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Jaslok Hospital unveils findings of comprehensive clinical trial aimed at slowing Parkinson’s disease progression

Apr 10,2024

Mumbai: On the eve of World Parkinson’s Day, Jaslok Hospital and Research Centre unveiled findings from a comprehensive clinical trial aimed at slowing the progression of Parkinson’s disease. Led by principal investigator Prof (Dr) Paresh Doshi, Director of Neurosurgery and Stereotactic and Functional Neurosurgical programme at Jaslok Hospital and Research Centre. The trial marks a significant milestone in Parkinson’s care, potentially revolutionising management approaches and enhancing the quality of life for patients and caregivers worldwide.

Parkinson’s Disease (PD) affects over 10 million people globally, with a particularly high prevalence in Asia, notably in India. The disease significantly impairs motor functions and quality of life due to the degeneration of dopaminergic neurons. Current treatments focus primarily on symptom management, leaving a critical gap in altering the disease’s progression.

This trial explores the potential of transformative approaches such as dance and music therapy, along with mindfulness meditation, in managing PD symptoms and improving overall well-being. The study, conducted at Jaslok Hospital and Research Centre, engaged 28 individuals diagnosed with mild to moderate PD over six months. After obtaining informed consent from the patient, patients were randomly assigned by a computer-generated algorithm either to a therapy or a control group. The group chosen for therapy was offered either dance or music as their preferred form of therapy. The philosophy is that people who love music may not like dance, and people who like to dance may prefer dance over music. Both groups of therapy were also given guided meditation by an expert trainer in the field of meditation. Several Parkinson’s disease-related scorings were performed to evaluate the motor function, behaviour, mood, and cognitive functions of these patients before the trial and on the completion of the trial. The control group was also evaluated in the same manner. Both groups continued their usual medical management. A patient diary was maintained to ensure adequate compliance, and patients who could not follow the required schedule were excluded from the trial.

The assessments were made on two main areas of primary results. The first was the quality of life (measured by the Parkinson’s Disease Questionnaire-PDQ39), and the second was the gold standard used to determine the impact of any treatment on the progression of Parkinson’s disease (Unified Parkinson’s Disease Rating Scale-UPDRS), including two other data points to evaluate the impact of this treatment on the caregivers: PDQ-Carer Change and Zarit Burden Interview Change. All four endpoints showed significant improvement, which was statistically significant, as seen in the below graph.

The results confirm that any therapy that the patient prefers, ie dance or music; along with meditation, has a definitive impact on the progress of Parkinson’s disease and also on the quality of life of the patient. This also translates into better well-being and an improved quality of life for the caretakers. Notably, the benefits observed in this trial extend beyond the intervention period, indicating the potential for long-lasting effects.

The results underscore the importance of exploring alternative therapies for managing PD comprehensively. Future directions include longer-term studies and investigations into diverse populations. Besides the above results, there was improvement in other areas like mood (Beck depression scale), memory function (MMSE), balance (TUG and Berg balance test), and anxiety (Anxiety scale).

Commenting on this Prof (Dr) Doshi said, “These results mark a significant leap forward in Parkinson’s care. Our trial demonstrates the potential of alternative therapies in not just managing symptoms, but in potentially slowing the progression of this debilitating disease. Through innovative approaches like dance and music therapy, we are paving the way for a brighter future for Parkinson’s patients and caregivers worldwide.”

Dr Doshi also highlighted that this is the first trial to have a blinded randomised evaluation of patients undergoing treatment and not undergoing therapy ever presented or studied in the world. This is the first-ever trial in the world that has evaluated not only Parkinson’s disease but also the caregivers’ burden in the management of Parkinson’s disease through dance and music therapy. Laying a lot of emphasis on the quality of life, which was one of the principal trial endpoints which again has been very rarely evaluated for this form of treatment. The level of detailed evaluation of motor disability, mood, behaviour, and cognition has always been performed in surgical interventional trials or medical interventional trials but never in any trials where no intervention accept therapy like dance and music were offered.

“By harnessing the power of alternative therapies, we are not just treating Parkinson’s disease, but transforming lives,” said Dr Milind Khadke, Director Medical Services, Jaslok Hospital.

Source: Healthworld

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