but there is little evidence assessing the related blood parameters, such as oxidative stress and neurotrophin levels. Objective: Assess the influence of treadmill training for patients with Parkinson’s on gait, balance, Brain-Derived Neurotrophic Factor (BDNF) and reduced glutathione. Methods: Twenty-two patients with PD (Hoehn and Yahr II and III), older than 40 years, were randomly allocated to two groups: CG (n = 12) - drug treatment and IG (n = 10) - treadmill. Assessments related to functional capacity (quality of life, static and dynamic analysis of gait) and blood parameters such as GSH and BDNF were conducted before and after the eight-week intervention. Results: The demographic data of the groups were homogeneous in terms of age, sex, height, weight, time since disease onset, mini mental examination and the geriatric depression scale. Significant intergroup differences were found for the mental component summary, surface variation, latero-lateral oscillation, antero-posterior oscillation and mean velocity in the post-intervention period. The IG exhibited a strong association between BDNF and GSH, with statistically significant values. Conclusion: It was concluded that controlled treadmill walking improves static balance, quality of life and plasma BDNF and GSH levels in patients with PD.

背景：帕金森病（PD）以黑质纹状体变性为核心病理特征，伴随多巴胺能耗竭及脑部炎症与氧化改变，进而引发运动与协调功能障碍。已有研究表明跑步机训练对该类患者有益，但目前鲜有研究评估其相关血液参数，如氧化应激与神经营养因子水平。
研究目的：评估跑步机训练对帕金森病患者的步态、平衡能力、脑源性神经营养因子（Brain-Derived Neurotrophic Factor, BDNF）以及还原型谷胱甘肽的影响。
研究方法：纳入22名年龄＞40岁的霍恩-亚尔（Hoehn and Yahr）分期II、III级帕金森病患者，将其随机分为两组：对照组（CG, n=12）仅接受药物治疗，干预组（IG, n=10）辅以跑步机训练。在为期8周的干预前后，分别对两组患者的功能能力（包括生活质量、静态与动态步态分析）以及血液参数（如还原型谷胱甘肽（GSH）与BDNF）开展检测与评估。
研究结果：两组的人口学基线资料在年龄、性别、身高、体重、发病时长、简易精神状态检查评分以及老年抑郁量表评分方面均具有同质性。干预后，两组在精神成分摘要评分、表面变异度、侧向摆动、前后摆动以及平均步态速度方面存在显著组间差异。干预组的BDNF与GSH水平呈现强相关性，且该相关性具有统计学意义。
研究结论：本研究证实，标准化跑步机步行训练可改善帕金森病患者的静态平衡能力、生活质量以及血浆BDNF与GSH水平。