Annals of Neurology: Parkinson's, regular aerobic exercise improves cognitive function

A growing body of research suggests that motor symptoms associated with Parkinson's disease (PD) can be improved with physical activity
.

We recently completed a clinical trial showing attenuated motor symptom progression in PD following aerobic exercise intervention (Park-in-Shape trial)

Martin E.
Johansson et al.
, Radboud University, The Netherlands, used longitudinal multimodal magnetic resonance imaging (MRI) to study the effects of aerobic exercise on brain changes in pre-defined and Unselected subset
.

We tested the hypothesis that aerobic exercise slows the natural circuit-level progression of PD

PD is associated with a shift in the functional connectivity of the cerebral cortex: sensorimotor regions of the cerebral cortex that normally communicate with the posterior occipital bone in healthy individuals are more dependent on the anterior occipital bone in PD patients
.

Similar adaptive changes were observed in healthy LRRK2 mutation carriers at risk of developing PD, suggesting that reorganization of cerebral cortical function may be involved in compensating for post-striatal dopamine depletion in early PD

Furthermore, the effects of exercise on intercortical connectivity may depend on structural changes upstream of the striatum, namely in the sensorimotor cortex and substantia nigra
.

In addition, aerobic exercise may also improve non-motor processes, such as cognitive control, which patients with PD may utilize to manage resources limited by motor dysfunction

manage

To explore this possibility, Martin E.

Johansson tested the effects of movement on behavioral and brain indicators of cognitive control, using an eye movement task sensitive to executive dysfunction in PD, and on 3 cortices known to be involved in cognitive control.
A measure of the network's quiescent state functional connectivity

The Park-in-Shape trial was a single-center, double-blind, randomized controlled trial in which 130 patients with Parkinson's disease were randomly assigned (1:1 ratio) to receive either aerobic exercise (stationary home trainer) or stretching ( Active control) intervention (duration = 6 months)
.

An unselected subset of this trial (motor, n = 25; stretching, n = 31) underwent resting-state functional and structural magnetic resonance imaging (MRI), as well as eye movements at baseline and 6-month follow-up Cognitive control tasks

They found that aerobic exercise, but not stretching exercise, resulted in increased functional connectivity between the anterior putamen and the sensorimotor cortex than did the posterior door push
.

Behaviorally, aerobic exercise also improved cognitive control
.

Furthermore, aerobic exercise increased functional connectivity of the right fronto-parietal network in direct proportion to improvements in physical fitness, and it reduced global brain atrophy
.

Aerobic exercise increased functional connectivity of the right fronto-parietal network in direct proportion to improvements in physical fitness, and it reduced global brain atrophy
.

The significance of this study lies in the discovery that aerobic exercise stabilizes disease progression in the sensorimotor network of cortical brain regions and improves cognitive performance
.

Aerobic exercise stabilizes disease progression in the sensorimotor network of cortical brain regions and improves cognitive performance
.

Original source:
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.
Annals of Neurology.
2022;91(2):203-216.
doi: 10.
1002/ana.
26291

Aerobic Exercise Alters Brain Function and Structure in Parkinson's Disease: A Randomized Controlled Trial.
Annals of Neurology.
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