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Run in the Light

Exploring exercise and photobiomodulation in Parkinson's disease
John Mitrofanis, Michael Hamblin


Parkinson's disease is a neurological disorder with cardinal motor signs of resting tremor, bradykinesia and lead-pipe rigidity. In addition, many patients display non-motor symptoms, including a diminished sensation of smell, gastrointestinal problems, various disorders of sleep and some cognitive impairment. These clinical features – particularly the motor signs – manifest after a progressive death of many dopaminergic neurones in the brain. Conventional therapies can reduce the signs of the disease, however, the progression of this neuronal demise has proved difficult to slow or stop, and the condition is relentlessly progressive. Hence, there is a real need to develop a treatment that is neuroprotective and slows the pathology of the disease effectively. 

At present, there are several neuroprotective therapies in the experimental pipeline, but these are for the patients of tomorrow. This book focuses on two therapies that are readily available for the patients of today. They involve the use of exercise and light (i.e. photobiomodulation: the use of red to infrared light therapy on body tissues). Given the heterogeneity of Parkinson's disease in humans, tackling the condition from a range of different angles – with several different therapies – would only serve to enhance the positive outcomes. This book considers the use of exercise and light therapies, proposing that they have the potential to make a powerful "dynamic duo", offering a most effective neuroprotective treatment option to patients.

About Editors

John Mitrofanis gained his PhD at The University of Sydney. He is professor of anatomy at Sydney Medical School. Throughout his career he has been an active teacher of topographical anatomy and neuroanatomy to medical and science students, and he has run a research programme on brain organisation. His research has examined the structure and patterns of connectivity in the adult and developing thalamus, cortex and brainstem, and he has explored different methods that improve the function and survival of neurones in Parkinson's disease.

Table of Contents




chapter 1 Parkinson's disease


signs and symptoms

the basal ganglia

basic structure, neurochemistry and connections

striatum: caudate and putamen 8 globus pallidus

subthalamic nucleus

substantia nigra

zona incerta

pedunculopontine tegmental nucleus

overall functions of basal ganglia

the loops

the direct and indirect pathways



zones of neuronal pathology

Lewy bodies and α-synuclein


growth factors

other pathological changes

mechanisms of neuronal death

neural circuits behind the signs and symptoms

predictive tests

risk factors


environmental toxin


head injury

gender and race  



animal models

toxin-induced models  

transgenic models


current treatments  

dopamine replacement drug therapy  

surgical treatment: deep brain stimulation at high frequency  

neuroprotection and future treatments

neuroprotection basics

neuroprotection versus symptomatic treatments?

why no neuroprotective treatment for patients?

future treatments


chapter 2 the run is exercise 


why should exercise work?

how much exercise do you need?

methods of exercise: how do you do it?

exercise-induced neuroprotection: a matter of survival

evidence for exercise-induced neuroprotection in animal models of Parkinson's disease

exercise-induced changes to the dopaminergic system

exercise-induced changes to the non-dopaminergic system

exercise stimulates growth factors

exercise-induced changes in mitochondrial function, neurogenesis and other cellular features

exercise reduces gliosis

key features of exercise-induced neuroprotection

is there exercise-induced neuroprotection in Parkinson's disease patients?

how does exercise neuroprotect: the mechanisms

exercise-induced symptomatic effects: a matter of function

evidence for exercise-induced changes in function in the brain

how does exercise influence neuronal function

exercise-induced functional and behavioural improvements

evidence for functional and behavioural changes in animal models of Parkinson's disease  

evidence for clinical effects in Parkinson's disease patients

safety of exercise

factors that generate exercise-induced functional and behavioural changes: neuroprotective or symptomatic?

summary and a working hypothesis of the trigger

what is the trigger


chapter 3 the light is photobiomodulation

general: what is light?

the light (photobiomodulation) and its history

neural applications of light

light sources, wavelengths, powers and modes

how far does light travel?

is light safe?

other light wavelengths

light-induced neuroprotection: a matter of survival

evidence for light-induced neuroprotection in animal models of Parkinson's disease

light-induced neuroprotection in the dish

light-induced neuroprotection in the whole animal

light reduces gliosis

light stimulates growth factors

effects of light on encephalopsin expression?

how does light neuroprotect: the mechanisms

direct light stimulation of neurones

indirect light stimulation of neurones using the circulation: the abscopal effect


light-induced symptomatic effects: a matter of function  

evidence for light-induced changes in brain function

how does light influence neuronal function?

light-induced functional and behavioural improvements in animal models of Parkinson's disease

evidence for functional and behavioural changes in animal models of Parkinson's disease

factors that generate light-induced functional and behavioural changes: neuroprotective or symptomatic?

how will light work in humans?

light-induced changes in Parkinson's disease patients

light application in other diseases and systems  

the road to a therapeutic option for light treatment in patients

why should light work?


chapter 4 the run and the light: the "dynamic duo"

they are so similar

animal models


do exercise and light use common mechanisms for two outcomes

potential benefits of a combined therapy: a cocktail

is there a precedent?

exercise plus light therapy in animal studies

exercise plus light therapy in humans


a combined therapy protocol for Parkinson's disease patients?

light wavelength, dosage and application site

exercise programme

timing of light application in relation to exercise

what about eating more vegetables





Paperback ISBN: 9780750330039

Ebook ISBN: 9781643277196

DOI: 10.1088/2053-2571/ab2f70

Publisher: Morgan & Claypool Publishers

Series: Series in Photomedicine and Biophotonics


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