Objective: To test whether aerobic exercise can influence Parkinson’s disease (PD)-related changes in resting-state functional connectivity in motor and non-motor brain networks, as measured with fMRI.

Background: Aerobic exercise alleviates motor symptoms in PD patients, potentially by stimulating neuroplasticity that protects and restores striatal function. This may contribute to impeding motor symptom progression in various ways, for example by maintaining communication between the putamen and sensorimotor cortex despite ongoing dopamine depletion, and by strengthening compensatory mechanisms in non-motor networks.

Method: This imaging experiment was performed in a subset of patients that participated in a larger clinical trial of exercise. Specifically, PD patients were assigned randomly to either aerobic exercise (n=21) or an active control intervention (n=25) and measured twice (at baseline, and immediately after the 6-month intervention). Patients allocated to aerobic exercise cycled for approximately 30 minutes 3 times/week whereas control patients performed stretching exercises. Using resting-state fMRI, we measured cortico-striatal functional connectivity and intrinsic functional connectivity in cortical motor and cognitive control networks. A subset of patients also performed an anti-saccade task as a measure of cognitive control.

Results: We observed a significant increase in functional connectivity between posterior putamen and right sensorimotor cortex for controls, but not the exercise group (Fig 1a, p=0.021, corrected). A voxel-based morphometry analysis showed a significant decrease in grey matter volume in the same sensorimotor region in controls, but not the exercise group (Fig 1a, p=0.023, corrected). Behaviorally, the exercise group, but not controls, showed a significant decrease in error rates during the anti-saccades task (Fig 1b, p=0.023). This was accompanied by a significant increase in intrinsic functional connectivity in the frontal pole of the right frontoparietal network for the exercise group (Fig 1c, p=0.007, corrected).

Conclusion: Aerobic exercise may protect PD patients from pathological changes in communication between the posterior putamen and the sensorimotor network, and improve cognitive control by strengthening communication in the right frontoparietal network. [figure1]

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MDS Abstracts - https://www.mdsabstracts.org/abstract/aerobic-exercise-alters-brain-structure-and-function-in-parkinsons-disease-a-randomized-controlled-trial/