Effects of aerobic-strength training on clinical state and cognitive functions in patients with mild to moderate Parkinson’s disease

Exercise improves clinical state of patients with Parkinson’s disease (PD), while deterioration of glucose metabolism and type 2 diabetes contribute to the progression of PD. Our aim was to assess the effects of exercise on cognitive functions, physical fitness, glucose and energy metabolism as well as on the molecular composition of cerebrospinal fluid (CSF) of patients with PD. Patients (M:F 9:8) aged 61.1 ± 8.8yrs; H&Y score I-III, BMI 27.6 ± 5.4 kg.m-2, completed a 4-month supervised aerobic-strength training (3x1h weekly). Clinical state was assessed by the United-Parkinson-Disease-Rating-Scale (MDS-UPDRS), in both ON and OFF states. Cognitive functions (computerized tests Memtrax and CogState; ACE-R), body composition (bioelectrical impedance, MRI: abdominal adiposity), cardiopulmonary fitness (VO2max, Rockport 1609 m walk test), muscle strength (dynamometry), resting energy expenditure and metabolic substrate preference (respiratory exchange ratio, indirect calorimetry), metabolic flexibility and insulin sensitivity (euglycemic hyperinsulinemic clamp) were measured before and after the exercise training intervention. Proteomic analysis of CSF, taken before and after the intervention, was performed by Mass Spectrometry. Training improved clinical state (MDS-UPDRS: all domains), muscle strength, cognitive performance and metabolic flexibility, reduced levels of visceral adiposity and glycosylated hemoglobin (all p<0,05). CSF proteomic analysis is in progress. Regular exercise has a potential to improve patients’ clinical state, including cognitive performance. It is plausible to speculate that these health benefits are, at least in part, attributable to the exercise-induced improvements in patients’ physical fitness and metabolism. Funding: APVV 20-0466, VEGA-2/0076/22, ADDIT-CE Horizon Europe 101087124, FWF KLI1122 (Austrian science foundation)