Acute and cumulative effects of hypoxia exposure in people with Parkinson's disease: A scoping review and evidence map

Author(s)

Kalva-Filho, Carlos A. ; Faria, Murilo Henrique ; Papoti, Marcelo ; Barbieri, Fabio Augusto

• Document type: Journal article
• Source: PARKINSONISM & RELATED DISORDERS; v. 118, p. 9-pg., 2024-01-04.

Abstract

Hypoxia exposure may promote neuroprotection for people with Parkinson's disease (PwPD). However, to implement hypoxia in practical settings and direct future research, it is necessary to organize the current knowledge about hypoxia responses/effects in PwPD. Thus, the present scoping review elucidates the evidence about hypoxia exposure applied to PwPD. Following the PRISMA Extension for Scoping Reviews, papers were searched in PubMed/NCBI, Web of Science, and Scopus (descriptors: Parkinson and hypoxia, mountain, or altitude). We included original articles published in English until August 12, 2023. Eight studies enrolled participants with early to moderate stages of disease. Acute responses demonstrated that PwPD exposed to normobaric hypoxia presented lower hypoxia ventilatory responses (HVR), perceptions of dyspnea, and sympathetic activations. Cumulative exposure to hypobaric hypoxia (living high; 7 days; altitude not reported) induced positive effects on motor symptoms (hypokinesia) and perceptions of PwPD (quality of life and living with illness). Normobaric hypoxia (isocapnic rebreathe, 14 days, three times/day of 5-7 min at 8-10 % of O2) improved HVR. The included studies reported no harmful effects. Although these results demonstrate the effectiveness and safety of hypoxia exposure applied to PwPD, we also discuss the methodological limitations of the selected experimental design (no randomized controlled trials), the characterization of the hypoxia doses, and the range of symptoms investigated. Thus, despite the safety of both normobaric hypoxia and hypobaric hypoxia for early to moderate levels of disease, the current literature is still incipient, limiting the use of hypoxia exposure in practical settings. (AU)

• FAPESP's process: 22/02971-2 - Unrevealing the gait asymmetry in patients with Parkinson’s Disease: from the neural and motor mechanisms to rehabilitation: AsymmGait-Parkinson study
• Grantee: Fabio Augusto Barbieri
• Support Opportunities: Research Grants - Initial Project
• FAPESP's process: 22/09235-0 - Intermittent hypoxia in Parkinson's disease: Acute effect on locomotion, sleep quality and blood biomarkers
• Grantee: Murilo Henrique Faria
• Support Opportunities: Scholarships in Brazil - Master