Parkinson’s disease (PD) is a degenerative neurological disorder characterized by motor and neuropsychological abnormalities, which result in disorders of both movement expression and action performing. The dopaminergic neuronal loss in substantia nigra pars compacta results in altered functional connectivity in cortico-basal ganglia networks: the latter is believed to be involved in the pathophysiology of the cardinal motor symptoms of the disease and, along with the degeneration of neural systems other than the dopaminergic one, contributes to the development of cognitive, motivational and emotional deficits.
Nowadays, PD should be regarded as a complex motor behavior disease. Given the multi-layered complexity of PD, its optimal management involves multidisciplinary approaches combining both pharmacotherapy and non-pharmacological interventions. Neurorehabilitation is a potentially effective non-pharmacological treatment for the management of PD: it is noteworthy that exercise paradigms entailing goal-directed practice and incorporating aerobic training may facilitate neuroplastic changes needed to overcome aberrant functioning within the basal ganglia and restore motor-cognitive circuitries in PD. In this purpose, the need to engage cognition to reach motor benefits in PD rehabilitation has been understood, but it remains to clarify how and what types of motor-cognitive protocols should be practiced in terms of intensity, frequency, duration, type of exercise, devices (i.e. virtual reality, trans-cranial magnetic stimulation) and setting.
This Research Topic aims to explore the best way to engage cognition to achieve motor benefits in PD. By engaging cognition and encouraging patients to perform beyond their self-perceived capabilities, aerobic physical therapy may facilitate motor learning and achieve broad clinical, motor and functional benefits.
Therefore, we welcome original research articles and reviews that focus on new methods and on applications aimed to i) maximize the neuroplasticity of both motor and cognitive circuitries through the aerobic exercise, ii) foster the re-learning process of lost habitual motor behavior in PD, iii) use adaptive techniques (bottom-up and top-down strategies) in PD, iv) activate the volitional-executive motor control system in PD, and v) reinforce the cortical mechanisms involved in motor drive in PD.
Finally, we encourage authors to describe how these protocols/techniques result in neuroplastic changes (including in animal models), clinical state, and quality of life.
We would like to acknowledge that
Dr. Paola Ortelli and
Dr. Davide Ferrazzoli (Moriggia-Pelascini Hospital, Italy) have acted as coordinators and have contributed to the preparation of the proposal for this Research Topic.