Ping Pong Parkinson's Neuroplasticity

You’ve heard the story of how researchers discovered that forced exercise bicycle riding is good for people with Parkinson’s and you've heard about the wonderful work the Mark Morris Foundation is doing with its Dance For PD program. You may have even heard about ping pong diplomacy which refers to the exchange of US and Chinese ping pong players in 1971 that paved the way for Nixon’s visit to China and started the thaw in US China relations. Well, I’ve discovered the ultimate beneficial activity for people with PD. Ping Pong. And it’s not because I’m good at it. I’m terrible, having played only two or three times previously.

I didn’t want to play because I was afraid of making a fool of myself by stumbling around and falling but another player was needed so I decided to try. Miraculously even though I was moving rapidly from side to side and back and forth I seemed to move smoothly and without thinking. And surprise, surprise I didn’t shake. Even though I have a noticeable tremor my hand was as steady as a rock and I didn’t shake even between points when the ball wasn’t in play.

But this post is not about ping pong, it’s about neuroplasticity, the brain’s ability to form new neural paths and reorganize synaptic connections throughout life. Until recently scientists believed that we were born with a fixed number of neural cells. When a cell died a new one couldn’t grow and we couldn’t generate new neural pathways. Modern brain imaging technology shows that the brain has the ability to reorganize itself and grow new neural cells and neural pathways throughout life. This is particularly important to people with Parkinson’s because the disease is thought to be caused a drop in dopamine levels due to nerve cell damage in the brain. Unfortunately neural regeneration has not yet been observed in the substantial nigra, the area off the brain most responsible for dopamine production. Let’s not give up hope.

It’s all about axons, neurons, synapses, and neural pathways. A neuron consist of a cell body containing a nucleus that receives incoming nerve impulses and an axon that carries impulses away from the cell body across a synapse to another cell. A synapse is where a nerve impulse passes from one neuron to another. A web quote “Brain reorganization takes place by mechanisms such as "axonal sprouting" in which undamaged axons grow new nerve endings to reconnect neurons whose links were injured or severed. Undamaged axons can also sprout nerve endings and connect with other undamaged nerve cells, forming new neural pathways to accomplish a new needed function.” Words like brain reorganization, new neural paths, and new needed functions are music to a person with Parkinson’s ear.

The way to keep the brain healthy and to develop new neural paths is to perform new activities and challenges that push your mental and physical limits. Learning a new language, solving sudoko puzzles, learning to play an instrument are all good but complex, demanding, random, forced physical activity repeated over time is best because it changes the way the brain works. Newly formed neural pathways need repetition and reinforcement to remain viable. The thing to do is to learn to look forward to new challenges and take pleasure in doing them.

One of the most important aspects of ping pong is that every shot is different and random. Ping pong involves fast reflexes, good hand-eye coordination, and demands balance. You’ve got to make continuous quick adjustments and decisions while rapidly moving because you never know where the ball is going to be. There are studies that show that fast paced (forced) random physical exercise demanding quick decision making and response is particularly beneficial to people with PD. Aerobic exercise is always good but static, repetitive exercise, like walking on a treadmill or stationary biking, is not as helpful to improve coordination, reflexes, balance and other movement-related skills as is random practice exercise in which you are required to change speed and direction and adjust responses at random intervals. I have a PD friend who plays ping pong with a paddle in each hand alternating hands with each shot. She says that it works both sides of her brain and forces even quicker adjustments and responses. She’s convinced it helps her PD. The problem with ping pong though is that the action is not sustained. It involves vey short bursts of activity and too many stops. Maybe the perfect exercise would be to play ping pong while riding a Theracycle.

Enough chit chat. Have to get back to the ping pong table and do more research so I can help cure PD and publish my findings in all the leading medical journals. Should I call it Ping Pong Parkinson’s or Parkinson’s Ping Pong? How about PPP or just P3? Ok, I admit I googled it and found out that a few other people say they found ping pong beneficial but no one mentions the best part - how enjoyable the laughter and excitement was and how good it made me feel to have fun with my family and friends.