Yoğun multidisipliner rehabilitasyon, Parkinson hastalığında serum ⁇ i>alfa ⁇ /i>-sinüklein ve miRNA ekspresyonunu modüle eder: randomize bir çalışmanın ön sonuçları.

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IntroductionParkinson's disease is a progressive neurodegenerative condition, and unfortunately, there are currently no treatments available that can halt or slow down its progression. However, recent research on intensive and multidisciplinary rehabilitation shows great promise, indicating that vigorous exercise may offer benefits to patients. This study is a randomized, single-blind, controlled, two-arm trial comparing an intensive outpatient multidisciplinary rehabilitation program with a home-based self-administered stretching program in Persons with Parkinson's disease (PwPD). This study aims to assess the effects of an intensive rehabilitation program compared to a home-based self-treatment plan on the serum expression of four molecular biomarkers: brain-derived neurotrophic factor (BDNF), total α-synuclein, miR-223-3p, and miR-7-1-5p in PwPD.MethodsWe enrolled seventy PwPD in mild-to-moderate stages (average age: 71.15 ± 16.19 years, disease duration: 7.67 ± 5.61 years; UPDRS: 38.06 ± 13.07). Out of these, 36 participants (19 males and 17 females) were assigned to an outpatient daily intensive multidisciplinary rehabilitation treatment (EXP-PwPD), while 34 (22 males and 12 females) participated in a home-based self-treatment stretching program (CTRL-PwPD). Serum samples were taken at baseline (T0), at the end of the intervention period (T1, 6 weeks after T0), and at T2 (3 months after T1). We measured the protein concentrations (BDNF and α-synuclein) and circulating miRNAs (miR-223-3p and miR-7-1-5p) in the serum, and compared results between the groups.Results and discussionThe intensive rehabilitation program led to a significant increase in serum BDNF and α-synuclein expression. Notably, the rise in serum α-synuclein was dependent on exercise, returning to baseline concentration at T2, while serum BDNF remained significantly elevated even 2 months post-program completion (T2) (p = 0.03). Among the miRNAs studied, miR-7-1-5p reflected the pattern of BDNF, showing a notable increase after intensive rehabilitation (p = 0.05) and persistence at follow-up (p = 0.04). There were no significant changes for miR-223-3p. In conclusion, this study indicates that intensive rehabilitation can modify circulating biomarkers in PD. Our findings indicate that intensive exercise induces a sustained elevation of serum BDNF and miR-7-1-5p, reflecting enhanced neuroplastic and neurotrophic activity.Clinical trial registrationClinicalTrials.gov, identifier: NCT05452655.

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