Brain modulation after exergaming training in advanced forms of Parkinson's disease: a randomized controlled study

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Digital Health

Background:

• Parkinson's disease (PD) significantly impacts gait and balance.
• Virtual reality (VR) and exergaming offer novel approaches to enhance engagement and clinical outcomes in PD management.
• Home-based interventions are crucial for sustained patient participation.

Purpose of the Study:

• To evaluate the effects of a home-based exergame training protocol on brain volume and resting-state functional connectivity (rs-FC) in individuals with PD.
• To compare the neurophysiological changes induced by active exergaming versus conventional computer-based control training.

Main Methods:

• A single-blind randomized controlled trial involving 23 PD patients with gait/balance disorders.
• The active group engaged in 18 sessions of a custom full-body movement exergame using a Kinect sensor at home.
• The control group performed the same training duration using a computer keyboard; brain MRI and clinical assessments were conducted pre- and post-intervention.

Main Results:

• The active group demonstrated significant improvements in gait and balance, alongside notable changes in rs-FC within sensorimotor, attentional, and basal ganglia networks.
• Specific rs-FC alterations included decreased connectivity between sensorimotor/attentional/basal ganglia networks and increased connectivity between cerebellar and basal ganglia networks.
• Post-training, the active group exhibited greater rs-FC between basal ganglia, motor cortical, and cerebellar areas compared to the control group.

Conclusions:

• Customized full-body movement exergaming effectively induced brain rs-FC changes in sensorimotor, attentional, and cerebellar networks in Parkinson's disease patients.
• These findings suggest that VR-based exergames can be a valuable tool for neurorehabilitation in PD.
• Further research is warranted to fully elucidate the neurophysiological mechanisms underlying these training-induced adaptations.