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Yoga as an Add-on Therapy in Parkinson’s Disease: A Single Group Open-label Trial

Published online by Cambridge University Press:  25 March 2024

Pooja Mailankody ,
Nitish Kamble ,
Amitabh Bhattacharya Open the ORCID record for Amitabh Bhattacharya [Opens in a new window] ,
G.S. Shubha Bhat ,
Thamodharan Arumugam ,
K. Thennarasu ,
Rashmi Arasappa ,
Shivarama Varambally ,
Ravi Yadav Open the ORCID record for Ravi Yadav [Opens in a new window]  and
Pramod Kumar Pal Open the ORCID record for Pramod Kumar Pal [Opens in a new window]
Pooja Mailankody
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Nitish Kamble
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Amitabh Bhattacharya
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
G.S. Shubha Bhat
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Thamodharan Arumugam
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
K. Thennarasu
Affiliation:
Department of Biostatistics, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Rashmi Arasappa
Affiliation:
Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Shivarama Varambally
Affiliation:
Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Ravi Yadav
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
Pramod Kumar Pal*
Affiliation:
Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
*
Corresponding author: Pramod Kumar Pal; Email: [email protected]
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Abstract

Objective:

We aimed to evaluate the effect of yoga on motor and non-motor symptoms and cortical excitability in patients with Parkinson’s disease (PD).

Methods:

We prospectively evaluated 17 patients with PD at baseline, after one month of conventional care, and after one month of supervised yoga sessions. The motor and non-motor symptoms were evaluated using the Unified Parkinson’s disease Rating Scale (motor part III), Hoehn and Yahr stage, Montreal Cognitive Assessment, Hamilton depression rating scale, Hamilton anxiety rating scale, non-motor symptoms questionnaire and World Health Organization quality of life questionnaire. Transcranial magnetic stimulation was used to record resting motor threshold, central motor conduction time, ipsilateral silent period (iSP), contralateral silent period (cSP), short interval intracortical inhibition (SICI), and intracortical facilitation.

Results:

The mean age of the patients was 55.5 ± 10.8 years, with a mean duration of illness of 4.0 ± 2.5 years. The postural stability of the patients significantly improved following yoga (0.59 ± 0.5 to 0.18 ± 0.4, p = 0.039). There was a significant reduction in the cSP from baseline (138.07 ± 27.5 ms) to 4 weeks of yoga therapy (116.94 ± 18.2 ms, p = 0.004). In addition, a significant reduction in SICI was observed after four weeks of yoga therapy (0.22 ± 0.10) to (0.46 ± 0.23), p = 0.004).

Conclusion:

Yoga intervention can significantly improve postural stability in patients with PD. A significant reduction of cSP and SICI suggests a reduction in GABAergic neurotransmission following yoga therapy that may underlie the improvement observed in postural stability.

Clinicaltrialsgov identifier:

CTRI/2019/02/017564

Résumé

Résumé

Le yoga comme traitement d’appoint de la maladie de Parkinson : résultats d’un essai non à l’insu, mené dans un seul groupe.

Objectif :

L’étude visait à évaluer l’effet du yoga sur les symptômes moteurs et non moteurs de la maladie de Parkinson (MP) ainsi que sur l’excitabilité corticale chez des patients atteints.

Méthode :

Il s’agit d’une étude prospective, réalisée chez 17 patients souffrant de la MP, qui ont été évalués au début, au bout d’un mois de soins usuels et d’un mois de séances supervisées de yoga. Les symptômes moteurs et non moteurs ont été évalués à l’aide de l’échelle Unified Parkinson’s disease Rating Scale (UPDRS, partie III, résultats moteurs), de l’instrument de stadification Hoehn and Yahr (H&Y), du test Montreal Cognitive Assessment (MoCA), de l’échelle de dépression d’Hamilton (HAM-D), de l’échelle d’anxiété d’Hamilton (HAM-A), du questionnaire sur les symptômes non moteurs (NMS) et du questionnaire de l’Organisation mondiale de la Santé sur la qualité de vie (QOL). L’enregistrement du seuil moteur au repos (RMT), du temps de conduction motrice centrale (CMCT), de la période silencieuse homolatérale (iSP), de la période silencieuse controlatérale (cSP), de l’inhibition intracorticale à intervalles courts (SICI) et de la facilitation intracorticale (ICF) a été effectué à l’aide de la stimulation magnétique transcrânienne.

Résultats :

L’âge moyen des patients était de 55,5 ± 10,8 ans, et la durée moyenne de la maladie, de 4,0 ± 2,5 ans. La stabilité posturale des patients s’est améliorée de manière significative après le yoga (0,59 ± ,5 à 0,18 ± 0,4; p = 0,039). Une réduction significative de la cSP, depuis le début (138,07 ± 27,5 ms) jusqu’à 4 semaine de traitement par le yoga (116,94 ± 18,2 ms; p = 0,004), a aussi été observée. Il en a été de même pour la SICI après 4 semaine de traitement par le yoga (0,22 ± 0,10 à 0,46 ± 0,23; p = 0,004).

Conclusion :

L’intervention par le yoga peut améliorer sensiblement la stabilité posturale chez les patients atteints de la MP. Quant à la réduction importante de la cSP et de la SICI, elle donne à penser à une diminution de la neurotransmission gabaergique après le traitement par le yoga, qui pourrait sous-tendre l’amélioration de la stabilité posturale.

Keywords

Parkinson’s diseaseresting motor thresholdshort interval intracortical inhibitionsilent periodtranscranial magnetic stimulationyoga
Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 52 , Issue 1 , January 2025 , pp. 102 - 109
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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Footnotes

Pooja Mailankody and Nitish Kamble both authors contributed equally to the manuscript. Hence both are to be considered as first authors.

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