Tai Chi improves non-motor symptoms of Parkinson's disease: One-year randomized controlled study with the investigation of mechanisms

Author: Gen Li1, Pei Huang2, Shishuang Cui1, Yachao He1, Qinying Jiang3, Binyin Li1, Yuxin Li3, Jin Xu3, Zheng Wang3, Yuyan Tan4, Shengdi Chen5
Affiliation: <sup>1</sup> Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People&#x27;s Republic of China. <sup>2</sup> Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People&#x27;s Republic of China; Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai, 201210, People&#x27;s Republic of China. Electronic address: hp12585@rjh.com.cn. <sup>3</sup> Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, People&#x27;s Republic of China. <sup>4</sup> Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People&#x27;s Republic of China. Electronic address: tyy11672@rjh.com.cn. <sup>5</sup> Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People&#x27;s Republic of China; Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai, 201210, People&#x27;s Republic of China. Electronic address: chensd@rjh.com.cn.
Conference/Journal: Parkinsonism Relat Disord
Date published: 2024 Jan 12
Other: Volume ID: 120 , Pages: 105978 , Special Notes: doi: 10.1016/j.parkreldis.2023.105978. , Word Count: 268


Background:
Tai Chi was found to improve motor symptoms in Parkinson's disease (PD). Whether long-term Tai Chi training could improve non-motor symptoms (NMS) and the related mechanisms were unknown.

Objective:
To investigate Tai Chi's impact on non-motor symptoms in PD and related mechanisms.

Methods:
95 early-stage PD patients were recruited and randomly divided into Tai Chi (N = 32), brisk walking (N = 31), and no-exercise groups (N = 32). All subjects were evaluated at baseline, 6 months, and 12 months within one-year intervention. Non-motor symptoms (including cognition, sleep, autonomic symptoms, anxiety/depression, and quality of life) were investigated by rating scales. fMRI, plasma cytokines and metabolomics, and blood Huntingtin interaction protein 2 (HIP2) mRNA levels were detected to observe changes in brain networks and plasma biomarkers.

Results:
Sixty-six patients completed the study. Non-motor functions assessed by rating scales, e.g. PD cognitive rating scale (PDCRS) and Epworth Sleepiness scale (ESS), were significantly improved in the Tai Chi group than the control group. Besides, Tai Chi had advantages in improving NMS-Quest and ESS than brisk walking. Improved brain function was seen in the somatomotor network, correlating with improved PDCRS (p = 0.003, respectively). Downregulation of eotaxin and upregulation of BDNF demonstrated a positive correlation with improvement of PDCRS and PDCRS-frontal lobe scores (p ≤ 0.037). Improvement of energy and immune-related metabolomics (p ≤ 0.043), and elevation of HIP2 mRNA levels (p = 0.003) were also found associated with the improvement of PDCRS.

Conclusions:
Tai Chi improved non-motor symptoms in PD, especially in cognition and sleep. Enhanced brain network function, downregulation of inflammation, and enhanced energy metabolism were observed after Tai Chi training.

Keywords: Anti-inflammation; Brain network; Non-motor symptoms; Parkinson's disease; Tai Chi.

PMID: 38244460 DOI: 10.1016/j.parkreldis.2023.105978