Partnered Dance Aerobic Exercise as a Neuroprotective, Motor and Cognitive Intervention in Parkinson's Disease

The primary outcome, the MDS-UPDRS-IV score measures medication related motor fluctuations, including dyskinesias, OFF-time, functional impact and complexity of fluctuations, and dystonia. The investigators will administer a monthly OFF-state diary for corroboration of these scores.

The product score is the product of the span and number of correct trials achieved by the participant. The Corsi Blocks is a test of spatial cognition, specifically visuospatial working memory.

The investigators will measure R2* in the NM-MRI defined SNc using a published image processing and analysis method. This method leverages a standard space SNc atlas developed using control population NM-MRI data, enabling R2* measurement in SNc with no operator-dependent segmentation steps

The six minute walk test is a validated test of endurance in older adults and in those with Parkinson disease. Participants are asked to walk as far as they can in 6 minutes, while being monitored and able to carry on a conversation. The distance is measured in meters.

This sub-maximal test can estimate the participant's VO2max and initial fitness level. This test uses a method in which heart rate (HR) workload values are obtained at 2-4 points and extrapolated to predict workload at the estimated maximum HR (e.g. 220-age). VO2max is then calculated from the predicted maximum workload.

At each study visit T1 MPRAGE, and T2* weighted blood oxygen level dependent (BOLD) fMRI data will be acquired at the Emory CSI, using a Siemens Prisma-Fit 3T MRI scanner with a 64 channel receive-only head coil in a protocol with total scan time one hour. BOLD signal will be measured in response to the functional task, the Block span task.

At each study visit NM-MRI, R2*, T1 MPRAGE, and T2* weighted blood oxygen level dependent (BOLD) fMRI data will be acquired. The investigators will carry out image processing to determine SNc volume using an automated approach previously shown to have high scan-rescan reproducibility.

The Delis Kaplan tower of London test is a validated measure of executive function in PD.

Judgment of Line Orientation is a standardized test of visuospatial skills commonly associated with functioning of the parietal lobe in the right hemisphere. The test measures a person's ability to match the angle and orientation of lines in space. Subjects are asked to match two angled lines to a set of 11 lines that are arranged in a semicircle and separated 18 degrees from each other.

Objective, spatiotemporal parameters including velocity, stride length, stance percent, velocity variability and other variables of preferred, backward and fast-as-possible walking will be assessed.

Trails making test A is a validated measure of attention and visuospatial processing in people with PD. The time to complete is considered.

Brooks spatial memory involves reporting back a specified path of numbers that patients are asked to visualize in a 4 x 4 grid.

The Mini BESTest is a 14-item test scored on a 3-level ordinal scale. Mini BESTest assesses dynamic balance, a unidimensional construct. It is validated in PD.

The FSST is a valid measure of motor cognitive integration and involves the participant stepping as quickly and safely as they can in four quadrants created by four canes arranged in a cross, in a clockwise order and then switching to counterclockwise order.

The DGI is a clinical tool to assess gait, balance and fall risk. It evaluates not only usual steady-state walking, but also walking during more challenging tasks.

Timed Up & Go Test (TUG) is a test of balance that is commonly used to examine functional mobility. The single condition requires participants to get up from a chair walk three meters, turn around and return to the chair as quickly and as safely as they can. The dual versions involve cognitive tasks (counting backward by 3s from given number) and manual, holding a full cup of water, while performing single tug.

The PDQ-39 is a 39-item self-report questionnaire, which assesses Parkinson's disease-specific health related quality over the last month Assesses how often patients experience difficulties across the 8 quality of life dimensions

This validate scale assesses the ability of people with impairments to complete various tasks of daily living ranging from holding a bag of groceries to walking a couple of blocks to being able to take a bath unassisted.

Part I assesses non motor aspects of experiences of daily living for people with PD. Part II assesses motor aspects of experiences of daily living for people with PD. Part III is a rated scale of motor function. The MDS UPDRS is validated and reliable and widely used globally.

This widely used test of depression is validated in PD.

The Freezing of Gait Questionnaire (FOG-Q) reliably detects FOG in patients with Parkinson's disease (PD).

PASE comprises measures of self-reported occupational, household, and leisure activities during a one-week period. Designed for use in epidemiologic studies and exercise interventions, the instrument can be administered by telephone, mail, or in person in 5 to 15 minutes.

A generic, multipurpose short-form survey with 12 questions selected from the SF-36 Health Survey which, when combined, scored and weighted, results in two scales of mental and physical functioning and overall health-related quality of life. Subscales of interest include the Mental composite and physical composite scores among others.

Participants will complete the Exit Questionnaire which asks their level of agreement on a Likert scale (1-5) with 1 indicating the most agreement about whether they think they improved in various aspects of wellbeing.

Participants will complete the Exit Questionnaire which asks their level of agreement on a Likert scale (1-5) with 1 indicating the most agreement about whether they think they improved in various aspects of wellbeing.

Valid for PD, this scale allows self report of level of satisfaction with life and life events in people with PD.

The MSPSS aims to determine how social support factors are perceived by individuals, with three subscales to evaluate support by family, friends and significant others.