A study based on functional connectivity magnetic resonance imaging (fcMRI) analysis of patients with Parkinson’s disease showed that exercise can benefit the patients. Parkinson’s disease (PD) is the progressive neurologic disorder primarily characterized by an altered motor function. An estimated 7 to 10 million people worldwide live with PD with most cases occurring after the age of 50.
The study, presented initially at last years’ RSNA meeting by Chintan Shah on behalf of a team of researchers from the Cleveland Clinic and subsequently published in the journal of Brain Connectivity (Beall et al. Brain Connect 2013; 3: 190) was initiated by a purely serendipitous finding. One of the Cleveland Clinic research team (Dr JL Alberts) had been on a fund-rasing event, namely cycling across a US state to raise awareness of PD. He was accompanied by a PD sufferer on a tandem bicycle. Alberts noticed that faster pedalling resulted in an improvement in the patients’ condition. This anecdotal observation was then further investigated in more detail in 26 PD patients who had given informed consent. Connectivity MRI (fcMRI) was used to study the effect of exercise in areas of the brain associated with motor ability. FcMRI enables changes in blood oxygenation levels in the brain to be measured so allowing the functional connectivity between different brain regions to be examined. FcMRI studies were carried out before and after an eight-week programme of exercise therapy on an exercise cycle. The patients underwent bicycle exercise sessions three times a week for eight weeks. Some patients exercised at a voluntary level and others underwent forced-rate exercise, i.e. pedalling at a speed above their voluntary rate. The researchers used a modified exercise bike to induce forced-rate activity.
The team calculated brain activation and connectivity levels from the fcMRI data and correlated the results with the average pedalling rate. Faster pedalling rate was the key factor related to clinical improvement. Other results suggested that the effects of exercise were equivalent or even superior to these produced by standard medication regimens used for treating PD patients. “The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson’s disease,” Shah said. However Dr. Alberts cautioned that while faster pedaling led to more significant results, not all Parkinson’s patients need to do forced-rate exercise to see improvement.