Project Background/Rationale. Depression may be an important component of Parkinson's disease (PD) in many patients, contributing to significant levels of disability and distress. However, there is no consensus on best pharmacological treatment for depression in PD as efficacy is lacking and there is much concern about polypharmacy and safety of various antidepressant medications. Therefore, it is essential that we characterize the effects of nonpharmacological interventions on depression in PD. Several studies reveal significant benefits of exercise in reducing depressive symptoms. Project Objectives. We propose to conduct a randomized, controlled trial of a novel program that uses resistance training coupled with real-time guidance delivered remotely in patients with depression in PD. We hypothesize that patients in the resistance training intervention program will improve on depression scores over 6 months, as compared with patients in the health education program. Project Methods. Community-dwelling veterans with PD and depression will be randomized to the resistance training intervention coupled with real-time guidance or to the health education control intervention. We will test the effects of the exercise intervention over 6 months for the primary outcome of the Hamilton Rating Scale for Depression and for the 2 secondary outcomes of the 39-item Parkinson's Disease Questionnaire and the Unified Parkinson's Disease Rating Scale. Furthermore, we will assess risk factors for compliance with the study protocol to enable us to possibly refine the design of a future large study.
This study will test the hypothesis that a home-based strength training intervention coupled with voice response guidance will reduce depression in veterans with Parkinson's disease and depression. This approach would offer an affordable way to continue to both instruct and encourage strength training by veterans virtually indefinitely through our remote access technology. These findings may help VA clinicians provide optimal care for the many veterans with depression in Parkinson's disease.