Effects of a 24-week yoga intervention on choriocapillaris density in Parkinson’s disease

Abstract

Introduction

Parkinson’s disease (PD) involves systemic microvascular dysfunction, with choriocapillaris density (CCD) potentially reflecting it. This study examined whether a 24-week yoga intervention alters CCD in PD and whether responses differ by disease duration, severity, or intervention style.

Methods

Fifteen PD patients completed a supervised 24-week yoga program involving two Hatha-based styles. CCD was measured using 3 × 3 mm macular optical coherence tomography angiography (OCTA) centered on 2.5-mm foveal region. Clinical assessments included disease duration, Hoehn and Yahr (H&Y) stage, and Montreal Cognitive Assessment (MoCA), conducted at baseline and after intervention. Correlation, stratified, and subgroup analyses were performed.

Results

No significant change in CCD was observed at the group level (62.9 % ± 3.9 % vs. 62.9 % ± 3.2 %; P > 0.05). Baseline CCD was inversely correlated with disease duration and H&Y stage (ρ = −0.71, P = 0.003). Patients with shorter disease duration (<5 years) or early-stage PD (H&Y stage 1) showed significant CCD reductions (ΔCCD = −4.7 %, P = 0.003; ΔCCD = −4.3 %, P = 0.002), whereas those with longer duration or advanced stage (H&Y 2–3) exhibited mild increases (ΔCCD = +2.3 %, ΔCCD = +2.8 %). Baseline CCD was inversely correlated with ΔCCD (ρ = −0.77, P < 0.001). CCD did not differ between the YogaCue and Hatha Yoga groups at baseline, follow-up, or in ΔCCD (P > 0.05).

Conclusions

These findings provide preliminary evidence that CCD responses to yoga vary with disease stage but not intervention style, suggesting a potential role for CCD as a vascular marker to inform individualized rehabilitation in PD.