Long-Term Exercise Significantly Modifies Neuronal Activity in Patients With PD
Patients with Parkinson disease (PD) demonstrated measurable changes in brain signals associated with motor control and movement after 12 sessions of dynamic cycling over a 4-week period, according to a pilot study published in Clinical Neurophysiology.
“We’ve already established over years of study that dynamic cycling regimens are beneficial for treating Parkinson’s tremor,” said corresponding author Aasef G. Shaikh, MD, PhD, of University Hospitals Case Medical Center, Cleveland, Ohio. “The latest study adds the use of deep brain stimulation and an ongoing exercise program to visualize how long-term exercise might be rewiring neural connections in the brain.”
The study specifically investigated how exercise affects the neurophysiological response of the subthalamic nucleus (STN), a pivotal structure within the basal ganglia. In 9 patients who had deep brain stimulation devices implanted to treat their motor symptoms, researchers used DBS electrodes positioned within the nucleus to record local field potentials (LFPs) originating from the STN before and after each cycling session.
The adaptive cycling sessions involved a motorized bike that helped riders attain speeds up to 80 rpm. A connected game screen presented real-time pedaling intensity as an on-screen balloon, which riders aimed to keep aloft over water for 30 minutes. Resistance was added and reduced depending on the rider’s effort. Participants took part in a maximum 12 sessions over 4 weeks.
“Our goal was to understand the immediate and long-term effects of the exercise in that region of the brain where the electrodes are implanted, which is also the same area where Parkinson’s pathology is evident,” Dr Shaikh said.
Researchers observed no immediate effects of dynamic cycling on LFPs. After 12 sessions, however, “long-term effects showed an increasing trend in power and the 1/f exponent of the power spectrum, a measure of fluctuation in the signal, in the dorsolateral region of the STN,” researchers reported.
There was no significant response in the ventral region of the STN.
“These results highlight the impact of dynamic cycling on STN neuronal activity in PD,” the authors concluded. “Prolonged interventions, even without immediate changes, bring about significant modifications, emphasizing the role of extended exercise in PD management and neuroplasticity.”
Although DBS systems provide a window into brain activity, they only capture signals from regions with implanted electrodes, the research team pointed out. Consequently, other brain areas could contribute to the observed changes but go unmonitored.
“There may be a broader circuit involved,” said Prajakta Joshi, lead author of the study and a PhD candidate at Case Western Reserve University, Cleveland, Ohio. “Numerous upstream and downstream pathways could be influenced by exercise, and it’s possible that we’re inducing a network-level change that drives the improvement in motor symptoms.”
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