AUTHOR=di Cagno Alessandra , Buonsenso Andrea , Centorbi Marco , Manni Luigi , Di Costanzo Alfonso , Casazza Giusy , Parisi Attilio , Guerra Germano , Calcagno Giuseppe , Iuliano Enzo , Soligo Marzia , Fiorilli Giovanni ,  for The WB-EMS Parkinson’s Group , Lena Francesco , Modugno Nicola , Quinzi Federico 

TITLE=Whole body-electromyostimulation effects on serum biomarkers, physical performances and fatigue in Parkinson’s patients: A randomized controlled trial

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=15

YEAR=2023

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1086487

DOI=10.3389/fnagi.2023.1086487

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>Whole-body electromyostimulation (WB-EMS) was never previously applied to Parkinson’s disease (PD) patients. This randomized controlled study aimed to find the most effective and safe WB-EMS training protocol for this population.</p></sec><sec><title>Methods</title><p>Twenty-four subjects (age: 72.13 ± 6.20 years), were randomly assigned to three groups: a high-frequency WB-EMS strength training group (HFG) (rectangular stimulation at 85 Hz, 350 μs, 4 s stimulation/4 s rest), a low-frequency WB-EMS aerobic training group (LFG) (rectangular stimulation 7 Hz, 350 μs, with a continuous pulse duration), and an inactive control group (CG). Participants of the two experimental groups underwent 24 controlled WB-EMS training sessions, with a duration of 20 min each, during 12-week intervention. Serum growth factors (BDNF, FGF-21, NGF and proNGF), α-synuclein, physical performance and Parkinson’s Disease Fatigue Scale (PFS-16) responses were analyzed to evaluate the pre-post variation and differences among groups.</p></sec><sec><title>Results</title><p>Significant interactions of Time*Groups were detected for BDNF (Time*Groups <italic>p</italic> = 0.024; Time*CG, <italic>b</italic> = −628, IC95% = −1,082/−174, <italic>p</italic> = 0.008), FGF-21 (Time*Groups <italic>p</italic> = 0.009; Time*LFG <italic>b</italic> = 1,346, IC95% = 423/2268, <italic>p</italic> = 0.005), and α-synuclein (Time*Groups <italic>p</italic> = 0.019; Time*LFG <italic>b</italic> = −1,572, IC95% = −2,952/−192, <italic>p</italic> = 0.026). <italic>Post hoc</italic> analyses and comparisons of ΔS (post–pre), performed independently for each group, showed that LFG increased serum BDNF levels (+ 203 pg/ml) and decreased α-synuclein levels (−1,703 pg/ml), while HFG showed the opposite effects (BDNF: −500 pg/ml; α-synuclein: + 1,413 pg/ml). CG showed a significant BDNF reduction over time. Both LFG and HFG showed significant improvements in several physical performance outcomes and the LFG showed better results than HFG. Concerning PFS-16, significant differences over time (<italic>b</italic> = −0.4, IC95% = −0.8/−0.0, <italic>p</italic> = 0.046) and among groups (among all groups <italic>p</italic> &lt; 0.001) were found, and the LFG exhibited better results than the HFG (<italic>b</italic> = −1.0, IC95% = −1.3/−0.7, <italic>p</italic> &lt; 0.001), and CG (<italic>b</italic> = −1.7, IC95% = −2.0/−1.4, <italic>p</italic> &lt; 0.001) with this last one that worsened over time.</p></sec><sec><title>Conclusion</title><p>LFG training was the best choice for improving or maintaining physical performance, fatigue perception and variation in serum biomarkers.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov/ct2/show/NCT04878679" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.clinicaltrials.gov/ct2/show/NCT04878679</ext-link>, identifier NCT04878679.</p></sec>