The Role of Gut Health in Parkinson’s disease: The Impact on Motor Symptoms and Fitness Levels

While Parkinson’s disease (PD) has traditionally been considered a central nervous system disease, recent groundbreaking research argues that PD symptomology is influenced by gut microbiota alterations (dysbiosis).1 People with PD suffer from dysbiosis,2-6 and gut symptoms characteristic of dysbiosis, like constipation.7,8 Given this evidence, strategies that improve gut health in PD are warranted. One possible strategy is exercise. In non-PD populations, fitness status is linked to gut health,9-13 and exercise which increases fitness status improves the gut.14-19 It is now known that exercise improves motor symptoms in PD,20-23 but the gut may be a moderator of these improvements. However, no study has taken the crucial first step to link fitness with motor and gut symptoms in PD. In addition, there is a need to determine whether norms for fitness status 24 indicate PD symptom severity to provide clinicians with a benchmark by which they can improve the fitness of people with PD. PURPOSE: We aimed to 1) associate fitness, motor symptoms, and constipation and 2) determine the influence of aerobic fitness norms on motor symptoms and constipation in 19 people with PD. METHODS: Constipation was measured via the ROME-IV survey (summing nine symptom questions). Fitness was defined as estimated oxygen consumption (VO2) via a 6-minute walk test (6MW). Normative classifications were used to determine whether participants met (HI) or did not meet aerobic fitness status (LO).25 Motor symptoms were assessed via the Unified Parkinson’s Disease Rating Scale III (UPDRS-III). A linear regression was used to associate VO2 peak, UPDRS-III, and constipation. A MANOVA was used to compare symptoms between HI and LO groups. RESULTS: VO2 peak was inversely associated with constipation (t= 2.67, p=.018, effect size = -.48, 95% CI= -.86 to -.10) and UPDRS-III scores (t= -2.35, p= .033, effect size= -.48, 95% CI= -.92 to -.04). The HI group had lower constipation (p=.018) and UPDRS-III scores (p=.03) than the LO group. DISCUSSION: Not only is there a link between aerobic fitness, motor function, and constipation in people with PD, but there seems to be aerobic fitness benchmarks (i.e., HI vs. LO) that clinicians can use to improve the fitness status of their patients. In doing so, this can not only lead to improvements in motor function, but also improved gut health in people with PD. REFERENCES 1. McCann H, Cartwright H, Halliday GM. Neuropathology of alpha-synuclein propagation and braak hypothesis. Mov Disord. 2016;31(2):152-160. 2. Aho VTE, Pereira PAB, Voutilainen S, et al. Gut microbiota in Parkinson\u27s disease: Temporal stability and relations to disease progression. EBioMedicine. 2019;44:691-707. 3. Scheperjans F, Aho V, Pereira PA, et al. Gut microbiota are related to Parkinson\u27s disease and clinical phenotype. Mov Disord. 2015;30(3):350-358. 4. Heintz-Buschart A, Pandey U, Wicke T, et al. The nasal and gut microbiome in Parkinson\u27s disease and idiopathic rapid eye movement sleep behavior disorder. Mov Disord. 2018;33(1):88-98. 5. Cilia R, Piatti M, Cereda E, et al. Does Gut Microbiota Influence the Course of Parkinson\u27s Disease? A 3-Year Prospective Exploratory Study in de novo Patients. J Parkinsons Dis. 2021;11(1):159-170. 6. Ren T, Gao Y, Qiu Y, et al. Gut Microbiota Altered in Mild Cognitive Impairment Compared With Normal Cognition in Sporadic Parkinson\u27s Disease. Front Neurol. 2020;11:137. 7. Fasano A, Visanji NP, Liu LW, Lang AE, Pfeiffer RF. Gastrointestinal dysfunction in Parkinson\u27s disease. Lancet Neurol. 2015;14(6):625-639. 8. Adams-Carr KL, Bestwick JP, Shribman S, Lees A, Schrag A, Noyce AJ. Constipation preceding Parkinson\u27s disease: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2016;87(7):710-716. 9. Clarke SF, Murphy EF, O\u27Sullivan O, et al. Exercise and associated dietary extremes impact on gut microbial diversity. Gut. 2014;63(12):1913-1920. 10. Durk RP, Castillo E, Marquez-Magana L, et al. Gut Microbiota Composition Is Related to Cardiorespiratory Fitness in Healthy Young Adults. Int J Sport Nutr Exerc Metab. 2019;29(3):249-253. 11. Yang Y, Shi Y, Wiklund P, et al. The Association between Cardiorespiratory Fitness and Gut Microbiota Composition in Premenopausal Women. Nutrients. 2017;9(8). 12. Estaki M, Pither J, Baumeister P, et al. Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions. Microbiome. 2016;4(1):42. 13. Barton W, Penney NC, Cronin O, et al. The microbiome of professional athletes differs from that of more sedentary subjects in composition and particularly at the functional metabolic level. Gut. 2018;67(4):625-633. 14. Cronin O, Barton W, Skuse P, et al. A Prospective Metagenomic and Metabolomic Analysis of the Impact of Exercise and/or Whey Protein Supplementation on the Gut Microbiome of Sedentary Adults. mSystems. 2018;3(3). 15. Resende AS, Leite GSF, Lancha Junior AH. Changes in the Gut Bacteria Composition of Healthy Men with the Same Nutritional Profile Undergoing 10-Week Aerobic Exercise Training: A Randomized Controlled Trial. Nutrients. 2021;13(8). 16. Louis S, Tappu RM, Damms-Machado A, Huson DH, Bischoff SC. Characterization of the Gut Microbial Community of Obese Patients Following a Weight-Loss Intervention Using Whole Metagenome Shotgun Sequencing. PLoS One. 2016;11(2):e0149564. 17. Kang SS, Jeraldo PR, Kurti A, et al. Diet and exercise orthogonally alter the gut microbiome and reveal independent associations with anxiety and cognition. Mol Neurodegener. 2014;9:36. 18. Campbell SC, Wisniewski PJ, Noji M, et al. The Effect of Diet and Exercise on Intestinal Integrity and Microbial Diversity in Mice. PLoS One. 2016;11(3):e0150502. 19. Allen JM, Mailing LJ, Cohrs J, et al. Exercise training-induced modification of the gut microbiota persists after microbiota colonization and attenuates the response to chemically-induced colitis in gnotobiotic mice. Gut Microbes. 2018;9(2):115-130. 20. Uhrbrand A, Stenager E, Pedersen MS, Dalgas U. Parkinson\u27s disease and intensive exercise therapy--a systematic review and meta-analysis of randomized controlled trials. J Neurol Sci. 2015;353(1-2):9-19. 21. Li Y, Song H, Shen L, Wang Y. The efficacy and safety of moderate aerobic exercise for patients with Parkinson\u27s disease: a systematic review and meta-analysis of randomized controlled trials. Ann Palliat Med. 2021;10(3):2638-2649. 22. Fisher BE, Wu AD, Salem GJ, et al. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson\u27s disease. Arch Phys Med Rehabil. 2008;89(7):1221-1229. 23. Tabak R, Aquije G, Fisher BE. Aerobic exercise to improve executive function in Parkinson disease: a case series. J Neurol Phys Ther. 2013;37(2):58-64. 24. Rikli RE, Jones CJ. Senior fitness test manual. Champaign, IL: Human Kinetics; 2001. 25. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384-1387

Peak Power Changes During a Countermovement Jump Following Treadmill and Cycling High-Intensity Interval Training

Within activities involving jumping, peak power can be a significant factor to consider when assessing an athlete’s overall physical performance. By investigating different modalities of exercise, it is possible to discover potential benefits or flaws in certain workout regimens that may influence jump performance. In turn, this could influence how physical trainers, athletes, and recreationally active people approach their exercise routine to maximize performance. PURPOSE: The purpose of this study was to investigate the changes in peak jump power during a countermovement jump (CMJ) immediately following and 1-hour post high-intensity interval training (HIIT) using high-impact (running) and low-impact (cycling) exercise modalities. METHODS: Eleven young, recreationally active volunteers (5 female, 6 males; 27.20 ± 3.42 years) completed a 4x4 HIIT protocol (4-minute 85-95% HRmax active; 3-minute 60-70% HRmax recovery) on a treadmill (TM) and a stationary cycle (CE) in a randomized order 1 week apart. Peak power during the concentric portion of a countermovement jump (CMJ) was measured using VALD ForceDecks platforms. Data are presented as percent change. RESULTS: The TM peak power increased by 7.3% immediately following the HIIT protocol and decreased by 8.5% 1 hour following to below baseline vales. The CE peak power increased by 5.7% immediately following and decreased by 7.5% 1 hour following to below baseline values. CONCLUSION: Based on these findings, the modalities had similar responses for peak power, with both revealing a notable increase immediately post-exercise. This suggests that the exercises may have primed the muscles for CMJ performance. Yet, after recovering for 1 hour, the peak power decreased in both modalities to below baseline values. These patterns in peak power during different periods post-exercise can inform coaches and trainers on how to approach warm-up routines before engaging in physical activity or competition

The Inflammatory Response to Different HIIT Modalities

Pro-inflammatory and anti-inflammatory cytokines have been documented to change in response to long-duration, aerobic exercise. Little work has been performed in high-intensity interval training (HIIT). Furthermore, it has yet to be elucidated whether the modality of HIIT affects this inflammatory response. PURPOSE: The purpose of this study was to investigate the changes in IL-8 and IL-10 cytokine concentrations pre-post and post-1hr following HIIT protocols using two different exercise modalities, treadmill running (TM) and stationary cycling (CE). METHODS: Eight young, healthy, recreationally active volunteers (1 female, 7 males; 25.50 ± 3.25 years) completed a 4x4 HIIT protocol (4-minute 85-95% HRmax active; 3-minute 60-70% HRmax recovery) on both a treadmill (TM) and a stationary cycle (CE). All participants completed both modalities in a randomized order 1 week apart. Blood samples were collected using Tasso+ devices attached to the upper arm. Plasma was isolated and frozen at -80C until protein analysis. IL-8 and IL-10 were measured using the Millipore HCYTOMAG60K assay. Data are presented as percent change, post- and 1h-post HIIT bouts. RESULTS: IL-8 was elevated by 8.11% immediately following TM HIIT and did not change following CE HIIT (0.3%). Following 1-hour of recover, IL-8 increased a further 28.96% after TM and increased by 2.08% after CE. IL-10 concentration was increased by 14.41% 1-hour following TM HIIT; however, it did not change 1 hour following CE HIIT. CONCLUSION: The immune system plays an important role in the maintenance of health. This study demonstrated that a higher-impact exercise (TM) elicits a proinflammatory response that persists for 1 hour after training. However, this pro-inflammatory response was not observed in the lower-impact CE modality. Accounting for differences in inflammatory response between modalities of HIIT is important when designing exercise programs for populations with impaired immune systems. Future work should be performed to identify differences in immune cell function following various HIIT modalities

Aerobic Fitness Levels Relate to Cognitive Function in People with Parkinson’s Disease as Assessed by the 6 Minute Walk Test

While individuals with Parkinson’s disease (PD) present with impaired motor control, 26% demonstrate cognitive impairment independent of dementia1. In fact, cognitive dysfunction often predates motor impairments and can diminish quality of life2 as well as life expectancy3. Fortunately, aerobic exercise has been shown to improve cognition in older adults4 as well as PD patients5-7. However, only a limited number of studies have determined a clear relationship between aerobic fitness levels and cognition in people with PD. Determining whether cognitive status and aerobic fitness levels are associated in people with PD would provide greater evidence for intervention focused on aerobic fitness that has a goal of improving cognition. Using the 6-minute walk test (6MWT), we were able to categorize participants based on their aerobic fitness levels9. This categorization allowed us to test the relationship between cognitive status and aerobic fitness. PURPOSE:The purpose of this study is to identify differences in cognition in people with PD who meet aerobic fitness norms compared to those who do not meet aerobic fitness norms. METHODS:19 people with PD (Hoehn & Yahr stages I-III) were recruited. Aerobic fitness was assessed via estimated oxygen consumption using the 6MWT (VO2 peak) This test has shown test-retest reliability in people with PD8. 6MWT classifications were used to determine if participants met (PD-HI) or did not meet fitness norms (PD-LO). Cognitive function was assessed via the Montreal Cognitive Assessment (MoCA) and scored out of 30 points. To compare the two groups, a Welch’s Two Sample T-Test was performed using the R Statistical Program, and p-values were set to \u3c0.05. RESULTS: The PD-HI group (n=9) had a mean MoCA score of 26.0(+/-1.5). The PD-LO group (n=10) had a mean MoCA score of 22.4(+/-3.2). The PD-HI group had significantly higher MoCA scores compared with the PD-LO group (p=0.004). CONCLUSION: This study is one of the first to observe a relationship between increased MoCA scores and high aerobic fitness status in populations with PD

Principles to Guide the Office of Legal Counsel

Former members of Office of Legal Counsel ( OLC ) in the Department of Justice offer guidance for their successors. Among the document\u27s recommendations are suggestions that the OLC provide an accurate and honest appraisal of applicable law, even if that advice will constrain the administration’s pursuit of desired policies; and publicly disclose its written legal opinions in a timely manner, absent strong reasons for delay or nondisclosure

The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys

This paper is designed to determine the effects of a home-based strength training (HBST) intervention on insulin sensitivity (SI), compensatory acute insulin response and β-cell function, body composition measures, and maximum strength in obese Latino boys. A total of 26 obese Latino males aged between 14 and 18 years were randomized to either a twice-weekly (n=15) or a control group (C; n=15) for 16 weeks. HBST for 16 weeks, composed of two 1-h sessions per week. Outcome measures were assessed pre-and post-intervention/control condition and included SI, acute insulin response to glucose (AIR) and disposition index (DI), fasting glucose, 2-h glucose, body composition using waist-hip circumferences, body mass index (BMI), dual energy X-ray absorptiometry (DEXA) scan, blood pressure, and strength by 1-repetition maximum. A repeated measures GLM was used to assess differences in changes in outcome measures, between the C and the HBST groups. There were no significant overall intervention effects on any of the outcome variables (p<0.05). These results suggest that an HBST does not improve SI, maximal strength or decrease adiposity in obese Latino boys

The Very Low Mass Component of the Gliese 105 System

Multiple-epoch, multicolor images of the astrometric binary Gliese 105A and its very low mass companion Gliese 105C have been obtained using the Hubble Space Telescope's Wide Field Planetary Camera 2 (WFPC2) and Near-Infrared Camera and Multi-Object Spectrometer (NICMOS). The optical and near-infrared colors of Gl 105C strongly suggest a spectral type of M7V for that star. Relative astrometric measurements spanning 3 yr reveal the first evidence of Gl 105C's orbital motion. Previous long-term astrometric studies at Sproul and McCormick Observatories have shown that the period of Gl 105A's perturbation is approximately 60 yr. To satisfy both the observed orbital motion and Gl 105A's astrometric period, Gl 105C's orbit must have an eccentricity of approximately 0.75 and a semimajor axis of approximately 15 AU. Measurements of Gl 105A's radial velocity over 12 yr show a linear trend with a slope of 11.3 m/s/yr, which is consistent with these orbital constraints and a nearly face-on orbit. As no other faint companions to Gl 105A have been detected, we conclude that Gl 105C is probably the source of the 60-yr astrometric perturbation.Comment: 16 pages, 6 figures; to be published in the October 2000 issue of The Astronomical Journa

Estimating Live Forest Carbon Dynamics with a Landsat-based Curve-fitting Approach

Direct estimation of aboveground biomass with spectral reflectance data has proven challenging for high biomass forests of the Pacific Northwestern United States. We present an alternative modeling strategy which uses Landsat’s spatial, spectral and temporal characteristics to predict live forest carbon through integration of stand age and site index maps and locally calibrated Chapman-Richards curves. Predictions from the curve-fit model were evaluated at the local and landscape scales using two periods of field inventory data. At the pixel-level, the curve-fit model had large positive bias statistics and at the landscape scale over-predicted study area carbon for both inventory periods. Despite the over-estimation, the change in forest carbon estimated by the curve-fit model was well within the standard error of the inventory estimates. In addition to validating the curve-fit models carbon predictions we used Landsat data to evaluate the degree to which the field inventory plots captured the forest conditions of the study area. Landsat-based frequency histograms revealed the systematic sample of inventory plots effectively captured the broad range of forest conditions found in the study area, whereas stand age trajectories revealed a temporally punctuated shift in land- use which was not spectrally detected by the inventory sample

Surface Meltwater Impounded by Seasonal Englacial Storage in West Greenland

The delivery of surface meltwater through englacial drainage systems to the bed of the Greenland Ice Sheet modulates ice flow through basal lubrication. Recent studies in Southeast Greenland have identified a perennial firn aquifer; however, there are few observations quantifying the input or residence time of water within the englacial system and it remains unknown whether water can be stored within solid ice. Using hourly stationary radar measurements, we present observations of englacial and episodic subglacial water in the ablation zone of Store Glacier in West Greenland. We find significant storage of meltwater in solid ice damaged by crevasses extending down to 48 m below the ice surface during the summer which is released or refrozen during winter. This is a significant hydrological component newly observed in the ablation zone of Greenland that could delay the delivery of meltwater to the bed, changing the ice dynamic response to surface meltwater.Publisher PDFPeer reviewe