Aerobic Exercise Stabilizes Motor Progression in Patients With Parkinson Disease

Aerobic exercise appears to stabilize motor progression and enhance cognitive performance in patients with Parkinson disease by stimulating functional and structural neuroplasticity in the corticostriatal sensorimotor network and cognitive control networks, according to authors of a study published in Annals of Neurology.

“These findings fit with data from animal models of Parkinson disease, where aerobic exercise stimulated protective and restorative forms of neuroplasticity in the sensorimotor network,” wrote a research team from The Netherlands. “We extend those data to Parkinson disease patients and show that exercise may benefit brain networks outside the motor domain.”

The study focused on a subset of participants from a trial called Park-in-Shape, in which 130 patients with Parkinson disease were randomly assigned to either aerobic exercise via a stationary home trainer or to a control intervention that focused on stretching. All intervention sessions lasted 30 to 45 minutes and took place 3 times a week over the 6-month study.

For this investigation, researchers looked at a subset of Park-in-Shape trial participants, 25 of whom were randomized to aerobic exercise and 31 to stretching. Each of the 56 participants underwent resting-state functional and structural magnetic resonance imaging and an oculomotor cognitive control task at the start and end of the study.

“Our primary aim was to investigate whether aerobic exercise shifts the balance of corticostriatal sensorimotor connectivity in Parkinson disease from the posterior putamen toward the anterior putamen,” wrote researchers. “In support of this, we found that aerobic exercise caused a relative posterior-to-anterior shift in corticostriatal sensorimotor connectivity, attenuating an opposite longitudinal increase in posterior putamen connectivity, which occurred in the stretching group.”

Aerobic exercise also improved cognitive control and reduced global brain atrophy, noted study authors. Aerobic exercise increased functional connectivity between the right dorsolateral prefrontal cortex and the right frontoparietal network, and greater gains in right frontoparietal network connectivity were associated with greater improvements in fitness.

“Our study suggests that a viable alternative [to current therapies] to influence clinical decline may be to focus on maintaining corticostriatal sensorimotor function against disease progression,” concluded researchers, “and to strengthen compensatory cognitive processes.”

Reference:
Johansson ME, Cameron IGM, Van der Kolk NM, et al. Aerobic exercise alters brain function and structure in Parkinson’s disease: a randomized controlled trial. Ann Neurol. 2022;91(2):203-216. doi:10.1002/ana.26291