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Investigator: Madeleine Hackney
Phone: (314) 412-4852 ext. 5006
Primary Research Interest: Other
Description of Research: This trial will recruit veterans and non-veterans with definite PD to compare the efficacy of PDAE versus WAE for motor, non-motor and neuroprotective effects. The primary outcome measure will be the UPDRS-IV scale, a patient-reported measure of experience of MRMF. 1.Examine effects of Training (3 mos.) and Maintenance phases (13 mos.) of PDAE vs. WAE on patient experience of OFF times. Prediction: Groups will report reduced OFF times, but PDAE effect will be greater at 3 and 16 months. 2.Compare PDAE vs.WAE at 3 and 16 mos. on endurance, behavioral and neural measures of spatial cognition. Predictions:1. PDAE will improve as much as WAE on endurance but PDAE will improve more on behavioral measures of spatial cognition. 2. Behavioral and neural measures of spatial cognition post-intervention will be positively correlated in PDAE. 3.Determine if PDAE vs. WAE vs. non-intervention controls is neuroprotective and if this neuroprotection is associated with OFF time (Aim 1), and cognitive (Aim 2) response to PDAE and WAE. Predictions: At 16 months, slowed NM loss and decreased iron accumulation rate will be noted in PDAE and WAE vs. non-intervention participants and slowed neurodegeneration will be associated with spatial function response.
Relevance to VA: People with PD have limited options for pharmacological and surgical treatments. PDAE may play a key role in reducing OFF Time experiences but empirical evidence is needed to confirm short and long term effects upon medication-related motor fluctuations, to influence physician prescribed treatments to veterans with PD. Our findings will be generalizable to the 75% of people with PD who experience OFF times, and the 50% with CI. We will target those people who have OFF times and include those with MoCA scores <26 who are frequently excluded from exercise trials. The latter criteria disproportionately affects veterans who typically score lower on MoCA. Understanding the mechanisms for improving cognition via PDAE will inform dual exercise/mental training methods and enhance efficacy in addressing cognitive impairment, one of the most disabling PD symptoms. Understanding the relationships between drug efficacy and exercise modalities will allow clinicians to target and treat PD suitably.

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