Effects of multimodal exercise program on motor and NON-motor symptoms of idiopathic parkinson patients and clinical correlation with ALPHA- synuclein level

Introduction: In this study, we are aimed to investigate the effect of multimodel exercise program on functional mobility, motor and non-motor symptoms, quality of life and serum exosomal alpha-synuclein level in people with Idiopathic Parkinson's disease. Method: In this study, 26 IPD patients who have scored better than 24 points in MMSE were assigned to a 12-week multimodel exercise program, The multimodel exercise program consisted of spinal flexibility, balance, coordination, and postural control. Following scales were used, level of disability-UPDRS, HYR, executive functions-Frontal Behavioral İnventory, Verbal Fluency Test, Abstraction Skill test, Clock Drawing Test, memory functions- Selective Reminding Test, Mood Disorders- HADS, PDQ-39 for quality of life, non-motor symptoms- NMSQ-TR, Epworth, Brief Pain Index Form, RLS Severity Rating Scale, Functional state-Tinetti gait and balance, FES, TUG and Plasma and exosomal derived alpha-synuclein levels. Findings: There were no significant differences in the MMSE and Clock Drawing Test, hence significant difference was observed in the HADS, Frontal Behavior Battery, scores. VFT Phonemic and Semantic sections, Selective Reminding Subtype LTS and STR. In addition, a significant difference was observed in UPDRS part 1 and part 3, NMSQ-TR, PDQ-39, Tinetti Balance & Gait Test, Tinetti, FES. There was no significant difference in plasma and exosomal alpha-synuclein levels. In the Spearman Rank correlation coefficient analysis, no significant correlation was found between UPDRS Chapter 3 and plasma total alpha-synuclein (p = 0.944, r = 0.230) and exosomal alpha-synuclein (p = 0.685, r = -0.103). Discussion: Multimodel Exercise Program had a positive effect on cognitive skills. We also confirmed the beneficial effect on motor and non-motor symptoms as we expected. However, no significant difference was observed between pre-and post-exercise values of plasma alpha-synuclein levels of the patients, and there was no correlation between the severity and duration of the disease. Keywords: Parkinson, Physical activity, Exercise, Exosome, Biomarker, Scale, Cognition, Nonpharmological Methods