Nrf2 and Cannabidiol (CBD): Protecting Cells in Parkinson’s Disease

Parkinson’s disease (PD) affects movement in a way like when a conductor of an orchestra starts giving mixed signals or stops conducting altogether. In the substantia nigra in the brain, dopamine acts like the conductor, ensuring that movement signals are well-coordinated. When the cells that produce dopamine die, this “conductor” is no longer able to keep everything in sync, leading to the tremors, stiffness, and difficulty moving seen in PD patients. Oxidative stress and aging are the primary risk factors for PD. Oxidative stress occurs when there is an imbalance between harmful free radicals and protective antioxidants in the body, leading to oxidation and damage to cells and tissues. In PD, this oxidative damage plays a significant role in worsening symptoms. A protein called Nrf2 serves as one of the body’s main defenders against oxidative stress. Nrf2 acts like a shield, protecting brain cells by activating antioxidant enzymes that neutralize harmful free radicals. However, under conditions of excessive oxidative stress, this protective shield can become damaged itself. Cannabidiol (CBD), one of the main non-psychoactive molecules of Cannabis sativa, is a strong antioxidant that may repair this protective shield by restoring proper Nrf2 function. CBD does not cause psychoactive effects (“the high”) because it does not bind receptors in the brain, and it can easily cross from the bloodstream into the brain. In my study, I will investigate how the breakdown of this protective Nrf2 shield contributes to PD and how CBD might repair it. I will examine brain samples from PD patients to see how Nrf2 functions differently compared to healthy brains. Using cell models that mimic PD conditions, I will test whether CBD can restore Nrf2’s protective function and potentially slow or prevent the death of brain cells. This research could lead to new CBD-based treatments for PD that target the fundamental oxidative damage that drives the disease process.

Improving Speech Control in Parkinson’s Disease

Parkinson’s disease affects more than 100,000 Canadians. While most people associate Parkinson’s with tremors and movement difficulties, speech problems are also common and can significantly impact social interaction and quality of life. When we speak, we constantly monitor the sound of our voice. This auditory feedback helps us maintain intelligible speech. Research suggests people with Parkinson’s rely on this feedback more than healthy individuals, causing them to overcorrect when they hear unexpected errors in their voice pitch. This might explain why their speech sometimes sounds unstable or unclear. We will investigate whether exposure to artificial, but predictable changes in voice pitch can help people with Parkinson’s develop more balanced speech control. Using functional Near-Infrared Spectroscopy (fNIRS), a portable brain imaging technology, we will measure blood flow changes in speech-motor brain regions while participants speak. Our goal is to determine if predictable pitch feedback reduces the excessive brain activation typically observed in Parkinson’s disease. If successful, this approach could lead to new speech therapy techniques that patients might practice at home using simple technology. By improving speech clarity, we hope to help those with Parkinson’s maintain meaningful conversations and social relationships, which are vital for quality of life. The insights gained will also deepen our understanding of how the brain controls speech, potentially informing future research into other communication disorders as well.

Combining Music and Non-invasive Brain Stimulation to Improve Gait in Parkinson’s Disease

Gait disturbances are a common and disabling symptom of Parkinson’s disease (PD), contributing to reduced mobility, increased risk of falls, and diminished quality of life. These impairments often persist despite standard treatments such as medication or deep brain stimulation, highlighting the need for complementary therapeutic approaches. This project investigates a novel strategy that combines transcranial direct current stimulation (tDCS) and rhythmic auditory stimulation (RAS) with music to improve gait in individuals with PD. The study targets the supplementary motor area (SMA), a brain region involved in planning movement and processing rhythm in music, which is frequently affected in PD. TDCS is a non-invasive technique that delivers low-intensity electrical current to modulate brain activity, and may enhance the brain’s responsiveness to external auditory cues, such as music. RAS, delivered through music with a strong beat, has been shown to support gait by providing temporal structure for movement coordination. By applying tDCS to the SMA while individuals walk in synchrony with rhythmic music, this study aims to investigate whether the combination of brain stimulation and music produces greater improvements in gait parameters—such as stride length, velocity, steps per minute, and variability—than either intervention alone. In addition to evaluating behavioral outcomes, the study seeks to explore the underlying neural mechanisms that support music-based gait rehabilitation in PD. Understanding how auditory and motor systems interact in the presence of neuromodulation may inform the development of targeted, evidence-based interventions to address gait deficits in PD. Here, we aim to contribute to the advancement of non-pharmacological strategies for improving motor function in PD.

Enhancing Self-Management and Health Program Service Delivery for Persons Living with Parkinson’s Disease and Carepartners 

Parkinson’s disease doesn’t just affect the person who was diagnosed, but also their carepartners, families, communities, and health care providers. In Canada, more than 100, 000 people live with Parkinson’s, including over 40, 000 in Ontario. These numbers are expected to rise significantly in the coming years due to an aging population and increased longevity. Yet despite this growing and complex population, there is no coordinated model of care. Access to specialists is limited, with only one neurologist available for every 1,400 patients. Many people face long wait times or have difficulty accessing allied health professionals, and health care providers often receive limited training in Parkinson’s specific care. This research explores how to better support people living with Parkinson’s and their carepartners, particularly in between medical appointments. By focusing on program evaluation and implementation, the goal is to improve access to self-management resources that help individuals feel more confident managing day-to-day symptoms and challenges. Recent research conducted by the graduate student have highlighted a lack of self-management programs in Canada that address the needs of both individuals with Parkinson’s and their carepartners. This project seeks to:

1) Understand the support and service needs of carepartners.

2) Identify barriers to delivering Parkinson’s-related services in southwestern Ontario.

3) Adapt, evaluate, and explore opportunities to scale up a multidisciplinary self-management program to better support persons with Parkinson’s disease and their carepartners.

Ultimately, this research aims to strengthen the coordination, consistency, and sustainability of Parkinson’s-related programs and services. By identifying current gaps and areas for improvement, the findings will inform help inform how supports are designed and delivered to better support individuals with Parkinson’s and their carepartners across community and clinical settings.

The Effects of Exercise Intensity on Cognitive Function in People with Parkinson Disease

Parkinson’s disease (PD) is best known for its impact on movement, but many afflicted individuals also experience cognitive impairment, which can worsen over time. While exercise is already recommended for people with PD to improve movement, we still don’t fully understand how exercise might benefit the brain—especially thinking skills like memory, attention, and visuospatial capabilities. This study explores how cycling at different intensities affects cognitive performance, brain blood flow, and certain blood markers related to brain health in people with PD. We will compare results from individuals with PD to healthy adults of the same age and sex. From this, we can better understand how exercise influences these measures. Proteins of interest include both Brain Derived Neurotropic Factor and ⍺-Klotho protein, as they have previously been seen to play a role in protecting against cognitive decline. Participants will complete three testing visits: one without exercise, one with moderate-intensity cycling, and one with high-intensity cycling. We will test memory, attention, and visuospatial abilities, as well as brain blood flow and blood protein levels before and after each session. Our goal is to identify the most effective exercise intensity for boosting brain health in people with PD. These findings could lead to better exercise recommendations and identify biological markers effected by exercise that play a role in aging. By working closely with Parkinson Society Southwestern Ontario, we aim to share our results widely—making sure they reach the people who can benefit most.

Investigating the Longitudinal Efficacy of Cognitive Cueing and Video Intervention for Gait in People with Parkinson’s Disease

Walking difficulties are a common and often frustrating symptom of Parkinson’s disease. Unlike many other motor symptoms, these walking challenges don’t usually improve with standard Parkinson’s medications like Levodopa. One well-supported method to help improve walking is through the use of external cues—such as rhythmic sounds or visual aids like laser lines—which act as goalposts to help regulate movement (for example, walking in time with a beat or stepping over a line). While effective, these cueing strategies often rely on technology, like headphones or special equipment, which can limit how practical, safe, or appealing they are in everyday life. An alternative approach, called cognitive cueing, involves using simple, self-directed verbal instructions (like “take big steps”) to guide movement. This method avoids the need for external devices. Preliminary research with a small group of participants showed that combining cognitive cueing with at-home gait-training videos helped improve walking speed and step length. Building on these early results, my project will involve a multi-week walking program that includes personalized gait-training videos made from each participant’s own walking footage. I will examine how this combination of video practice and cognitive cueing impacts walking, as well as other important areas like mobility, quality of life, and confidence with balance. My goal is to determine whether this approach is an effective, safe,  and user-friendly way to support walking and facilitate meaningful occupation for people with Parkinson’s disease.Sarah Park