# Partnered Dance Aerobic Exercise as a neuroprotective, motor and cognitive intervention in Parkinson's disease

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## Abstract

Parkinson’s disease (PD), an intractable condition impairing motor and cognitive function, is imperfectly treated
by drugs and surgery. Two priority issues for a majority of people with PD are OFF-time and Cognitive
impairment. Even under best medical management, 74% of people with PD experience “OFF-time” related to
medication-related motor fluctuations, which severely impacts both quality of life and cognition 1. Cognitive
deficits are found even in newly diagnosed people with PD and are very difficult to treat 2. However, our strong
preliminary data demonstrate that partnered dance-aerobic exercise reduces OFF-time (Cohens standardized
d=1.09), on the Movement Disorders Society Unified Parkinson Disease Rating Scale-IV, MDS-UPDRS-IV) and
ameliorates other disease features 5-8, with retention of benefits for at least one month post-PDAE. These data
motivate this proposal. PDAE provides AE during an improvisational, cognitively-engaging rehabilitative physical
activity. Cognitive engagement is a critical component of PDAE, which has benefitted spatial cognition (d=.76).
Consistent with these findings, we have strong preliminary evidence, obtained via functional magnetic resonance
imaging (fMRI), that biweekly PDAE training increases activity in brain regions implicated in cognition. Although
exercise benefits motor and cognitive symptoms and may be neuroprotective for PD, 3,4 studies using robust
biomarkers of neuroprotection in humans are quite rare. We propose to perform a randomized, controlled trial in
veterans and non-veterans with diagnosed PD to compare the efficacy of PDAE versus walking AE (WAE) for
OFF-time, cognition, and neuroprotection. Importantly, we will assess neuroprotection with novel neuromelanin-
sensitive MRI (NM-MRI) and iron-sensitive (R2*) MRI sequences to quantify neuromelanin loss and iron
accumulation in substantia nigra pars compacta (SNc) 3,8 9. We will use these biomarkers, neuromelanin loss
and iron accumulation, as tools to chart the course of neurodegeneration in patients with PD who have
undergone long-term (16 months) intervention. Our overall hypothesis is that PDAE – a cognitively engaging AE
– is more effective at reducing OFF-time and improving cognition than WAE. However, similar to WAE, we
believe PDAE is neuroprotective in PD. We will randomly assign 102 veterans with mild-moderate PD to 16
months of PDAE or WAE. The 16-month observation period is required to robustly assess neuroprotection with
imaging outcomes. The innovative 16-month intervention period will consist of previously established Training
(3 months of biweekly sessions) and novel Maintenance (13 months of weekly sessions) phases. We will assess
participants at baseline, 3 months (immediately post-Training), and 16 months (immediately post-Maintenance)
for OFF-time and behaviorally and physiologically measured cognition. We will acquire NM-MRI and R2* imaging
data at baseline and 16 months to assess neuroprotection. We will: 1. examine eff...

## Key facts

- **NIH application ID:** 9837023
- **Project number:** 1I01RX002967-01A2
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Madeleine Eve Hackney
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2019-11-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9837023

## Citation

> US National Institutes of Health, RePORTER application 9837023, Partnered Dance Aerobic Exercise as a neuroprotective, motor and cognitive intervention in Parkinson's disease (1I01RX002967-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9837023. Licensed CC0.

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