Unleashing the potential of dance: a neuroplasticity-based approach bridging from older adults to Parkinson's disease patients

Abstract

Parkinson's disease (PD) is a neurodegenerative disorder that affects >1% of individuals worldwide and is manifested by motor symptoms such as tremor, rigidity, and bradykinesia, as well as non-motor symptoms such as cognitive impairment and depression. Non-pharmacological interventions such as dance therapy are becoming increasingly popular as complementary therapies for PD, in addition to pharmacological treatments that are currently widely available. Dance as a sensorimotor activity stimulates multiple layers of the neural system, including those involved in motor planning and execution, sensory integration, and cognitive processing. Dance interventions in healthy older people have been associated with increased activation of the prefrontal cortex, as well as enhanced functional connectivity between the basal ganglia, cerebellum, and prefrontal cortex. Overall, the evidence suggests that dance interventions can induce neuroplastic changes in healthy older participants, leading to improvements in both motor and cognitive functions. Dance interventions involving patients with PD show better quality of life and improved mobility, whereas the literature on dance-induced neuroplasticity in PD is sparse. Nevertheless, this review argues that similar neuroplastic mechanisms may be at work in patients with PD, provides insight into the potential mechanisms underlying dance efficacy, and highlights the potential of dance therapy as a non-pharmacological intervention in PD. Further research is warranted to determine the optimal dance style, intensity, and duration for maximum therapeutic benefit and to determine the long-term effects of dance intervention on PD progression.

Keywords: dance; neurodegeneration; rhythm; sensorimotor integration; tremor.

FIGURE 1

Demands of dancing and impacts of dance-interventions. Indicated are studies that demonstrate the demands or impacts, of which the full citation can be found in the references. Note that the citations do not exhaustively cover the impacts and demands, and are predominantly covered by the cited (systematic) reviews, while in the main body of the text detailed claims from specific studies can be found. ¹ Allen et al. (2017); ² Batson et al. (2014); ³ Burzynska et al. (2017); ⁴ Duncan and Earhart (2012); ⁵ Duncan and Earhart (2014); ⁶ Esposito et al. (2013); ⁷ Hackney and Earhart (2009c); ⁸ Ji et al. (2018); ⁹ Karpodini et al. (2022); ¹⁰ Kattenstroth et al. (2010); ¹¹ Li et al. (2015); ¹² McKay et al. (2016); ¹³ McNeely et al. (2015a); ¹⁴ McNeely et al. (2015b); ¹⁵ Müller et al. (2017); ¹⁶ Niemann et al. (2016); ¹⁷ Porat et al. (2016); ¹⁸ Rehfeld et al. (2018); ¹⁹ Shanahan et al. (2015); ²⁰ Westheimer (2008); ²¹ Wu et al. (2022).