Impact of exercise on brain energy in Parkinson's disease

The Effect of Exercise on Brain Energetics in Parkinson's Disease

This study is testing how exercise affects brain energy in people with Parkinson's disease by comparing brain scans before and after a workout program.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 40 (estimated)
• Ages: 40 Years to 80 Years
• Sex: All
• Sponsor: Pacific Parkinson's Research Centre (Academic / other)
• Drugs / interventions: radiation
• Locations: 1 site (Vancouver, British Columbia)
• Trial ID: NCT04426786 on ClinicalTrials.gov

What this trial studies

This project investigates how exercise affects brain energetics in individuals with Parkinson's disease (PD) using advanced imaging techniques like functional Magnetic Resonance Imaging (fMRI) and Positron Emission Tomography (PET). Participants with mild to moderate PD will undergo brain scans before and after a supervised exercise program to assess changes in brain energy metabolism. Additionally, healthy volunteers will be scanned for comparison, allowing researchers to understand the differences in brain energetics between healthy individuals and those with PD. The study aims to derive meaningful insights into the relationship between exercise and mitochondrial function in the brain.

Who should consider this trial

Good fit: Ideal candidates are individuals diagnosed with idiopathic Parkinson's disease who currently engage in less than 120 minutes of exercise per week.

Not a fit: Patients with atypical Parkinson syndromes or significant comorbidities such as severe osteoporosis or other chronic diseases may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved exercise recommendations for enhancing brain health in patients with Parkinson's disease.

How similar studies have performed: While previous studies have explored the link between exercise and brain health, this specific approach using simultaneous fMRI and PET measurements in PD is novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Idiopathic PD according to UK Brain Bank criteria (modified to permit inclusion of subjects with a family history)
2. Mild to moderate Parkinsonism (Hoehn \& Yahr stages I-III)
3. Currently exercise less than 120 minutes per week (PD non-exercisers)

General exclusion criteria:

1. atypical Parkinson syndrome (progressive supranuclear palsy, multiple system atrophy, drug-induced etc.);
2. significant osteoporosis or arthritis;
3. history of cancer within 5 years of study participation;
4. high dose of radiation from other procedures within the year;
5. not able to tolerate being off PD medication for up to 24 hours;
6. a female subject who is breast-feeding or pregnant;
7. current or past substance use problems;
8. serious head injury with loss of consciousness for ≥ 5 minutes;
9. people with other chronic diseases such as diabetes, kidney problems, high blood pressure, other known neurological disorders, or heart diseases;
10. people who report having a significant respiratory disorder (e.g. asthma, chronic obstructive pulmonary disease (COPD)) or using home oxygen will be excluded to avoid discomfort or breathing difficulties from respiratory manipulations.
11. current or past neurological disorder (e.g. strokes, seizures, neurodegenerative disease other than Parkinson's disease);
12. current or past psychiatric disorders (e.g. depression, anxiety disorders);
13. severe claustrophobia (a fear of closed in spaces);
14. weight of more than 158kg (347 lbs);
15. inability to lay still for up to 90 minutes;
16. are not medically cleared to exercise;
17. certain medications or conditions may impact participant's ability to participate and these will be discussed on a case by case basis with the participant and the study team.

MRI-specific exclusion criteria:

1. Machinist or metalworkers;
2. cardiac pacemakers, wires, or defibrillator;
3. past injury where a piece of metal lodged in your eye or orbit;
4. ferromagnetic aneurysm clip;
5. artificial heart valve;
6. electrical stimulator for nerves or bones;
7. ear or eye implant;
8. implanted drug infusion pump;
9. coil, catheter, or filter in any blood vessel;
10. orthopedic hardware (artificial joint, plate, screws);
11. other metallic prostheses;
12. shrapnel, bullets, or other metal fragments;
13. dentures, braces, or retainer;
14. surgery (brain or otherwise), tattoos, or injection into a joint in the last 6 weeks;
15. pierced body parts (other than earrings) or tattooed eyeliner;
16. non-MRI safe intrauterine device (IUD).

Subjects may be excluded following study enrollment if they meet any of the following exclusion criteria:

1. significant cognitive impairment or depression;
2. significant or unstable cardiovascular or respiratory disease - all subjects will undergo a screening aerobic exercise test;
3. failure to comply with the exercise intervention program by not completing at least 60 of the 72 exercise classes.

Where this trial is running

Vancouver, British Columbia

• Pacific Parkinson's Research Centre — Vancouver, British Columbia, Canada (Recruiting)

Study contacts

• Principal investigator: Vesna Sossi — University of British Columbia
• Study coordinator: Jessamyn McKenzie

Conditions Parkinson Disease; Parkinson's disease; Exercise; Brain energetics; Positron Emission Tomography; MRI; PET