生活方式干预措施预防帕金森病

文摘

帕金森病(PD)的患病率增长迅速,放大寻求疾病修饰治疗在疾病早期阶段病理仍然是有限的。生活方式干预提供一个大有前途的途径阻止进展前驱的清单PD。我们说明这个主要是为1特定的生活方式干预,即有氧运动,因为其他的主要生活方式因素(饮食干预)修改的前驱的PD目前没那么有说服力了。各种观测暗示疾病潜在的运动。首先,与实验震颤麻痹在啮齿动物的研究表明,运动引发自适应神经可塑性在基底神经节电路。第二,锻炼与降低患帕金森病的风险有关,表明疾病修饰的潜力。第三,2人的大型试验清单PD表明锻炼可以帮助稳定电机震颤麻痹,尽管这可能也反映了有症状的效果。此外,运动似乎是一个可行的干预,鉴于其最小的副作用的风险。理论包括风险的增加下降事件和心血管并发症,但这些担忧似乎可以接受低。创新方法使用游戏化元素表明足够的长期遵守规律的运动项目可以实现,尽管更多的工作仍然需要证明持久坚持多年。 Advances in digital technology can be used to deliver the exercise intervention in the participant's own living environment and also to measure the outcomes remotely, which will help to further boost long-term compliance. When delivering exercise to prodromal participants, outcome measures should focus not just on phenoconversion to manifest PD (which may well take many years to occur) but also on measurable intermediate outcomes, such as physical fitness or prodromal nonmotor symptoms. Taken together, there seems to be sufficient evidence to advocate the first judicious attempt of investigating exercise as a disease-modifying treatment in prodromal PD.