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t m c n e w s . o r g 14 t m c n e w s . o r g Managing Early-Onset Parkinson's with Exercise Matt Kintzele, diagnosed five years ago, is training for triathlons M att Kintzele could feel that the air had chilled overnight, but he got up anyway. He pulled on his clothes, ate a quick breakfast, then drove to the local YMCA in Katy, a large suburb on the westward end of Houston's sprawl. He was tired, but he had laps to swim. By the time he entered the pool, his hands were shaking uncontrollably. But that wasn't going to stop him—nothing, he told himself, would. Five years ago, the 51-year-old was diagnosed with early-onset Parkinson's disease, a progressive disorder of the central nervous system caused by a loss of dopa- mine in the brain. The condition affects movement and often leads to tremors and rigidity in the muscles. Kintzele had first noticed a tremor in his left thumb, which eventually progressed to his entire hand. After seeking answers from a host of doctors and specialists, he visited Baylor College of Medicine for a second opinion. There, he met with Joseph Jankovic, M.D., director of the Parkinson's Disease Center and Movement Disorders Clinic. "One of the things Dr. Jankovic said when I got my diagnosis was how important exercise is," Kintzele said. "I took that very seriously. I wasn't working out that much at the time, but I started working out basi- cally every other day, three to four times a week, to try to battle it." Jankovic gives the same advice to all his patients, calling on dozens of studies concluding that aerobic exercise has a direct influence on brain function and can even slow the progression of neurodegenera- tive diseases like Parkinson's. "There have been many, many studies that show that patients with Parkinson's disease who exercise do much better in the long run than those who don't exercise," Jankovic said. He cited research focusing on an increase in the production of certain proteins, including BDNF (brain-derived neurotrophic factor) and GDNF (glial cell line-derived neurotrophic factor), which are critical for healthy brain function and provide support and nutrition for neurons and nerve cells. "Animals who exercise have much higher production of these neurotrophic factors," Jankovic said. "There's also evidence that animals that exercise actually have increased brain volume, and there have been studies in humans that showed that long-term exercise can result in greater volume of the cerebral cortex and the hippocampus. People who exercise also have increased connectivity within the brain and they have less age-related degeneration of the brain. All of these factors support a notion that the brain benefits from long-term exercise, and this has been spe- cifically shown in patients with Parkinson's disease." Jankovic had no problem convincing Kintzele of the benefits of exercise, but, for Kintzele, acting on the doctor's advice would prove easier said than done. "That first year when I was diagnosed, I wasn't taking any meds for [Parkinson's] yet. And over the course of about six months, I began to not be able to walk fast," Kintzele said. "In my left leg, when I tried to run, my toes wouldn't push off. I just couldn't do it, and so I walked, but then I became unable to walk really fast. That was frustrating because I was a runner earlier in life." He shifted to weight-lifting, boxing and some cycling, but was eventually advised to take medica- tion to help control his symptoms. The medication worked wonders. "I suddenly didn't have prob- lems writing, and suddenly my leg was working so I could run again," Kintzele said. ➟ Facing page: Matt Kintzele swims laps at his local YMCA in Katy, Texas, on Feb. 1, 2020. B y A l e x a n d r a B e c k e r