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

Abstract

The incidence of Parkinson's disease (PD) is expected to increase as our population ages and will likely strain the projected capacity of our health care system. Despite being the most common movement disorder, there have been few noninvasive therapeutic advances for people with PD since the first levodopa clinical trial in 1961. The study of PD pathogenesis, combined with an appreciation for the biochemical mechanisms by which physical activity and exercise may impact physiology, has resulted in emerging hypotheses for new modifiable risk factors for PD. Physical activity and exercise as a means of preventing PD, or maintaining the functionality of people with PD, are a promising area of investigation. Conversely, physical inactivity is implicated in many disease states, some of which are also correlated with the development of PD, such as metabolic syndrome. The primary relationship between these diseases is likely rooted in heightened inflammation and oxidative stress at the cellular level. Physical activity and exercise as a means of attenuating inflammation have led to increased interest in related potential therapeutic targets for PD. Ultimately, these findings may translate into low‐cost, universally available therapies for PD disease modification or prevention. © 2016 International Parkinson and Movement Disorder Society

Intermittent metabolic switching, neuroplasticity and brain health

“…Increasing evidence suggests that individuals with sedentary, overindulgent lifestyles are at increased risk of developing AD and PD, and animal studies support the notion that a chronic positive energy balance devoid of IMS renders the brain prone to AD and PD 131,132 . Conversely, exercise and moderation of energy intake reduce the risk of AD and PD 133,134 , and exercise intervention trials further suggest that IMS reduces clinical symptoms in many patients with AD and PD 135,136 .…”

Associations between Early Markers of Parkinson's Disease and Sarcopenia

“…First, we are not able to determine whether further, not yet considered parameters could explain our finding. For example, it could be that physical inactivity is at least indirectly (e.g., through the metabolic syndrome) related to the development of PD (LaHue et al, 2016), and physical inactivity is certainly associated with lower muscle mass. Although we included physical activity as a covariable in our model, future studies should investigate such interactions in more detail and with quantitative measures.…”

Recent advances in treating Parkinson’s disease

“…In addition, in the last decade, an increasing number of partly well-designed and conducted studies have investigated the effect of non-medical/non-surgical supportive “activating” therapies; these include physical exercise, physiotherapy (more than 30 trials) 14, 15, 82, 83 , dance interventions (4 trials), and logopedic training of dysphagia (2 trials) on the neurological symptoms of PD patients and their quality of life (comprehensively reviewed in 15, 16). Despite all of these achievements until today, we still treat PD at an entirely symptomatic level 17 .…”

“…2) With increasing age, the extent of comorbidity increases (for example, orthopedic syndromes, diabetes mellitus and metabolic syndrome 16 , heart failure, and stroke). This comorbidity in patients with PD is a major challenge in the ambulatory care.…”