Analysis Of The Cortical Hemodynamic Responses To Active-assistive Exercise In Individuals With Parkinson’S Disease.

Abstract

Background: Gait and motor impairments are common symptoms in people with Parkinson’s disease (PD). Previous studies found active-assistive exercise to be effective in improving PD symptoms. The underlying neural mechanism contributing to these improvements is currently unknown. No previous studies have investigated how the brain responds to active-assistive exercise in people with PD. PURPOSE: To investigate the cortical hemodynamic responses to active-assistive exercise in individuals with PD. METHODS: A total of 7 individuals with PD (70.29 ± 5.44) and 10 controls (58.71 ± 9.30) participated in this cross-sectional study. All participants completed three modes of exercise including active exercise (AE), passive exercise (PE), and active-assistive exercise (AAE) using computerized cycling equipment (MOTOmed viva 2, RECK MOTOmed, Betzenweiler, Germany, 2017). Each mode of exercise was performed at a predetermined pace for 10 minutes on three separate days while a neuroimaging device, functional near-infrared spectroscopy (NIR Sport, NIRx Medical Technology, Berlin, Germany, 2017) captured oxy-hemoglobin (HbO) levels in the prefrontal lobe. RESULTS: Repeated measures ANOVA showed no significant difference in 𝚫;;;;HbO among exercise modes. A trend showed that the PD group displayed the greatest level of 𝚫;;;;HbO during PE and minimum with AE. A 2x3 mixed model ANOVA revealed no significant group x mode interaction. However, a trend showed that the PD group displayed greater levels of 𝚫;;;;HbO during PE and AAE whereas the control group revealed greater levels during AE and AAE. Four representative channels were selected for regional comparison of brain activation during AAE between groups. They demonstrated significant differences in the middle frontal cortex (p<.049), orbital cortex (p<.039), intermediate frontal cortex (p<.033), and granular frontal cortex (p<.022). CONCLUSION: Our findings suggest that people with PD showed higher levels of brain activity during passive and active-assistive modes of exercise as compared to active cycling. Brain activity levels during active-assistive exercise can be different when compared to those without PD. The results may help understand the underlying neural mechanism associated with positive outcomes following active-assistive exercise in PD.