Exercise increases caudate dopamine release and ventral striatal activation in Parkinson's disease

Abstract

Background The objective of this study was to examine the effects of aerobic exercise on evoked dopamine release and activity of the ventral striatum using positron emission tomography and functional magnetic resonance imaging in Parkinson's disease (PD). Methods Thirty‐five participants were randomly allocated to a 36‐session aerobic exercise or control intervention. Each participant underwent an functional magnetic resonance imaging scan while playing a reward task before and after the intervention to determine the effect of exercise on the activity of the ventral striatum in anticipation of reward. A subset of participants (n = 25) completed [11C] raclopride positron emission tomography scans to determine the effect of aerobic exercise on repetitive transcranial magnetic stimulation‐evoked release of endogenous dopamine in the dorsal striatum. All participants completed motor (MDS‐UPDRS part III, finger tapping, Timed‐up‐and‐go) and nonmotor assessments (Starkstein Apathy Scale, Beck Depression Inventory, reaction time, Positive and Negative Affect Schedule, Trail Making Test [A and B], and Montreal Cognitive Assessment) before and after the interventions. Results The aerobic group exhibited increased activity in the ventral striatum during functional magnetic resonance imaging in anticipation of 75% probability of reward (P = 0.01). The aerobic group also demonstrated increased repetitive transcranial magnetic stimulation‐evoked dopamine release in the caudate nucleus (P = 0.04) and increased baseline nondisplaceable binding potential in the posterior putamen of the less affected repetitive transcranial magnetic stimulation‐stimulated hemisphere measured by position emission tomography (P = 0.03). Conclusions Aerobic exercise alters the responsivity of the ventral striatum, likely related to changes to the mesolimbic dopaminergic pathway, and increases evoked dopamine release in the caudate nucleus. This suggests that the therapeutic benefits of exercise are in part related to corticostriatal plasticity and enhanced dopamine release. © 2019 International Parkinson and Movement Disorder Society

Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

“…Three studies showed that motor symptoms either improved (when measured in the on-medication state) [28] or attenuated (when measured in the off-medication state) [4,23]. This was not confirmed in the eight other studies [11,24,25,27,[29][30][31]33]. However, these latter studies were generally of lower methodological quality.…”

“…Quality assessments were compared and discussed when necessary. In total, three studies were rated with the low risk of bias [4,23,24], 10 studies with some concerns about the risk of bias [11,[25][26][27][28][29][30][31][32][33], and four studies with the high risk of bias [34][35][36][37] (Fig. 2).…”

“…3). Ten randomized controlled trials investigated the effect of aerobic exercise on physical fitness, as assessed with a (sub)maximal graded exercise test (VO 2 max) [4,11,23,24,29,31,[33][34][35]37]. All studies showed a beneficial effect of aerobic exercise on physical fitness, although two studies only reported within-group effects [11,35].…”

High-Intensity Interval Cycle Ergometer Training in Parkinson's Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject Research Design

“…There has been considerable progress in the area of physical training-induced neuroplasticity effects in PD (11,54,55), though our understanding is far from complete. Studies reported that PD patient show increased serum NfL protein levels (17) compared to age-matched healthy controls.…”

Molecular Regulatory Mechanism and Toxicology of Neurodegenerative Processes in MPTP/Probenecid-Induced Progressive Parkinson’s Disease Mice Model Revealed by Transcriptome

“…Currently, the dopamine replacement therapy is one of the most common treatment strategies for PD. Deep brain stimulation, stem cell transplantation, gene therapy, rehabilitation therapy, and other non-drug therapies also could be most used clinically [8][9][10][11][12]. Although these therapies can improve the symptoms on some extent, their role in effectively ceasing the progress of PD is unknown.…”