Effects and Mechanisms of Exercise on Brain-Derived Neurotrophic Factor (BDNF) Levels and Clinical Outcomes in People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Author:

Kaagman Daan G. M.1,van Wegen Erwin E. H.2345ORCID,Cignetti Natalie6,Rothermel Emily6,Vanbellingen Tim7,Hirsch Mark A.68

Affiliation:

1. Faculty of Behavioral and Human Movement Sciences, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands

2. Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands

3. Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands

4. Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands

5. Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands

6. Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Atrium Health Carolinas Rehabilitation, Charlotte, NC 28203, USA

7. Gerontechnology and Rehabilitation Group, University of Bern, 3008 Bern, Switzerland

8. Department of Orthopaedic Surgery and Rehabilitation, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA

Abstract

Introduction: Exercise therapy may increase brain-derived neurotrophic factor (BDNF) levels and improve clinical outcomes in people living with Parkinson’s disease (PD). This systematic review was performed to investigate the effect of exercise therapy on BDNF levels and clinical outcomes in human PD and to discuss mechanisms proposed by authors. Method: A search on the literature was performed on PubMed up to December 2023 using the following key words: Parkinson’s disease AND exercise, exercise therapy, neurological rehabilitation AND brain-derived neurotrophic factor, brain-derived neurotrophic factor/blood, brain-derived neurotrophic factor/cerebrospinal fluid AND randomized clinical trial, intervention study. Only randomized clinical trials comparing an exercise intervention to treatment as usual, usual care (UC), sham intervention, or no intervention were included. Results: A meta-analysis of BDNF outcomes with pooled data from five trials (N = 216 participants) resulted in a significant standardized mean difference (SMD) of 1.20 [95% CI 0.53 to 1.87; Z = 3.52, p = 0.0004, I2 = 77%], favoring exercise using motorized treadmill, Speedflex machine, rowing machine, and non-specified exercise. Significant improvements were found in Unified Parkinson’s Disease Rating Scale (UPDRS), UPDRS-III, 6 Minute Walk Test (6MWT), and Berg Balance Scale (BBS). Methodological quality of trials was categorized as “good” in three trials, “fair” in one trial, and “poor” in one trial. Conclusion: Key results of this systematic review are that exercise therapy is effective in raising serum BDNF levels and seems effective in alleviating PD motor symptoms. Exercise therapy confers neuroplastic effects on Parkinson brain, mediated, in part, by BDNF.

Publisher

MDPI AG

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