Effects of Exercise and B Vitamins on Homocysteine and Glutathione in Parkinson’s Disease: A Randomized Trial

Abstract

Background: Individuals with Parkinson’s disease (PD) have decreased glutathione levels and elevated homocysteine levels. These substances are considered markers of health, and an inverse relationship has been suggested through the transsulfuration pathway. This experiment tested the effects of exercise and B vitamin supplementation on homocysteine and glutathione levels, and if a relationship was present between these two markers in those with PD. Secondary aims included examining the impact of the interventions on aerobic efficiency and strength. Methods: Thirty-six subjects were randomly assigned to 4 groups. The Vit group received vitamins B₆, B₁₂ and folic acid daily for 6 weeks. The Ex group received aerobic and strength training twice weekly for 6 weeks. The Vit + Ex group received both interventions. A control group received no intervention. Subjects were tested prior to and after intervention on the following measures: glutathione and homocysteine levels, strength measures and oxygen consumption. Results: Subjects who received 6 weeks of B vitamin supplementation had lowered homocysteine levels. Subjects who received 6 weeks of exercise training had increased glutathione levels, strength and aerobic capacity. The combination of vitamin and exercise did not yield greater changes than the separate intervention. The control subjects did not change on any measures. Conclusion: Positive results were realized with each intervention; however, the expected relationship between glutathione and homocysteine was not found in this sample of subjects with PD. Homocysteine and glutathione levels can be improved independently in individuals with PD with exercise or vitamins B₆, B₁₂ and folic acid supplementation.

Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…There were nine eligible studies [ 35 – 43 ]. Of the nine included studies, four were randomized controlled trials (RCTs) [ 36 , 39 , 40 , 42 ], one study was match-randomized according to disease severity and gender [ 35 ], one study was gender-match-randomized [ 41 ] and three studies incorporated an intervention group and a control group (parallel group design) without further details on their study design [ 37 , 38 , 43 ]. Two studies [ 35 , 41 ] compared RT alone with a control group that received standard medical practice; one study (RCT) [ 40 ] compared RT with another intervention (Tai Chi or Stretching); four studies [ 36 – 38 , 43 ] including one RCT [ 36 ] compared an intervention that comprised RT combined with another form of exercise (aerobic or balance training) with a control group that received standard medical practice; two studies [ 39 , 42 ] (both RCTs) compared an intervention that comprised RT combined with another form of exercise (balance training or stretching) with another intervention that did not contain any strengthening component.…”

“…The Unified Parkinson’s Disease Rating scale (UPDRS) [ 45 ], as another measure of PD status, was described in three studies [ 36 , 41 , 42 ] (see Table 1 for details). The PD duration was reported in five studies [ 36 – 38 , 40 , 42 ] and the mean was 7.1 ± 1.7 years.…”

“…In summary, the majority of studies targeted the lower limbs in their RT [ 35 , 36 , 39 – 43 ], particularly the knee extensors and flexors, hip extensors and plantarflexors and conducted machine-based training [ 35 , 38 , 39 , 41 – 43 ]. Intervention durations ranged from six weeks [ 38 ] to six months [ 36 , 40 ]. Exercise frequency was either two [ 35 , 37 , 38 , 40 , 41 ] or three days per week [ 36 , 39 , 42 , 43 ].…”

The best medicine? The influence of physical activity and inactivity on Parkinson's disease

“…Although exercise acutely increases the production of reactive oxygen species, rodent models demonstrated that activity chronically suppresses systemic oxidative stress through an adaptive process that increases antioxidants (eg, superoxide dismutase and glutathione) and oxidative damage repair enzymes . Consistent exercise can even increase serum levels of glutathione in humans . This is especially important because in human studies, people with PD have decreased baseline levels of antioxidants, such as glutathione and urate, compared with people without PD, providing support for recent clinical trials …”

“…55,56 Consistent exercise can even increase serum levels of glutathione in humans. 57 This is especially important because in human studies, people with PD have decreased baseline levels of antioxidants, such as glutathione and urate, compared with people without PD, providing support for recent clinical trials. [58][59][60][61] Physical activity and exercise disrupt the molecular mechanisms underlying PD pathogenesis in numerous ways.…”