Efficacy of Cold Plasma in Stimulating Hippocampal Neurogenesis in Patients with Early-Stage Parkinson’s Disease with the Mediating Role of BDNF Gene Expression and Cognitive Performance

Author
Mohammad Hossein Roudbari
Department of Clinical Psychology, Faculty of Medicine, Islamic Azad University, Kish Island, Iran
Abstract
Introduction: Early-stage Parkinson's disease is associated with the loss of dopaminergic neurons and impaired hippocampal neurogenesis, leading to cognitive deficits. Cold atmospheric plasma (CAP), a novel intervention, exhibits anti-inflammatory and stimulatory effects on neural cells. Brain-derived neurotrophic factor (BDNF) plays a pivotal role in hippocampal neurogenesis. This study investigated the efficacy of CAP in stimulating hippocampal neurogenesis in patients with early-stage Parkinson's disease, examining the mediating roles of BDNF gene expression and cognitive performance.

Materials and Methods: A quasi-experimental study with a pretest-posttest control group design was conducted in neurology clinics in Tehran. The sample consisted of 60 patients with early-stage Parkinson’s disease (30 in the intervention group and 30 in the control group), all at Hoehn-Yahr stages 1–2. The intervention group received 12 sessions of 20-minute each of CAP (dose: 10 kV/cm) applied to the scalp, especially the temporal region. The assessment tools included the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination for cognitive evaluation, quantitative polymerase chain reaction for measuring peripheral blood BDNF gene expression, and hippocampal MRI to measure the volume of the dentate gyrus (DG). Data were analyzed using structural equation modeling (SEM) in AMOS.

Results and Discussion: Post-intervention, neurogenesis (based on DG volume) increased by 28% (p < 0.001). BDNF gene expression mediated 35% (β = 0.35) and cognitive performance (with MoCA score improving from 22.4 to 26.7) mediated 42% (β = 0.42), both of which were statistically significant. SEM confirmed the indirect pathway: CAP → BDNF → neurogenesis (GFI = 0.95; RMSEA=0.06). No adverse events were reported during the study.

Conclusion: CAP is a safe and effective approach for stimulating hippocampal neurogenesis in early-stage Parkinson’s disease, acting through BDNF. It is recommended that CAP be integrated into clinical treatment protocols.

Keywords
BDNF
Cognitive performance
Cold plasma
Hippocampal neurogenesis
PARKINSON’S DISEASE