6th Edition of Neurology World Conference 2026

Abstract

Purpose :Sequential working memory is impaired in patients with Parkinson’s disease (PD), especially the ability to manipulate thoughts and actions in an appropriate order. As a traditional Chinese activity, Tai Chi training could improve the performance in the sequential working memory test. Here we aimed to examine the neural correlates of this therapeutic effect of Tai Chi in patients with early PD.

Methods :We combined functional magnetic resonance imaging (fMRI) with a novel digit ordering task where participants had to reorder and recall a sequence of four random digits in ascending order or simply to recall them. The task included interleaved “pure recall” (REO-, 30 trials) and “reorder & recall” trials (REO+, 32 trials). In “pure recall” trials, the digits were presented in ascending order. In “reorder & recall” trials, the digits were randomized and participants always had to reorder them. This study had a double-blind design. Fifty-four PD patients (25 males, age 45-75 years, education 5-20 years, Hoehn and Yahr Stages 1 to 2) were recruited and randomized divided into two groups. None of them was demented or depressed. Tai Chi training group was administered regular Tai Chi “Five Gong Six Fa” training (60 min on three days each week for 8 weeks). The control group was engaged in regular activities according to personal habits during these 8 weeks. They completed the novel digit ordering task with fMRI after intervention. The group differences in accuracy and activation and functional connectivity of the three regions of interest were examined.

Results :All patients responded less accurately in the REO+ than REO-. The control group responded less accurately than Tai Chi group regardless of trial type. Across groups, the whole-brain analysis (p<0.05 corrected) revealed greater activations for REO+ than REO- in the dorsolateral prefrontal cortex (DLPFC), ventrolateral PFC (VLPFC), posterior parietal cortex (PPC), dorsomedial PFC (DMPFC), subthalamic nucleus, thalamus, and cerebellum. Compared to control group, the whole-brain analysis revealed greater activations in the DLPFC and stronger DLPFC-subthalamic nucleus functional connectivity in Tai Chi training group. Moreover, in Tai Chi training group, the linear regression model exhibited that ordering accuracy cost (REO+ versus REO-) was negatively correlated with the ordering-induced DLPFC activity change and DLPFC-subthalamic nucleus functional connectivity. In control group, the linear regression model was not significant.

Conclusion :We observed a positive effect of the Tai Chi on the ordering-related brain activity. Namely, Tai Chi training could enhance lateral prefrontal activations underlying sequential working memory in early PD. As the personalized exercise prescriptions emerge as a novel therapeutic avenue for PD patients, there is a pressing need for robust and high-caliber research to design optimal and tailored exercise regimens.