Aerobic exercise versus combined cognitive and aerobic exercise in people with Parkinson's: Effects on cognition and biomarkers of neuroplasticity

Citation

Ferrusola-Pastrana A, Davison G, Javadi A, Fullerton C & Meadows S (2024) Aerobic exercise versus combined cognitive and aerobic exercise in people with Parkinson's: Effects on cognition and biomarkers of neuroplasticity., 04.07.2024-04.07.2024. https://sport-science.org/index.php/scientific-programme/scientific-programme

Abstract
Introduction: Neuropsychological impairments, such as cognitive decline, mild cognitive impairment or dementia, are common in PwP and can impact their daily activities and quality of life. Pharmacological procedures have limited effects to treat those, and research suggests that non-pharmacological interventions, such as exercise or cognitive training, could have the potential to improve cognition. Considering the efficacy of exercise to also promote physical and cognitive improvements, the implementation of the combined modalities could be more beneficial than single-domain training. Aim: to investigate BDNF and pro-BDNF kinetics in PwP during different acute exercise interventions and their relationship with measures of cognitive function, with the overall aim to evaluate if there are added beneficial outcomes from combining physical and cognitive tasks compared to engaging with aerobic exercise only. Methods: 6 participants (age 61 ± 12 years; Hoehn and Yahr (H&Y) scale I to II) participated in 4 supervised conditions: a session of acute cycling (A), a second acute cycling session 24 h. after A (B), combined acute session of cycling and cognitive tasks (C) and a resting condition (D). In A, B and C participants completed 30 min of cycling at RPE 14 on a cycle ergometer. Outcome measures included blood and saliva biomarkers (BDNF and pro-BDNF) and measures of cognition (the Stroop test and the Free-Recall test). Results: Visits B (second) and C (combined) were able to elicit larger improvements in the Stroop test with large (d=0.853) and small to medium (d=0.349) effects, respectively, and up to 30 and 40% improvements, respectively, in immediate long-term memory (LTM) compared to the resting control visit D. Serum and capillary BDNF levels were positively correlated with cognitive performance, whilst platelet-poor plasma BDNF correlations seemed to be headed in the opposite direction. Conclusion: Due to the small sample size of this preliminary study, there was poor sensitivity to detect effects in cognition even though medium to large effect sizes were observed for some comparisons. Therefore, it is not yet fully known to what extent cycling combined with cognitively challenging tasks, compared to cycling alone, improves cognitive function and modulates biomarkers of neuroplasticity in PwP.