Rehabilitative exercise in idiopathic Parkinson disease: microstructural white matter changes by using Diffusion Tensor Imaging

Poster Session C - Sunday, April 14, 2024, 5:00 – 7:00 pm EDT, Sheraton Hall ABC

Manfredi Alberti¹, Carla Battisti, Davide Momi, David Cioncoloni, Armando Bucciarelli, Roberto Marconi, Alessandra Renieri, Alessandro Rossi, Federica Ginanneschi, Lucia Monti; ¹University Hospital of Siena, Siena, Italy, ²Clinical Neurology and Neurophysiology Unit; University of Siena;, ³Keller's Laboratory for Personalized Neurotherapeutics, Stanford University, 450 Jane Stanford Way., Stanford, CA 90305;, ⁴Rehabilitative Healthcare Professions Unit, University Hospital of Siena, ⁵Rehabilitative Healthcare Professions Unit;, ⁶Neurology Unit, General Hospital of Grosseto,, ⁷Medical Genetics, University of Siena, ⁸Neurology Unit, University of Siena;, ⁹Clinical Neurology and Neurophysiology Unit;, ¹⁰Neuroimaging Unit, University Hospital of Siena,

Background DTI in idiopathic PD patients revealed disruptions in cortico-thalamic connectivity, leading to basal ganglia output inhibition and dysfunction in cortico-subcortical circuits. The aim is to determine if specific rehabilitative exercise induces changes in DTI parameters reflecting myelin-axonal integrity. Material and methods Thirteen (mean age 69.1±6.5 years) patients with idiopathic Parkinson's disease (PD) underwent rehabilitative exercise (RE). Upper-limb RE were conducted over an 8-week period. DTI images were acquired and preprocessed using FSL and MRtrix3. DTI tractography was performed using DSI Studio. Computerized dynamic posturography and UPDRS-III were employed to assess the clinical improvement. Results Whole brain DTI conducted before (t0) and after motor training (t1) showed statistically significant differences for the values of MD(p=0.0092), AD(p=0.017), RD(p=0.0092) of the inferior cerebellar peduncle, for the MD value (p=0.047) of the middle cerebellar peduncle, for the MD(p=0.009),AD(p=0.03), and RD(p=0.01) values of the right anterior corticothalamic radiation , and for the AD value of the left superior corticothalamic radiation (p=0.047). Recovery in postural stability (p=0.017) and enhancement in motor activity (p=0.0074). Discussion There is a gap in studies investigating microstructural changes before and after rehabilitation using DTI. The reduction of pathological findings in the inferior cerebellar peduncle, identified through DTI analysis is crucial for processing proprioceptive and cerebellovestibular stimuli and may influence changes in the anterior and superior corticothalamic tracts. This underscores the potential contribution of the cerebellum to PD compensatory mechanisms. Our research aims to address this gap, potentially advancing our understanding of treatment effects and refining interventions for PD patients.

Topic Area: METHODS: Neuroimaging