Frontiers in Neurology (Dec 2017)

Aerobic-Strength Exercise Improves Metabolism and Clinical State in Parkinson’s Disease Patients

  • Patrik Krumpolec,
  • Silvia Vallova,
  • Silvia Vallova,
  • Lucia Slobodova,
  • Lucia Slobodova,
  • Veronika Tirpakova,
  • Matej Vajda,
  • Martin Schon,
  • Martin Schon,
  • Radka Klepochova,
  • Radka Klepochova,
  • Zuzana Janakova,
  • Zuzana Janakova,
  • Igor Straka,
  • Stanislav Sutovsky,
  • Peter Turcani,
  • Jan Cvecka,
  • Ladislav Valkovic,
  • Ladislav Valkovic,
  • Chia-Liang Tsai,
  • Martin Krssak,
  • Martin Krssak,
  • Martin Krssak,
  • Peter Valkovic,
  • Milan Sedliak,
  • Barbara Ukropcova,
  • Barbara Ukropcova,
  • Barbara Ukropcova,
  • Jozef Ukropec

DOI
https://doi.org/10.3389/fneur.2017.00698
Journal volume & issue
Vol. 8

Abstract

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Regular exercise ameliorates motor symptoms in Parkinson’s disease (PD). Here, we aimed to provide evidence that exercise brings additional benefits to the whole-body metabolism and skeletal muscle molecular and functional characteristics, which might help to explain exercise-induced improvements in the clinical state. 3-months supervised endurance/strength training was performed in early/mid-stage PD patients and age/gender-matched individuals (n = 11/11). The effects of exercise on resting energy expenditure (REE), glucose metabolism, adiposity, and muscle energy metabolism (31P-MRS) were evaluated and compared to non-exercising PD patients. Two muscle biopsies were taken to determine intervention-induced changes in fiber type, mitochondrial content, and expression of genes related to muscle energy metabolism, as well as proliferative and regenerative capacity. Exercise improved the clinical disability score (MDS-UPDRS), bradykinesia, balance, walking speed, REE, and glucose metabolism and increased muscle expression of energy sensors (AMPK). However, the exercise-induced increase in muscle mass/strength, mitochondrial content, type II fiber size, and postexercise phosphocreatine (PCr) recovery (31P-MRS) were found only in controls. Nevertheless, MDS-UPDRS was associated with muscle AMPK and mechano-growth factor (MGF) expression. Improvements in fasting glycemia were positively associated with muscle function and the expression of Sirt1 and Cox7a1, and the parameters of fitness/strength were positively associated with the expression of MyHC2, MyHC7, and MGF. Moreover, reduced bradykinesia was associated with better muscle metabolism (maximal oxidative capacity and postexercise PCr recovery; 31P-MRS). Exercise training improved the clinical state in early/mid-stage Parkinson’s disease patients, including motor functions and whole-body metabolism. Although the adaptive response to exercise in PD was different from that of controls, exercise-induced improvements in the PD clinical state were associated with specific adaptive changes in muscle functional, metabolic, and molecular characteristics.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT02253732.

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