Parkinson's patients should consider taking up cycling, according to new findings that show that the exercise appeared to help restore connections between brain regions linked to the disease, and improve coordination and balance.
Using brain scans, researchers presenting the study this week at the annual meeting of the Radiological Society of North America in Chicago found that pedaling on stationary bikes led to greater connectivity in brain regions responsible for movement in Parkinson's patients, especially if they pedaled hard and fast at rates above what patients would choose for themselves.
Experts estimate that around 7 to 10 million people worldwide are affected by Parkinson's disease, a chronic, progressive neurological disorder where nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the brain regions cannot properly send messages, ultimately leading to the loss of muscle function.
The main symptoms of the disease are movement related and include shaking or tremor, muscle stiffness, rigidity, slowness of physical movement and loss of balance. Most cases occur after the age of 50, and as the disease progresses the frequency of side effects increases, and can eventually lead to cognitive and behavioral problems such as dementia.
Lead researcher Jay Alberts, a neuroscientist at the Cleveland Clinic Lerner Research Institute, began the research after he noticed improvements in a female Parkinson's patient after a long-distance charity bike ride across Iowa.
"The finding was serendipitous. I was pedaling faster, which forced her to pedal faster," Alberts said in a statement. "She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function."
For the study, Alberts' co-researcher Chintan Shah, and other colleagues from the Cleveland Clinic, used functional connectivity magnetic resonance imaging (fcMRI) to look into the effect of exercise on 26 Parkinson's disease patients between the ages of 30 and 75.
Researchers explained that fcMRI measures changes in blood oxygen in the brain, allowing them to look at how active different brain regions are and how well they connect with each other.
Researchers split the participants into two groups with half pedaling at their own voluntary pace, while the other group pedaled at a forced rate, in which participants were made to pedal faster by motors installed to their bikes.
Results of the study revealed that pedaling, particularly forced vigorous pedaling, improved connections between brain regions linked to movement.
Researchers found improvements in task-related connectivity between the primary motor cortex and the posterior region of the brain's thalamus, which were still present at follow-up.
Researchers noted that some of the results were similar to patterns of activation during deep brain stimulation of Parkinson's patients. While deep brain stimulation is an effective therapy for late-stage Parkinson's it is an invasive and costly treatment.
"The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson's disease," Shah said in a statement.
Researchers noted that while greater pedaling exertion led to more significant results, not all patients need to do forced-rate exercise to see improvement.
Alberts and his team are now researching how patients improve with exercise bikes in their homes. Researchers also want to study whether other forms of exercise like swimming a rowing have similar benefits to brain connectivity.