Document Detail

Does vigorous exercise have a neuroprotective effect in Parkinson disease?
MedLine Citation:
PMID:  21768599     Owner:  NLM     Status:  MEDLINE    
Parkinson disease (PD) is progressive, with dementia and medication-refractory motor problems common reasons for late-stage nursing-home placement. Increasing evidence suggests that ongoing vigorous exercise/physical fitness may favorably influence this progression. Parkinsonian animal models reveal exercise-related protection from dopaminergic neurotoxins, apparently mediated by brain neurotrophic factors and neuroplasticity (predicted from in vitro studies). Similarly, exercise consistently improves cognition in animals, also linked to enhanced neuroplasticity and increased neurotrophic factor expression. In these animal models, immobilization has the opposite effect. Brain-derived neurotrophic factor (BDNF) may mediate at least some of this exercise benefit. In humans, exercise increases serum BDNF, and this is known to cross the blood-brain barrier. PD risk in humans is significantly reduced by midlife exercise, documented in large prospective studies. No studies have addressed whether exercise influences dementia risk in PD, but exercised patients with PD improve cognitive scores. Among seniors in general, exercise or physical fitness has not only been associated with better cognitive scores, but midlife exercise significantly reduces the later risk of both dementia and mild cognitive impairment. Finally, numerous studies in seniors with and without dementia have reported increased cerebral gray matter volumes associated with physical fitness or exercise. These findings have several implications for PD clinicians. (1) Ongoing vigorous exercise and physical fitness should be highly encouraged. (2) PD physical therapy programs should include structured, graduated fitness instruction and guidance for deconditioned patients with PD. (3) Levodopa and other forms of dopamine replenishment therapy should be utilized to achieve the maximum capability and motivation for patients to maintain fitness.
J Eric Ahlskog
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurology     Volume:  77     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-19     Completed Date:  2011-09-16     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  288-94     Citation Subset:  AIM; IM    
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Brain-Derived Neurotrophic Factor / metabolism
Disease Models, Animal
Disease Progression
Exercise / physiology*
Meta-Analysis as Topic
Nerve Degeneration / etiology,  prevention & control*
Parkinson Disease / complications,  rehabilitation*
Physical Fitness / physiology*
Prospective Studies
Reg. No./Substance:
0/Brain-Derived Neurotrophic Factor; 0/brain-derived growth factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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