12-Week Aerobic Interval Training Boosts Neuroplasticity and Motor Function in Parkinson's Disease: Insights From BDNF, [18F]Fluorodopa PET/CT, and EEG.

Abstract

BackgroundAnimal models suggest that intensive physical training may promote neuroplasticity in Parkinson's disease (PD), but its effects in humans remain underexplored.ObjectivesTo investigate the effects of aerobic interval training (AIT) on brain-derived neurotrophic factor (BDNF) levels, striatal [¹⁸F]fluorodopa positron emission tomography/computed tomography (PET/CT) uptake ([¹⁸F]DOPA_PET/CT), electroencephalography (EEG), and motor function, and to explore their interrelations.MethodsThirty PD patients were randomly assigned to a 12-week moderate-intensity AIT group (PD Training Group [PD-TR], n = 15) or a non-training group (PD Non-Training Group, n = 15). Pre- and post-intervention assessments included BDNF levels, striatal [¹⁸F]DOPA_PET/CT, EEG during motor task-evoked desynchronization (ERD_MT) and rest-evoked synchronization (ERS_REST) in primary motor cortex (M1) and supplementary motor area (SMA), and motor function assessed using the Unified PD Rating Scale (UPDRS) Part III and the Manual Bradykinesia Score for the Affected Upper Extremity (MBS-AUE) calculated as the sum of UPDRS items 3.4 to 3.6.ResultsThe PD-TR group showed increased BDNF levels (P < .001) and improved motor scores (UPDRS III and MBS-AUE; P < .05). Both groups exhibited increased EEG-ERS_REST M1 (P < .05) over time, with no changes in striatal [¹⁸F]DOPA_PET/CT uptake. Significant group differences were observed in correlations between changes (Δ = POST minus PRE) in: ΔBDNF with Δ[¹⁸F] DOPA_PET/CT uptake in the putamen and ΔEEG-ERD_MT M1 (P < .001); Δ[¹⁸F]DOPA_PET/CT uptake in the putamen with Δ[¹⁸F]DOPA_PET/CT uptake in the caudate and ΔEEG-ERS_REST SMA (P < .05); ΔMBS-AUE scores with ΔEEG-ERS_REST SMA (P < .001).ConclusionsTwelve-week AIT enhanced BDNF levels and motor function in PD-TR, with central nervous system neuroplasticity supporting motor recovery.