Although the 6-Minute Walk Test (6MWT) is among the recommended clinical tools to assess gait impairments in individuals with Parkinson’s disease (PD), its standard clinical outcome consists only of the distance walked in 6 min. Integrating a single Inertial Measurement Unit (IMU) could provide additional quantitative and objective information about gait quality complementing standard clinical outcome. This study aims to evaluate the test–retest reliability, validity and discriminant ability of gait parameters obtained by a single IMU during the 6MWT in subjects with mild PD. Twenty-two people with mild PD and ten healthy persons performed the 6MWT wearing an IMU placed on the lower trunk. Features belonging to rhythm and pace, variability, regularity, jerkiness, intensity, dynamic instability and symmetry domains were computed. Test–retest reliability was evaluated through the Intraclass Correlation Coefficient (ICC), while concurrent validity was determined by Spearman’s coefficient. Mann–Whitney U test and the Area Under the receiver operating characteristic Curve (AUC) were then applied to assess the discriminant ability of reliable and valid parameters. Results showed an overall high reliability (ICC ≥ 0.75) and multiple significant correlations with clinical scales in all domains. Several features exhibited significant alterations compared to healthy controls. Our findings suggested that the 6MWT instrumented with a single IMU can provide reliable and valid information about gait features in individuals with PD. This offers objective details about gait quality and the possibility of being integrated into clinical evaluations to better define walking rehabilitation strategies in a quick and easy way.

Complexity analysis of electroencephalogram (EEG) signals has emerged as a valuable tool for characterizing Parkinson’s disease (PD). Fractal dimension (FD) is a widely employed method for measuring the complexity of shapes with many applications in neurodegenerative disorders. Nevertheless, very little is known on the fractal characteristics of EEG in PD measured by FD. In this study we performed a spatio-temporal analysis of EEG in PD using FD in four dimensions (4DFD). We analyzed 42 resting-state EEG recordings comprising two groups: 27 PD patients without dementia and 15 healthy control subjects (HC). From the original resting-state EEG we derived the cortical activations defined by a source reconstruction at each time sample, generating point clouds in three dimensions. Then, a sliding window of one second (the fourth dimension) was used to compute the value of 4DFD by means of the box-counting algorithm. Our results showed a significantly higher value of 4DFD in the PD group (p < 0.001). Moreover, as a diagnostic classifier of PD, 4DFD obtained an area under curve value of 0.97 for a receiver operating characteristic curve analysis. These results suggest that 4DFD could be a promising method for characterizing the specific changes in the brain dynamics associated with PD.

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients’ quality of life.

Background: To date, there has been no medication that has prevented the progression of Parkinson’s disease (PD). Many benefits of intensive and multidisciplinary rehabilitation program for PD are supported by clinical, epidemiological, and experimental data. The main question is whether high-intensity motor and cognitive exercises have an effect on the disease’s biological mechanisms. Objective: This study protocol is a Randomized Controlled Trial (RCT) designed to determine the efficacy of an experimental, intensive, and multidisciplinary treatment in comparison to a home-based self-treatment in improving biomolecular and functional parameters in PD. Methods: A total of 72 participants will be randomly allocated to two different groups, experimental (n = 36) and control group (n = 36). The rehabilitation program will last 6 consecutive weeks and will involve the execution of a total of 30 sessions, one for each day of the week from Monday to Friday. Participants allocated to the control group will carry out a home-based self-treatment program that includes muscle-stretching and active mobilization exercises for 40’/day for 6 consecutive weeks. The primary outcome measure is the effects of both treatments on a new set of molecular biomarkers such as oligomeric alpha-synuclein and neurotrophic factors measured in peripheral neural derived extracellular vesicles (NDEVs). Secondary outcomes will include changes of motor and non-motor symptoms, balance and gait performance and cognitive functioning. This RCT has been registered as “Intensive Multidisciplinary Rehabilitation and Biomarkers in Parkinson’s Disease” on 30 May, 2022 to ClinicalTrials.gov with the Study ID number: NCT05452655. Discussion: This rehabilitation program is believed to be crucial in modifying biomolecular and functional parameters in people with PD. We expect that this study will provide additional evidence to understand the impact of an aerobic and intensive rehabilitation program on brain plasticity in patients with PD.

Rehabilitation is a key component of Parkinson’s disease (PD) management, although individual responses differ substantially. Genetic factors involved in neuroplasticity and inflammation may contribute to this variability. We investigated whether selected polymorphisms in inflammation- and neuroplasticity-related genes influence motor outcomes following intensive multidisciplinary rehabilitation in patients with PD. Sixty-six patients with a diagnosis of idiopathic PD were consecutively enrolled and randomly allocated to an intensive multidisciplinary rehabilitation group (EXP-Group, n = 34) or a home-based stretching control group (CTRL-Group, n = 32) for six weeks. MDS-UPDRS III score was assessed at baseline (T0) and post-treatment (T1). SNPs in the TNF, IL6, IL6R, IL1A, IL1B, IL10 and BDNF genes were genotyped. Possible associations between genotype, treatment group and MDS-UPDRS III score at T1 were analyzed using ANCOVA and linear mixed-effects models, adjusting for baseline MDS-UPDRS III score, age, sex, disease duration and levodopa equivalent daily dose (LEDD). A significant treatment group x TNF rs1800629 genotype interaction was observed (p = 0.033). Among EXP-Group patients, GG homozygotes showed lower adjusted MDS-UPDRS III scores than did the A-allele carriers (29.10 vs. 36.11; p = 0.029). Longitudinal analyses revealed a significant time × treatment group × TNF rs1800629 genotype interaction (p = 0.010), with GG homozygotes showing an approximately 10-point reduction in MDS-UPDRS III score (40.87 to 30.87; p < 0.001). These findings suggest that TNF rs1800629 contributes to variability in response to intensive multidisciplinary rehabilitation in PD.