Effects of exergaming on hippocampal volume and brain‐derived neurotrophic factor levels in Parkinson’s disease

Abstract

Background and objective Cognitive impairment is among the most burdensome non‐motor symptoms in Parkinson's disease (PD) and has been associated with hippocampal atrophy. Exercise has been reported to enhance neuroplasticity in the hippocampus in correlation with an improvement of cognitive function. We present data from the Training‐PD study, which was designed to evaluate effects of an “” training protocol on neuronal plasticity in PD. Methods We initiated a 6‐week exergaming training program, combining visually stimulating computer games with physical exercise in 17 PD patients and 18 matched healthy controls. Volumetric segmentation of hippocampal subfields on T1‐ and T2‐weighted magnetic resonance imaging and brain‐derived neurotrophic factor (BDNF) serum levels were analyzed before and after the training protocol. Results The PD group showed a group‐dependent significant volume increase of the left hippocampal subfields CA1, CA4/dentate gyrus (DG) and subiculum after the 6‐week training protocol. The effect was most pronounced in the left DG of PD patients, who showed a significantly smaller percentage volume compared to healthy controls at baseline, but not at follow‐up. Both groups had a significant increase in serum BDNF levels after training. Conclusions The results of the present study indicate that exergaming might be a suitable approach to induce hippocampal volume changes in PD patients. Further and larger studies are needed to verify our findings.

Survival in patients with Parkinson’s disease: a ten-year follow-up study in northern China

“…This study found a correlation between a certain amount of physical exercise and better survival in univariate analysis. In terms of molecular biology, exercise intervention exerts neuroprotective effects by resisting oxidative stress and neuroinflammation and upregulating the expression of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) in the nigrostriatal pathway [ 29 – 31 ]. In terms of clinical benefits, exercise intervention delays motor progression and cognitive decline in PD patients and improves their physical function and sleep quality [ 15 , 32 , 33 ].…”

Lactate Threshold Training Program on Patients with Multiple Sclerosis: A Multidisciplinary Approach

“…Recently, many studies have reported the beneficial effects of physical activity in a number of neurodegenerative diseases, underlining the neuroprotective effect of exercise [48][49][50][51]. Physical activity can indeed increase the expression of the genes involved in antioxidant defense, can counteract the debilitating effects of many pathologies of the nervous system, and can even improve cognitive functions and memory.…”

Effect of Physical Activity on Depression in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…However, some studies have suggested that this may be due to (1) alterations in brain structure, such as hippocampal atrophy and hippocampal neuron damage; (2) alterations in neurotransmitter signaling, such as norepinephrine, dopamine, and 5-HT systems, which are known to be affected in PD patients (and these neurotransmitters are also involved in mood regulation); (3) alterations in inflammation and brain-derived neurotrophic factor (BDNF) levels; and (4) psychosocial factors and pain, which may also contribute to the development of depression in PD patients [ 44 ]. A large part of the above-mentioned mechanisms that may contribute to the emergence of depression in PD patients is influenced by physical activity, because some studies have found evidence that physical activity may alleviate depression in PD patients by (1) protecting the hippocampal volume of the brain [ 45 ] and regenerating hippocampal neurons by decreasing glucocorticoid receptors [ 46 , 47 ]; (2) increasing tryptophan hydroxylase, supplying 5-hydroxytryptamine synthesis [ 48 ], promoting dopamine release to improve patients’ mood [ 49 ], activating the endogenous cannabinoid system, altering the hypothalamic pituitary–adrenal axis function, and increasing norepinephrine levels [ 48 ]; (3) increasing cerebral blood flow, alleviating oxidative stress and inflammation, and increasing the expression of brain-derived neurotrophic factor (BDNF) [ 50 , 51 ]; and (4) reducing disability rates and increasing patients’ quality of life [ 24 ]. It is evident that a variety of exercise programs have proven to be valid studies.…”