Intense Balance Training May Affect Brain Structure in Parkinson Disease

A highly challenging, supervised balance and gait training program led to subtle structural brain changes in patients with Parkinson disease (PD), according to a study published in the Journal of Parkinson’s Disease.

“Altogether, our results show tendencies that the HiBalance training program has an impact on brain structure in participants with Parkinson disease, and that this effect could lead to better motor performance,” researchers wrote. “The study yields an important contribution to physical exercise as treatment and informs further clinical intervention studies.”

The study randomized 95 patients with PD to HiBalance balance and gait training or an active control speech training intervention. Group sessions met for 1 hour twice a week over 10 weeks. Researchers were mainly interested in brain structure changes as captured by magnetic resonance imaging before and after the intervention and any effect on balance and gait symptoms.

Study results showed no group-by-time effect on brain structure, balance performance, or gait speed, researchers reported. However, analyses revealed that brain network topology changed in HiBalance participants, “resulting in reorganization of communities and increased bilateral thalamic to right cerebellar connectivity,” according to the study. Furthermore, within-group analyses showed increased whole-brain gray matter volume in the left putamen in HiBalance participants. Left putamen volume correlated positively with measures of gait speed after training.

No brain topology or volume changes occurred after training in active control participants.

“Based on these results, we cannot draw a definite conclusion that the training is effective,” researchers wrote. “However, our results show a tendency that the training impacts participants’ brain structure.”

They advised more studies into whether training modifications or alternative methods of assessment would result in stronger effects.

Reference:
Albrecht F, Pereira JB, Mijalkov M, et al. Effects of a highly challenging balance training program on motor function and brain structure in Parkinson’s disease. J Parkinsons Dis. 2021;11(4):2057-2071. doi:10.3233/JPD-212801