The Effects of Multimodal Exercise on Sleep Quality and Architecture, Motor Function, Cognition, Fatigue, and Systemic Inflammation in Corticobasal Syndrome: A Case Report.

IMPORTANCE

Corticobasal syndrome (CBS) is a rare tauopathy, with a complex pathophysiology that usually includes neuroinflammation. Parkinsonism, cognitive impairments, and sleep disturbances are common in CBS, although alterations in sleep architecture remain poorly characterized. Regular exercise has been recommended in CBS to manage gait dysfunction, balance issues, and cognitive decline. However, the effects of regular exercise on sleep quality, sleep architecture, and systemic inflammation in CBS remain unclear.

OBJECTIVE

The purpose of this study was to describe the effects of regular exercise in CBS.

DESIGN

The design of this study was a case report.

SETTINGS: This study was conducted in an academic laboratory.

PARTICIPANTS

An individual with CBS participated in this case study.

INTERVENTION: The participant completed a 12-week multimodal training program.

MAIN OUTCOME(S) AND MEASURE(S): Cardiorespiratory fitness level was assessed with a symptom-limited cardiopulmonary exercise test and strength with a submaximal 1-repetition maximum test. Subjective and objective sleep quality were assessed using the Parkinson Disease (PD) Sleep Scale-2 and actigraphy, respectively. Sleep architecture was evaluated with polysomnography. Cognition and motor function were assessed with the Scale for Outcomes in PD-Cognition and Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS-III), respectively, functional mobility with the Time Up and Go (TUG), and fatigue with the PD Fatigue Scale. Concentrations of inflammatory markers, including interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor, and C-reactive protein, were measured from serum collected after a 12-hour fasting period.

RESULTS

Following the training program (34 sessions; 25.35 hours), improvements in fitness, objective sleep quality and architecture, cognition, TUG, and a reduction in systemic inflammation were observed. Conversely, MDS-UPDRS-III scores deteriorated, and the participant reported diminished subjective sleep quality and increased fatigue.

CONCLUSIONS

These results, which should be interpreted with caution, suggest that various clinical outcomes improved following multimodal training. Controlled studies are warranted to confirm these observations.

RELEVANCE: This is the first case report describing the effects of a training program on sleep architecture and systemic inflammation in CBS.