"Parkinson's Disease, Early Rehabilitation Therapy More Effective in Preventing Progression"

Professor Jo Seong-rae's Research Team at Severance Hospital

A study has found that the earlier rehabilitation for Parkinson's disease and Lewy body dementia begins, the better the treatment effects, including cognitive function improvement and protection of dopamine neurons.

Professor Seongrae Cho's research team from the Department of Rehabilitation Medicine at Severance Hospital announced on the 11th that the timing of starting rehabilitation treatment for Parkinson's disease and Lewy body dementia, representative neurodegenerative brain diseases caused by the accumulation of toxic alpha-synuclein protein, affects not only cognitive function improvement but also the protection of dopamine neurons.

Professor Cho Sung-rae, Department of Rehabilitation Medicine, Severance Hospital.

Parkinson's disease occurs as toxic alpha-synuclein accumulates within dopamine neurons. It mainly presents physical symptoms such as tremors, slowed movements, and postural instability. Lewy body dementia occurs when toxic alpha-synuclein accumulates throughout the brain, forming Lewy bodies (protein clumps found inside degenerating neurons). In addition to the physical symptoms of Parkinson's disease, cognitive decline, hallucinations, and REM sleep behavior disorder appear. Rehabilitation treatment is important for both diseases. To slow symptom progression, exercise rehabilitation such as gait training, as well as physical therapy, occupational therapy, and cognitive therapy, must be conducted.

The research team conducted animal experiments (mice) with genetically modified Parkinson's disease and Lewy body dementia models that accumulate toxic alpha-synuclein to investigate whether rehabilitation treatment protects dopamine neurons and actually induces improvements in motor and cognitive functions. Rehabilitation treatment was conducted for two months in an enriched environment, which differed from the standard animal housing by providing a large enclosure equipped with toys, tunnels, and running wheels to offer voluntary physical exercise and sensory-cognitive stimulation. As a result, Reelin protein and LAMP1 (Lysosomal-associated Membrane Protein 1) lysosomal protein in dopamine neurons reduced the toxic alpha-synuclein protein.

Additionally, a study was conducted to examine the differences in treatment effects by varying the timing of rehabilitation initiation in Parkinson's disease and Lewy body dementia mice. Mice in the early disease stage at 4 to 6 months old and in the late disease stage at 14 to 16 months old were exposed to the same rehabilitation environment for two months, providing free physical exercise and sensory-cognitive stimulation. Both groups showed improvements in olfactory and motor functions. However, olfactory function showed a 1.5 times greater improvement in the early-stage group at 6 months old, and cognitive function improvement and dopamine neuron protection effects were significant only in the early-stage group at 6 months old.

Professor Seongrae Cho stated, "This study elucidated the mechanism by which rehabilitation treatment not only improves physical strength but also reduces toxic proteins, thereby preventing the worsening of Parkinson's disease," adding, "The earlier rehabilitation begins in the disease course, the greater the effect in preventing disease progression."

The results of this study were published in the international neuroscience journal Neurobiology of Disease.

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