The Effects of Multimodal Exercise on Sleep Quality and Architecture, Motor Function, Cognition, Fatigue, and Systemic Inflammation in Corticobasal Syndrome: A Case Report.

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Abstract Importance. Corticobasal syndrome (CBS) is a rare tauopathy, with a complex pathophysiology that usually includes neuroinflammation. Parkinsonism, cognitive impairments, and sleep disturbances are common in CBS, although alterations in sleep architecture remain poorly characterized. Regular exercise has been recommended in CBS to manage gait dysfunction, balance issues, and cognitive decline. However, to our knowledge, no studies examined the effects of regular exercise on sleep quality, sleep architecture and systemic inflammation in CBS. Objective. To describe the effects of a 12-week training program in CBS. Methods. An individual with CBS “On” antiparkinsonian medications was assessed before and after a 12-week multimodal training program. Cardiorespiratory fitness level (V̇O2peak) was assessed with a symptom-limited cardiopulmonary exercise test and strength with a sub-maximal 1-RM test. Subjective and objective sleep quality were assessed using the Parkinson’s Disease (PD) Sleep Scale-2 and actigraphy, respectively. Sleep architecture was evaluated with polysomnography. Cognition and motor function were assessed with the Scale for Outcomes in PD-Cognition (SCOPA-COG) and MDS-UPDRS-III, respectively. Fatigue was assessed with the PD Fatigue Scale. Concentrations of inflammatory cytokines interleukin (IL)1β, IL6, IL10, tumor necrosis factor (TNF)α, and C-reactive protein (CRP) were measured from serum collected after a 12-hour fasting period. Results. Following the training program (34 sessions; 25.35 hours), we observed improvements in fitness, objective sleep quality and architecture, cognition and a reduction in systemic inflammation. Conversely, motor function deteriorated, and the participant reported diminished subjective sleep quality and increased fatigue. Conclusions. Our results suggest that exercise may improve specific clinical outcomes in CBS. However, it had no positive effects on motor signs, subjective sleep quality and fatigue, which worsened. Controlled studies are warranted to confirm and expand our observations. Impact. To our knowledge, this is the first case report describing the effects of a training program on sleep architecture and systemic inflammation in CBS.

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