Objective: To examine the relationship between cardiovascular (CV) fitness, plasma biomarkers associated with PD progression and/or exercise and dopaminergic denervation, measured by I-123-Ioflupane single photon emission computed tomography (DAT-SPECT), in Parkinson disease (PD).

Background: Exercise improves motor symptoms in PD and epidemiologic evidence suggests a role as a putative disease modifying therapy. We are conducting a randomized controlled trial comparing aerobic walking (5 times per week) to normal activity in early PD. The primary outcome will be between treatment group differences in the rate of semiquantitative regional DAT-SPECT decline in the striatum over one year. We report here on preliminary data from a small cohort of subjects with who have undergone baseline analysis.

Method: Subjects (N=9) have a clinical diagnosis of Hoehn/Yahr ≤2 PD and abnormal DAT-SPECT. Baseline assessments include CV fitness (VO2max measured during a metabolic treadmill stress test), motor function (OFF Unified Parkinson’s Disease Rating Scale Part III-UPDRS3), non-motor symptoms (NMSQ), quality of life (PDQ-8) and plasma biomarkers associated with exercise and/or PD risk (brain-derived neurotrophic factor-BDNF, ApoA1, uric acid). Semi-quantitative analysis of DAT-SPECT uptake in the caudate, anterior and posterior putamen, and striatum was performed using MIMNeuro®.

Results: The cohort described is comprised of 89% men with a mean age of 67.1±7.7 and UPDRS3 of 19.4±4.0. Baseline CV fitness levels were uniformly low.  Mean baseline VO2max was 19.6±5.7 mL/kg/min. Mean age/sex-adjustedVO2max percentile was 5.9±9.1 (lower percentile indicating lower fitness). and the range was 1st-29th. Baseline CV fitness was not associated with clinical measures, biomarkers or DAT-SPECT. We did observe strongly positive correlations between plasma BDNF levels and regional DAT-SPECT Z-scores, adjusted for age, but these will need to be validated as the cohort grows.

Conclusion: Baseline levels of cardiovascular fitness were low in a small cohort of Veterans with early PD. We will report on the associations among CV fitness, clinical features, biomarkers and regional DAT-SPECT at baseline and after the exercise intervention.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cardiovascular-fitness-plasma-biomarkers-and-dopaminergic-denervation-in-parkinsons-disease/