For many people with Parkinson’s disease (PD), pickleball has become a new way to infuse exercise with socialization.

Exercise is a vital part of Parkinson’s disease management. It helps maintain balance, mobility, flexibility and overall quality of life. Research shows that consistent exercise — at least 2.5 hours per week — can slow symptom progression and improve physical and emotional wellbeing. 

Pickleball is a paddle sport played indoors or outdoors on a court smaller than a traditional tennis court. It is played in singles or doubles with a light, plastic ball. USA Pickleball sets official rules and supports programs nationwide. One reason the sport is popular is because it is easy to learn but challenging, and is accessible for people of all ages and abilities.

When it comes to Parkinson’s symptoms, Pickleball is an aerobic workout that strengthens balance, agility, builds muscle and cognitive function. A player’s ability to think and respond quickly while playing pickleball can boost brain activity. Additionally, it is a great way to socialize, an important part of living well with Parkinson’s as isolation following a diagnosis can lead to depression, a common PD symptom.

Trying a sport like pickleball can make staying active feel social and motivating. Setting a small, achievable goal, such as playing pickleball once a week, can help turn exercise into a habit you look forward to rather than a chore.

Here are 10 tips for playing Pickleball to stay active with Parkinson’s:

1.  Get clearance from your neurologist.
   Before starting any new exercise, talk to your neurologist or PD doctor to make sure starting a new sport or exercise is safe. They may recommend seeing a physical therapist to prevent injuries.
2. Work with a physical therapist (PT).
   Telling your physical therapist that you are playing pickleball or plan to start can help them customize your sessions to improve movement and mobility. PT can address stiffness and help you train to keep on-court movements safe. PT can also help build strength and improve coordination.
3. Incorporate other exercises to up your pickleball game.
   Pickleball is a great way to evolve your exercise routine. Explore other exercises, like PD Health @ Home on-demand videos that address PD-specific balance, agility and movements between games.
4. Warm up before playing pickleball to prevent injury.
   Before playing, develop a pickleball warm-up routine that works for you. This is a great opportunity for your physical therapist to weigh in.

5. Don’t play hurt.
   Rest when your body needs more recovery time. Parkinson’s symptoms can change from day to day, listen to your body and don’t push yourself on days you need more rest.
6. Play during “on” times, when symptoms are most manageable.
   Medications like levodopa, commonly used for PD, help manage symptoms. As PD progresses, the brain's response to these medications may change, which can lead to symptom fluctuations, known as "on" and "off" periods. If possible, schedule pickleball games during "on" periods, when medication is working well.
7. Use pickleball to build community and bond with a family member or spouse.
   Playing doubles can also help reduce court coverage and build relationships. Joining a pickleball league could be a great opportunity to start a new pastime with your adult child or spouse.
8. Always stay hydrated.
   On or off the court, being dehydrated can make some PD symptoms worse, including constipation, swallowing issues and low blood pressure. On the court, not drinking enough liquids can bring muscle cramps and dizziness. Hydrate whenever possible.
9. Modify the game as needed.
   Adjust game lengths, build in more breaks or stick to playing doubles. Joining a PD league or playing with others who have Parkinson’s is a great way to build in modifications.
10. Explore Pickleball for Parkinson’s events.
    

    

    Join an upcoming Pickleball for Parkinson’s event or start your own. For qualifying events, the pickleball paddle manufacturer Selkirk offers a sponsorship. Learn more.

Pickleball can be more than a game. For people living with Parkinson’s, it can be a powerful tool for movement and connection —essential elements of living well with PD.

Exercise Resources

The best way to see benefits is to exercise consistently. People with PD enrolled in exercise programs for longer than six months, regardless of exercise intensity, see significant gains in functional balance and mobility compared to shorter programs. Explore our exercise resources:

• Find a PD exercise class near you through our Parkinsons’ Foundation Chapters or contact our Helpline at 1-800-4PD-INFO (1-800-473-4636) or Helpline@parkinson.org.

• Explore Fitness Friday on-demand exercise classes through our PD Health @ Home program.

• Celebrate movement with your local PD community. Sign up for a Moving Day event.

• Read Fitness Counts: A Body Guide to Parkinson’s Disease.

Explore tips and learn more about exercise and Parkinson’s research on our Parkinson’s and exercise page.

At The Kensington in White Plains, NY, compassionate care for people living with Parkinson’s disease (PD) isn’t just a promise, it is a practice grounded in training and personalization. 

Through expert-led training and measurable outcomes, the Parkinson’s Foundation Community Partners in Parkinson’s Care educates and prepares care staff working in senior living communities and home care agencies to provide optimal support for people living with Parkinson’s disease (PD). The program focuses on practical, day-to-day strategies on how Parkinson’s affects movement and mood — and how PD care can improve quality of life. 

As a community partner, The Kensington ensures residents with Parkinson’s receive individualized, person-centered support. In this article, The Kensington Associate Executive Director Joanne Hubbard shares how her team puts these practices into action every day. 

How prevalent is Parkinson’s disease at The Kensington?  

Joanne: It fluctuates but about 15 to 30% of our total resident population are living with Parkinson's. In New York, there's a special license for assisted living communities called an enhanced license that allows our residents to age in place. The Kensington has that license, which enables people to remain in our community while receiving higher acuity care as their condition progresses. 

Our promise is to love and care for our residents like we would our own family. Parkinson’s care is more than managing symptoms, we aim to preserve dignity, purpose, voice and quality of life at every stage.

Why did you become a Community Partner?  

Joanne: Community Partners in Parkinson’s Care training equips our team to do more than share information — it builds a shared understanding that allows residents, families and team members to navigate Parkinson’s together. Our team and most residents recognize how Parkinson’s can affect daily activities and symptoms related to Parkinson's. Because of our commitment to excellence in Parkinson’s care, and our partnership with Community Partners in Parkinson’s Care, we support more people with Parkinson’s. The Community Partners provides our team, residents and families with information they need to succeed now. 

What are some examples of how staff provides specialized Parkinson’s care?

Joanne: Our THRIVE with Parkinson’s program for residents with Parkinson’s and other movement disorders and their family members stands for: Therapeutic, Holistic, Revitalizing, Inspiring Independence, Vocally Vibrant and Empowering. When it comes to Parkinson’s, our team staff is trained to be intentional with time. They know to slow down, allow medication time to take effect, and adjust communication so instructions are clear and manageable. They know to give residents extra time for a response if they're having an off episode.  

 When you see these strategies making a difference, it reinforces that Parkinson’s training truly works. Anyone coming into this work is doing it because you love people and you want to help. These strategies enable you to actualize that goal. 

How do you train staff to provide better Parkinson’s care?  

Joanne: We use the Community Partners Portal, which staff can complete at their own pace, but I'm an advocate of the classroom approach so we watch the courses together. When a new team member starts, they participate in a full day of Parkinson's training. I also advocate for experiential learning — if you're not doing it yourself, you are less likely to apply it. I want people to feel scenarios in their bodies. We practice in real time and discuss scenarios. We also have some of our residents with Parkinson’s join the training for a Q&A, which is highly impactful. 

As a Community Partner we are given educational resources for our team like the Experiential Toolkit. The kit includes heavyweight shoes with Velcro that especially resonate with staff because they get stuck to the carpet. So, when they get up from a chair wearing these shoes, they can’t take that first step. They can really imagine what a freezing of gait episode feels like. And they can apply that feeling to helping a resident who freezes when going through a threshold or walking into the elevator.  

Our team also customizes routines for residents with Parkinson’s. We promote independence. For example, we schedule time to help Ben complete his night routine while seated, or if he wants to stand, we will stand behind him. Our goal is to not do things for residents they can do for themselves. 

The Kensington is known for its ability to deliver Parkinson’s medication on time. How and why is this a goal for your center?   

Joanne: Providing Parkinson’s medication on time is a major key of the Community Partner program. It was the main area that made me start digging into what do we need to do differently to improve our Parkinson’s care. 

After joining the Parkinson’s Foundation Community Partners program, we created an additional nursing position to administer Parkinson's medication. Many of our residents with Parkinson’s require up to eight medication passes a day. That level of frequency made it an impossible task for one nurse to get to all residents on time.  

Today, our residents with Parkinson's get their PD medications within a 15-minute window. We recognize that many care centers do not have the same level of resources available. That is one of the reasons I am so proud to work at The Kensington, our leadership understands it's always about the people. Our promise is to love and care for our residents as if they're our own family. And when there is a need, we look at how we can solve it. 

What’s your favorite Kensington program?  

Joanne: We offer programs that serve the body, mind, spirit. Our music therapy program is led by a therapist with a background in neurologic music therapy. He encompasses a lot of neurology-based approaches — a mix of coordination, range of motion and movement. He also does a lot of breathing, meditation and relaxation exercises. Our residents experience a lot of stiffness and anxiety, so it’s a win if we can give them tools they can then use in their own time.  

I also run our vocal gym that focuses on our vocal structure, monotone speech, issues with breath support and voice control. I educate attendees about dopamine and how we need it to have coordination and movement. I talk a lot about Parkinson’s in the vocal gym and what's happening in the brain and the body. This helps the residents understand what is happening and gives them a sense of control.  

Learn more about Speech & Swallowing Issues in Parkinson’s

One way Kensington is unique is that it educates residents about Parkinson’s too. Why?  

Joanne: We keep our Parkinson's programming open for everybody. Our residents were noticing when their friends’ symptoms were interfering with something they were doing and would bring it up to staff, saying “hey, I'm noticing Joanne's having a harder time at breakfast with her utensils.” We provide a context and understand about Parkinson’s in how maybe Joanne’s experiencing an “off” time to help them understand what is happening rather than feel concerned or confused. 

How does Kensington offer emotional support for residents?  

Joanne: We offer Parkinson’s and movement disorders support groups for residents and a separate one for care givers and family members. They help residents better understand their own experiences and relate to others. We meet monthly and they run the group; I just facilitate it — it's an amazing group. They find support in one another.  

What has surprised you about Parkinson’s disease?  

Joanne: My support group told me I can share this, but I was surprised to learn how isolated people in the group felt because of Parkinson’s. They felt misunderstood and judged, some were told they were making their Parkinson’s up. For them to be able to come to this group and be able to talk has given them a community within the community.  

Just last month I brought up delusions to the group, a topic we don't hear a lot from the residents about. Like an onion, the group unfolded. Some people were very aware they had experienced delusions, while others were realizing it during the group. It was a powerful session to say the least.  

Can you share a resident story that inspired you?  

Joanne: We have a resident that was unable to walk unassisted. Right away he expressed his goal, which was to walk his daughter down the aisle for her upcoming wedding. It was helpful for staff to know his goal. With hard work, steady Parkinson’s care and therapy, he walked her down the aisle. He danced with her at her wedding, and he even gave a speech. The impression we got is that these things weren’t even on his radar when he joined us. We were all so moved.   

Do you have any advice for family members of people with Parkinson’s considering community living?  

Joanne: When looking at potential senior living communities, always ask questions. I would start with these topics and avoid feeding staff answers: 

1. Ask all the PD medication questions: How are medications managed? Who manages them? Can the person manage their own medications or does a nurse or a medication aide administer it? What is the window of time that they'll get medications?  

2. What kind of specialized programs do you have for people with Parkinson's? 

3. What support opportunities do you have for residents? And for the families?  

4. Ask about their training in Parkinson’s care. Look for the Parkinson's Foundation Community Partners badge, which shows they’ve completed additional Parkinson’s training.

The Parkinson’s Foundation is grateful to Acadia Pharmaceuticals and the Edmond J. Safra Foundation for their support of Community Partners in Parkinson’s Care.

Learn more about the Community Partners in Parkinson’s Care program and find a community partner site near you.

Nada puede prepararlo para escuchar las palabras "tiene Parkinson". Desde la confusión hasta el alivio, lo que sienta después de que lo hayan diagnosticado a usted o a un ser querido es completamente natural. 

En este artículo, describimos cinco pasos que le ayudarán a procesar un nuevo diagnóstico de la enfermedad de Parkinson (EP), incluyendo Historias de la EP de personas que cuentan su propio encuentro con la noticia que les cambió la vida. 

1. Determine sus objetivos

Planificar cuando hay un nuevo diagnóstico médico puede resultar abrumador si no se sabe dónde encontrar recursos y apoyo. Esto es especialmente cierto si antes no estaba familiarizado con el Parkinson y sus opciones de atención. Armarse de información actualizada puede ayudarle a establecer objetivos a corto y largo plazo para navegar en su recorrido por la EP.

"Cuando me diagnosticaron Parkinson... mi respuesta fue hacer un curso intensivo para aprender todo lo que pudiera acerca de esta enfermedad 'progresiva' y ver qué medidas podía tomar. 

Mi objetivo es ser lo más activo posible física y mentalmente. El diagnóstico también me ha hecho reflexionar más acerca de la vida. Aunque no estoy seguro de lo que me espera en el futuro, agradezco haber encontrado un ‘poder a través de la debilidad’. Gracias a esta experiencia, tengo una nueva perspectiva y esperanza en el futuro".  

– John Rosiak, viviendo con Parkinson

Armado con la información sobre la EP, estará listo para crear hábitos saludables basados en lo que tiene más significado para usted. Lea más acerca de cómo fijarse objetivos específicos y realistas mediante la dieta y la nutrición e inspírese con nuestros videos de fitness adaptados a la EP que presentan un entrenamiento en casa diferente cada mes, incluyendo ejercicios de equilibrio y coordinación para alcanzar sus objetivos de condición física. 

2. Busque un experto 

Buscar el asesoramiento de un experto en la EP a la hora de procesar un nuevo diagnóstico tiene muchas ventajas. Recomendamos recibir atención de un especialista en trastornos del movimiento o de un neurólogo que haya completado una formación en el tratamiento de la enfermedad de Parkinson. Sin embargo, tal vez no encuentre estos especialistas, dependiendo de dónde viva. 

"El neurólogo me explicó que el Parkinson es un diagnóstico clínico y que yo tenía varios de los  síntomas motores  (temblor, bradicinesia y rigidez muscular). El neurólogo también me mandó hacer algunas pruebas diagnósticas incluyendo análisis de sangre, una resonancia magnética cerebral y un DaT scan. 

Unos meses más tarde, busqué una segunda opinión sobre mi diagnóstico y vi a un especialista en trastornos del movimiento en el Rush University Medical Center, un  Centro de Excelencia de la Parkinson's Foundation. Se confirmó: efectivamente, tenía Parkinson". 

- Vanessa Russell-Palmer, viviendo con Parkinson 

Encontrar un especialista no tiene por qué ser una tarea desalentadora. Estas son algunas de las maneras en las que puede encontrar a un especialista en la EP: 

• Encuentre un centro de la Red Global de Atención que ofrezca atención especializada cerca de usted 

• Comuníquese a la Línea de Ayuda de la Parkinson’s Foundation llamando al 1-800-4PD-INFO (1-800-473-4636), opción 3 para español, o escribiendo a  Helpline@Parkinson.org para una referencia 

• Pida una recomendación a su médico de atención primaria 

• Póngase en contacto con su compañía de seguros para obtener una lista de neurólogos o especialistas en trastornos del movimiento de su red 

• Pida recomendaciones a otras personas que viven con Parkinson 

3. Encuentre a alguien con quien hablar y crear su red de apoyo 

Puede ser difícil hablar del Parkinson. Expresar sus sentimientos e inquietudes es un paso importante para procesar un diagnóstico de la EP. Además, hablar con un trabajador social tiene muchas ventajas para ayudar a aliviar su ansiedad y crear un plan. 

"Con la ayuda de mi trabajadora social, superé la incertidumbre creando  planes a corto y largo plazo  para mi nueva vida con Parkinson. Me puso en contacto con recursos relevantes para mi estilo de vida y mis síntomas y me animó a prepararme para lo peor pero esperar lo mejor. Para mí, seguiré haciendo todo lo que quiero hacer de la forma que quiero hacerlo, hasta que el Parkinson me quite esa capacidad". 

– Liz Brouillard, viviendo con Parkinson 

Recomendamos unirse a  PD Conversations, un lugar donde hacer preguntas, conectar con otras personas que viven con Parkinson y formar parte de una red de apoyo. Es una gran solución para quienes aún no están listos para compartir públicamente su diagnóstico. También puede seguirnos en redes sociales para mantenerse conectado.  

 4. Cree hábitos saludables 

A medida que procese el diagnóstico, puede ser útil fijarse objetivos personales para mantenerse sano mental y físicamente. Conozca a Frank a continuación y aprenda de su experiencia personal en la creación de hábitos saludables tras un diagnóstico de la EP de inicio temprano. 

"Un momento crucial fue cuando me puse en contacto con un especialista en trastornos del movimiento. Esta colaboración cambió mi percepción de cómo manejar el Parkinson. Juntos, creamos un enfoque holístico para enfrentar mis síntomas, estableciendo un plan que giraba en torno al ejercicio, la dieta y el manejo del estrés. Conectamos de una manera profunda que cambió mi perspectiva y me ayudó a aprender nuevas técnicas para afrontar la EP. 

Impulsado por la positividad y la visualización, imaginé una vida libre de obstáculos para la movilidad, impulsándome hacia una mayor actividad y menos miedo. Este recorrido de abrazar el Parkinson se convirtió en una lección para entender mi cuerpo y sus señales". 

– Frank Antonicelli, viviendo con Parkinson 

Para aprender más acerca de cómo crear hábitos saludables, explore nuestros webinars en los que participan expertos en la EP, cuyo objetivo es educar y responder a sus preguntas más apremiantes. 

5. Manténgase activo 

Vivir bien con la EP es posible. Un diagnóstico y recibir una atención adaptada a la EP pueden ayudarle a sentirse motivado y listo para aprender a vivir con la EP a su manera. Ya sea que esté listo para establecer una nueva rutina de ejercicios, priorizar la nutrición o involucrarse como voluntario o promotor de la investigación, podemos ayudarle a empezar. 

"Soy entrenadora de fuerza y bienestar desde hace más de 40 años. A medida que mi capacidad para hacer deporte empezó a disminuir, me pareció gratificante dedicar más esfuerzo a entrenar a mis atletas. Ya han pasado un par de años y estoy disfrutando de verdad poniendo mi esfuerzo en entrenar a clientes. 

La Parkinson’s Foundation me ha ayudado con recursos e información, webinars,  artículos de blog  y  podcasts. El material y la información han sido invaluables. Mi consejo y mi recomendación para cualquier persona con la EP es que no se rinda y siga adelante.” 

– JR Rosania, viviendo con Parkinson 

Encuentre su comunidad de Parkinson y clases locales de bienestar y ejercicio adaptadas a la EP visitando el sitio web de su Chapter de la Parkinson’s Foundation más cercano. Ayude a generar más conciencia mediante actividades como  eventos de Moving Day, nuestra experiencia de ciclismo interior Parkinson’s Revolution  y programas locales para ayudar a garantizar que las personas con Parkinson, sus familias y sus aliados en el cuidado vivan lo mejor posible. 

¿Listo para participar? ¡Aprenda acerca del  voluntariado  con la Parkinson's Foundation o ayude a impulsar la investigación acerca del Parkinson al inscribirse en nuestro estudio PD GENEration! 

Recursos principales para recién diagnosticados 

Explore estas herramientas diseñadas para cualquier persona a la que se le haya diagnosticado Parkinson recientemente: 

1. Recién conociendo el Parkinson: página web con información y enlaces a recursos valiosos. 

2. Línea de Ayuda: llame al 1-800-4PD-INFO (1-800-473-4636), opción 3 para español o escriba a  Helpline@Parkinson.org  para obtener respuestas a sus preguntas acerca de la EP y referencias de especialistas y clases locales para la EP. 

3. Encuentre recursos en su zona: encuentre un especialista en la EP y recursos cerca de usted, así como el Chapter más cercano. 

Mientras aprende a vivir con el Parkinson, estamos para ayudar y empoderarlo en cada etapa. Cuando esté listo, explore nuestra  Guía para recién diagnosticados. 

In a landmark investment to accelerate the path to a Parkinson’s disease (PD) cure, in 2019, the Parkinson’s Foundation awarded $8 million to establish four elite Parkinson’s Foundation Research Centers: Yale School of Medicine, University of Michigan, University of Florida, and Columbia University. Each one received $2 million over four years.

In this series of articles, we will share the story of each center — their goals, successes, surprises and the future of their PD research. In this article, we check in with the Parkinson’s Foundation Research Center at the University of Michigan.

The Thalamus and Parkinson’s Disease 

Most research on how Parkinson’s affects the brain has focused on the substantia nigra. This brain region — slightly smaller than a piece of popcorn — plays key roles in regulating movement and healthy cognition.

In PD, the dopamine brain cells in the substantia nigra break down over time, leading to the progressive movement and cognitive symptoms of the disease. However, not all symptoms of PD can be explained by the loss of these substantia nigra neurons. For example, issues with gait and balance or visual dysfunction in PD do not seem to respond to dopamine therapies.  This biological puzzle led the Michigan researchers to explore how PD impacts another part of the brain – the thalamus – and how dysfunction in this part of the brain may contribute to PD symptoms, and importantly, how targeting this area for therapies could improve the lives of people living with PD. 

The thalamus is made of a pair of small, egg-shaped structures of grey matter that straddle the middle of the brain – one on the right side and one on the left. The most well-understood function of the thalamus is that it acts as a sensory “hub,” relaying signals of sight, sound, touch, and taste from the body to various regions of the cerebral cortex, the wrinkled, outer layer of the brain that provides functions like awareness, memory, and consciousness. 

However, recent research on the thalamus has hinted that it may do more than just relay sensory information. In fact, new evidence suggests that the thalamus actively modifies the signals that it sends along, playing an active role in the process connecting sensation to thought and to action.  

Looking to unravel the role of the thalamus in PD, the researchers at the Parkinson’s Foundation Research Center at the University of Michigan, led by Roger Albin, MD, Nicolaas Bohnen, MD, PhD, and Daniel Leventhal, MD, PhD, each investigated the thalamus in a different way. By taking a cross-sectional approach, this Parkinson’s Foundation funded research team developed a new, thorough and detailed way to look at how thalamic disruption impacts PD — and how to address it. 

“The Parkinson's Foundation Research Center was a chance to bring our more basic science researchers into pursuing something in an integrated topic. It was also the chance to explore something that hasn't been explored very much in Parkinson's research — the thalamus — but it's clearly an important area in neuroscience.” Dr. Albin.

Utilizing PET Scanning to Map Dopamine Neurons in the Thalamus 

The University of Michigan is home to some of the most advanced brain imaging technologies available, including Positron Emission Tomography (PET) scanning. Neuroscientists can use this technology to visualize neurons in the brain.

For Dr. Bohnen and Dr. Albin, the Research Center funding combined with PET scanning technology created a rare opportunity to map and measure neurons in the human thalamus. They sought to understand how the thalamus directs vision, balance and movement, and how its disruption could contribute to PD.

Dr. Bohnen focused on how PD affects the dopamine neurons in the thalamus. Early findings from his team found that loss of dopamine neurons in the thalamus was strongly linked to PD-like symptoms and was a better predictor of symptom severity than assessing similar changes in the substantia nigra.

“Thanks to the Parkinson’s Foundation, we have been able to use novel brain imaging tools to study chemical messenger molecules in the thalamic complex in the living brain in people with Parkinson’s and how this relates to more complex gait functions.”

For his Research Center project, Dr. Bohnen designed a larger trial to dive deeper into how thalamic dopamine neuron loss contributes to PD symptoms. He used PET scanning to measure the amount and health of thalamic dopamine neurons in participants in different stages of PD. Understanding how dopamine neuron breakdown in the thalamus coincides with PD movement symptoms could help researchers design new treatments that target this area of the brain.

Exploring the Impacts of Acetylcholine  

Another important signaling molecule used in the brain is acetylcholine. Neurons that communicate using acetylcholine are called cholinergic neurons and are the primary focus of Dr. Albin’s research project.

Cholinergic neurons in the thalamus play critical roles in visual attentional functioning - how the mind coordinates what it sees with how it reacts via movement. For example, entering a doorway requires high visual attentional function: arm movement to open the door must be coordinated with moving through the doorway, while also minding any step or threshold that could be tripped on.

“The work of our Parkinson’s Foundation Research Center project cemented our understanding of the importance of another major set of brain systems — the cholinergic systems — that are affected in Parkinson disease.”

Recent studies by Dr. Albin and his team found people with PD that fall more often, a dangerous and common risk of PD, had greater disruption in their thalamic cholinergic neurons. These results hinted that losing such neurons impaired those people’s visual attentional function, increasing their risk of falling.

Dr. Albin wanted to determine whether people with fewer healthy cholinergic neurons in the thalamus had more difficulty with visual attention tasks. Working with Dr. Bohnen, he designed a way to measure thalamic cholinergic neurons using PET scans, coordinated with Dr. Bohnen’s study of dopaminergic neurons.

By comparing PET scan results with participants’ performances on visual attention computer tests, he sought to determine if cholinergic neurons in the thalamus play a role in these tasks. Findings from this research could open new possibilities for future PD treatments addressing movement symptoms that are centered on acetylcholine neurons, in addition to dopaminergic ones.

Impacting Movement Symptoms

While the first two projects studied the thalamus in people, Dr. Leventhal used an animal model, the laboratory rat, to determine how PD-related changes in movement signals from other parts of the brain affect the “motor thalamus”.

The “motor thalamus” is a part of the thalamus responsible for regulating voluntary movement. It receives signals from two key regions of the brain:

• The basal ganglia: associated with initiating movement

• The cerebellum: connected to fine-tuning movement

In PD, disruptions in the function of the basal ganglia lead to movement symptoms – but we don’t exactly know how. Dr. Leventhal hypothesized that:

• Signals from the basal ganglia to the thalamus were more important for reaction time and speed than the signals received from the cerebellum.

• If he simulated PD-like neurodegeneration in rats, their reaction time would decrease as the signaling from the basal ganglia to the thalamus declined.

Pinpointing where the movement signal coordination occurs in the thalamus could guide new deep-brain stimulation (DBS) targets. Having new thalamic DBS treatment options could make DBS an option for more people with PD, granting them new opportunities to address their movement symptoms and improve their quality of life.

Mining Mountains of Data for Parkinson’s Breakthroughs

As with nearly all clinical research, the COVID-19 pandemic led to delays in Research Center projects. However, the Parkinson’s Foundation supported University of Michigan researchers to wait until it was safe to begin their studies.

“The Parkinson’s Foundation support was essential in maintaining our critical research infrastructure and personnel during the COVID-19 pandemic. This allowed us to compete successfully for major extramural funding, including a Udall Center grant and a major grant from the Farmer Family Foundation.” Dr. Albin.

Additionally, the Research Center grant helped Dr. Bohnen and Dr. Albin form an international collaboration with PD researchers at the University of Groningen in the Netherlands. These collaborators, led by Teus van Laar, MD, PhD, were coincidentally running a similar clinical study called the Dutch Parkinson Cohort (DUPARC), also performing imaging collection with people with PD in northern Netherlands. By combining the University of Michigan data with DUPARC data, both groups significantly expanded their datasets.

With so much data available, the researchers are still deep in analysis, but some breakthroughs have emerged and have been published in major scientific journals. In particular, the cholinergic research has revealed how acetylcholine neurons across the brain decline over normal aging as well as in PD, charting degeneration patterns that researchers had never fully mapped before. By understanding how these neurons break down both with and without the influence of PD, scientists can better understand how the disease affects or accelerates that process and how to better slow or stop it.

Some early symptomatic correlations with cholinergic neurons have been discovered as well. Dr. Bohnen and Dr. Albin identified specific brain regions —inside and outside the thalamus — that are important for gait and balance. In those regions, when cholinergic neurons were impaired, there were greater issues with posture and movement coordination. These results break ground for new treatments to be developed that target those regions to help with balance and gait symptoms.

Dr. Leventhal’s research into the motor thalamus using rats is still ongoing, with results soon to be reported. In the meantime, his project has inspired collaborations with other researchers at the University of Michigan, investigating other dopamine neuron dynamics in rats with Christian Burgess, PhD, and identifying new brain feedback signals that could guide DBS placement during surgery with Enrico Opri, PhD.

“There is so much exciting research across disciplines right now. I teach a class on PD research to undergraduates and am amazed at how much I have to update the curriculum every year.”

A Research Center Becomes a Launchpad for PD Research 

Research projects, especially clinical studies involving complex imaging, require significant time and funding. The Parkinson’s Foundation Research Center designation and its stable and long-term support allowed researchers to embark on this ambitious PD research effort.

The early results from these studies, and the many breakthroughs still to come from the analysis of the collected data, show how critical this support is in driving PD research toward new treatments. Their projects have revealed new insights about how PD affects neurons in the thalamus and the brain overall, guiding future treatment design to improve symptoms.

“We are on the cusp of understanding at a deep computational level how the brain regions affected by PD normally interact with each other, and how that changes in PD. Armed with that understanding, I am hopeful that we can more efficiently restore motor and nonmotor function with fewer side-effects to people with PD.”

University of Michigan researchers have developed a launchpad of PD research that spans not just their institution, but across the world. As their scientific work continues, their findings will propel the university and the greater PD research community toward new treatments and, someday, a cure.

Learn More

The Parkinson’s Foundation works to improve care for people with PD and advance research toward a cure. Learn more with these resources:

• Read the first article in this series: From Parkinson’s Foundation Research Center to Powerhouse: How Yale Became a Leader in Parkinson’s Science.

• Discover how we are working to close gaps in knowledge about PD: Advancing Research.

• Learn about and enroll in PD GENEration — a global genetics study that provides genetic testing and counseling at no cost for people with Parkinson’s.

• Explore ways to get involved in the Parkinson’s Foundation — from becoming a research advocate to joining a research study.