Can Tandem Bicycling Help Treat Parkinson’s Disease

There have been several breakthroughs in the treatment of Parkinson’s disease. Scientists from the University of South Carolina School of Medicine in Greenville found that pedaling on a stationary bicycle built for two may improve the health and well-being of both people suffering from the disease. Meanwhile, scientists at Mass General Brigham found that deep brain stimulation (DBS) was able to pinpoint dysfunctions in the brain that are responsible for four cognitive disorders, including Parkinson’s.

The team from Mass General Bingham identified optimal networks to target in the frontal cortex that could be used for treating Parkinson’s disease, dystonia, obsessive compulsive disorder (OCD) and Tourette’s syndrome. Their results are published in Nature Neuroscience.

“We were able to use brain stimulation to precisely identify and target circuits for the optimal treatment of four different disorders,” said co-corresponding author Andreas Horn, MD, PhD, of the Center for Brain Circuit Therapeutics in the Department of Neurology at Brigham and Women’s Hospital and the Center for Neurotechnology and Neurorecovery at Massachusetts General Hospital. “In simplified terms, when brain circuits become dysfunctional, they may act as brakes for the specific brain functions that the circuit usually carries out. Applying DBS may release the brake and may in part restore functionality.”

Connections between the frontal cortex in the forebrain and basal ganglia, structures located deeper in the brain, are known to control cognitive and motor functions. If brain disorders occur, these circuits may become affected, and their communication may become overactive or malfunction.

As for bicycling, the University of South Carolina School of Medicine researchers conducted a study of 18 participants, nine with Parkinson’s disease and their corresponding nine care partners.

For the tandem cycling program, pairs of people with Parkinson’s disease and their care partners cycled on indoor, stationary tandem bicycles while using a virtual reality platform two times per week for eight weeks. During each session, all participants could visualize themselves cycling along real life, scenic outdoor routes by watching large television screens that were synced to the cycling intensity. The tandem cycling set-up also allowed the care partners to help adjust the cycling pace and facilitate a higher pedaling rate for greater health benefits.

“Our study found that a unique cycling program that pairs people with Parkinson’s disease with their care partners can improve the physical, emotional and mental well-being of both cyclists to improve their quality of life,” said Jennifer Trilk, PhD, of the University of South Carolina School of Medicine in Greenville. “It is just as important that care partners also receive care, so that is why we included them as the cycling partner. The goal of our small study was to determine if tandem cycling was beneficial. The next step will be to confirm the results with subsequent studies that would include more participants.”

Parkinson’s disease is a progressive neurological disorder that affects movement. It is characterized by tremor, rigidity, bradykinesia (slow movement), and postural instability. Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain. Dopamine plays a vital role in regulating the movement of the body.

Early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Problems may also arise with cognition, behavior, sleep, and sensory systems. Parkinson’s disease dementia is common in advanced stages.

There is no cure for Parkinson’s disease, but there are treatments that can help manage the symptoms. These treatments include medications, surgery, and physical therapy.