Possible implications for patients and the public

Three experts, not involved in this research, spoke to MNT about their views on the study findings.

“With neurodegenerative diseases like Parkinson’s or sporadic Parkinson’s disease we don’t have definitive causes so there have been limits on treatments,” said psychiatrist Dr. Howard Pratt, board-certified medical director at Community Health of South Florida.

“We are often treating the symptoms rather than the cause so, more and more efforts are looking for that root cause. I’m excited about this different approach to looking at the cause of Parkinson’s,” added Dr. Pratt. “The implications are so significant because knowing the cause will guide us toward the best treatments.”

“This particular study looks at signaling pathways of mitochondrial DNA and how its disruption can potentially induce sporadic Parkinson’s disease-like symptoms. What’s interesting about that is that by injecting damaged mitochondrial DNA into mouse brains it induced sporadic Parkinson’s disease symptoms. This is huge. And potentially could guide us to curative treatments.”

– Dr. Howard Pratt

Dr. J. Wes Ulm, a bioinformatic scientific resource analyst, and biomedical data specialist at the National Institutes of Health, further noted that “the findings reported here are consistent with our mechanistic knowledge of central nervous system function and metabolism, on the one hand, and shed interesting new light on the role of subcellular processes in pathophysiology (the rise of disease) germane to Parkinson’s on the other.”

“This article, in its core findings, indicates that damage to this mitochondral DNA (mtDNA) may be one important subcellular trigger that can lead to the spread of the pathophysiology that is involved in Parkinson’s disease and other conditions like it,” Dr. Ulm explained.

Dr. Kathy Doubleday, doctor of physical therapy and clinical director at Physio Ed, agreed, saying that “the findings in this study show a mechanism for the spread of mitochondrial DNA damage in Parkinson’s disease-like knockout mice model.”

“The mechanism is important to find a molecular solution to the energy system and transcription problems that lead to death of neurons in the basal ganglia and then by projections to other areas of the brain. The study is one in a long list of new theories on the origin and progression of Parkinson’s disease and how it may be treated in the future.”

– Dr. Kathy Doubleday

Can we prevent mitochondrial damage?

More research is needed on the potential role of mitochondrial damage in neurodegenerative conditions. However, Dr. Doubleday highlighted that “in physical therapy we have changed our perspective on patients with degenerative neurologic conditions and have been turning them into ‘athletes’ by increasing their physical exercise and physical conditioning.”

“This trend is being seen in many gyms and therapy clinics that are designed for Parkinson’s clients to work hard on their fitness and function,” Dr. Doubleday explained. “The reasoning for this is that we see clinical gains in function with increasing demands on the physical body.”

“One of the most promising clinical treatments is high intensity aerobic exercise. The research on aerobic exercise shows an effect on the mitochondria and the cells ability to produce ATP for energy, messenger RNA and gene transcription of proteins. In fact, several studies have shown that young and old adults have a similar oxidative capacity to produce energy from mitochondria but is dependent on physical activity levels.”

Dr. Kathy Doubleday

Dr. Doubleday noted that this study emphasizes the importance of prescribing exercise to Parkinson’s patients early in their diagnosis. This could potentially mitigate the damage caused by the disease’s effect on the mitochondria.

Physical therapists are researching the ideal exercise type, intensity, and timing for the most therapeutic benefit. Exercise as an early and frequent intervention can help combat the decline in function seen in Parkinson’s.

“My main takeaway from this study is that the aerobic exercise regimes that we implement in physical therapy may currently be our best way of intervening in this mitochondrial DNA and energy system,” Dr. Doubleday said.

“By progressing the intensity of aerobic exercise, adding functional challenges of all kinds, and educating patients on how exercise can make changes to how brain cells function, we can empower patients to influence the course of their own brain changes in Parkinson’s disease,” she emphasized.