Neuroscience of Exercise - Final Exam

• Motor symptoms of Parkinson's

  bradykinesia (slow movement)

  tremors/shaking

  gait and postural instability
• Non-motor symptoms of Parkinson's

  decreased independence (decreased QOL), mood disorders, hallucinations, changes in BP
• cognitive impairment - parkinsons

  **usually not present at the time of diagnosis

  
  

  attention, executive function, decreased speed of thought

  
  

  loss of gray matter

  
  

  primary motor cortex (plan execution) is disrupted

  
  

  prefrontal cortex (plan formation) is dirsupted
• how early can someone display non-motor symptoms?

  up to 20 years prior
• how many people worldwide have parkinsons?

  >4 million people
• how many people worldwide WILL have parkinsons by 2040

  1 million
• what is the most 2nd common neurodegenerative disease?

  parkinson's
• how many people out of 1000 are diagnosed with PD?

  1-2
• What is the onset of motor symptoms in relation to the time of diagnosis of Parkinson's disease?

  gradually progressive dsiease, symptoms worsen over time

  
  

  early symptoms may be mild and go unnoticed

  
  

  (postural instability with advanced diagnosis)
• definition of parkinson's

  a neurodegenerative disease characterized by presence of a movement order

  
  

  MOTOR AND NONMOTOR
• what contributes to parkinson's diagnosis?

  dopaminergic neurons in the substantia nigra die - decreased dopamine
• what confirms parkinson's diagnosis?

  interference with ADLs due to up to 80% of dopaminergic cells dying
• when do motor symptoms start to appear?

  once 60-80% of the dopaminergic cells have died
• diagnosis of parkison's largely depnds on

  level of independence

  
  

  unilater --> bilateral --> lose independence overtime
• what does "Genetic predisposition loads the gun, and the environment pulls the trigger" mean?

  there is a balance of genetic and environmental factors that underlie occurrence of PD
• What are the different methodologies that we discussed to treat Parkinson's disease?

  Surgical Electrode implant

  
  

  Dopamine manipulation

  
  

  neurotransmitter faciliation

  
  

  Music therapy

  
  

  Dancing

  
  

  Exercise

  
  

  Healthy diet
• Surgical Electrode implant - parkinson's

  basal ganglia

  reduces symptoms
• Dopamine manipulaiton - Parkinsons

  levodopa with carbidopa
• NT facilitation = parkisons

  treatment of dyskinesia, tremors, rigidity
• Dancing - parkinson's

  connects damaged signals from brain to limb

  
  

  ****motor fitness hypothesis

  
  

  not necessarily medicine but does improve QOL
• Be familiar with the proposed mechanisms of how exercise may benefit those with Parkinson's disease as presented by Dr. Barrett

  Exercise improves motor symptoms (improvement in balance, gait speed, leg strength)

  
  

  large-amplitude movements

  
  

  improves QOL and non-motor symtpoms (cognition, depression, sleep)
• exercise in parkinson's leads to

  enhanced neuroplasticity

  increased BDNF

  angiogenesis (VEGF)
• what is VEGF


  a chemical our cells make that causes blood vessels to grow toward the cell to feed it
• does exercise improve executive function in parkinsons?

  NO
• is there a FITTD for PD?

  NO, but we know that something is better than nothing

  
  

  F = 3x a week

  I = light to moderate

  T = meet them where they are

  T = 15-20mins

  D = lifelong
• what are the different types of exercise for parkinson's

  Aerobic

  amplitude (dancing)

  progressive resistance

  Group-based
• what is the definition of concussion?

  A traumatic brain injury caused by a direct blow to the head, neck, or body resulting in an impulsive force being transmitted to the brain
• S/S of concussion

  common = headache, dizziness, nausea, difficulty concentrating
• Loss of consciousness appears in _____% of concussions

  20%
• Which population(s) and what demographic variables have been demonstrated to lead to an increased risk of sustaining a sport concussion?

  women at higher risk

  countries with higher number of pedestrians and biking

  contact sports
• What percent of concussions occur because of sport?

  30%

  (the other 70% is life)
• Be familiar with the neurometabolic cascade associated with sport concussion.

  Concussion - biomechanical force to head, neck or body

  
  

  What happens to the neurons during a concussion? They stretch and glutamate is released

  
  

  Binds to NDA receptor

  
  

  During normal depolarization → K+ leaves, Na+ enters

  
  

  During concussion, glutamate enters and binds to the Nmd receptor, sodium enters, calcium comes in as well, potassium out

  
  

  Influx of calcium and sodium BUT this requires ATP

  
  

  Calcium impairs mitochondrial function

  T

  o produce ATP, we need glucose

  
  

  But we are in short supply of oxygen because cerebral blood flow is reduced by 50%

  
  

  Limited glucose and oxygen delivery

  After 7-10 days, cerebral blood flow goes back to normal, and we hit homeostasis.
• Can concussions be diagnosed with standard neuroimaging techniques?

  NO
• How do we assess sport concussion? What is the best (as of 2017) approach to assess sport concussion? Why?

  measure symptoms, cognitive function, and balcance

  there is no gold standard
• what is the sensitivity when you measure symptoms, cognitive function, and balance together?

  100%
• do we still grade concussions?

  no, you either have one or you don't
• Sensitivity concussions

  ability of a test to detect a concussion when a concussion is present
• Specificity concussion

  ability of a test to detect a healthy individual when healthy
• What is the typical recovery from sport concussion (in days) for adolescent vs adult athletes? Is there a difference?

  No difference - about 14 days
• Be familiar with the stages of the return-to-play protocol following a sport concussion

  1. No activity

  2. light aerobic exercise (walking, swimming, stationary bike at moderate intensity)

  3. sport-specific exercise

  4. non-contact training drills

  5. full-contact practice

  6. return to normal game play