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Regular exercise may restore brain connections in Parkinson's over the long term
Last reviewed: 03.08.2025
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A new study conducted at the University Hospitals and Veterans Affairs Healthcare System of Northeast Ohio (through the Cleveland Center for Functional Electrical Stimulation (FES)) offers clues: It shows that long-term dynamic exercise programs may have a broader restorative effect on brain signals in Parkinson's disease patients than previously thought.
The researchers used recordings from participants' deep brain stimulation (DBS) devices to assess how long-term exercise programs could "reactivate" connections damaged by Parkinson's disease.
Unlike previous studies, this study aimed to decipher the brain changes associated with motor symptom relief using second-generation DBS devices and a long-term dynamic cycling program in patients with Parkinson's disease.
Details of the study are published in the journal Clinical Neurophysiology.
The pilot study was led by neurologist Aasef Shaikh, MD, PhD, of UH&VA, who is also vice chair for research at University Hospitals, professor of neurology, and associate medical director of the Cleveland FES Center.
The paper's lead author, Prajakta Joshi, is a PhD candidate in biomedical engineering in the Shaikh Lab at University Hospitals Cleveland and the FES Center at the Louis Stokes VA Medical Center in Cleveland.
“We have shown for many years that dynamic cycling training is useful for treating tremor in Parkinson’s disease,” said Dr. Shaikh. “The new study adds the use of deep brain stimulation and an ongoing exercise program to visualize how long-term training can rewire neural connections in the brain.”
Another unique and key element of the study, Dr. Shaikh added, was the collaboration between the two medical systems, which allowed for a wider pool of participants to be recruited.
Participants with Parkinson's disease, including military veterans, were asked to complete 12 sessions of dynamic cycling training over four weeks. All participants had previously received implanted deep brain stimulation devices to treat motor symptoms, while brain signals in the area where the electrodes were placed were simultaneously measured.
Another important aspect of the study was the adaptive cycling program. This technology allows the exercise bike to “learn” how the patient pedals.
For example, while watching a game screen, cyclists were asked to pedal at 80 rpm and maintain that speed for about 30 minutes. The pedaling intensity was displayed on the screen as a balloon that had to be kept above water but within the given parameters.
But the machine's adaptability kept participants guessing about how much effort to put in. The bike's motor helped them reach 80 rpm, but also increased and decreased resistance depending on their effort. The researchers believe this "push and pull" mechanism is particularly useful in treating Parkinson's symptoms.
Kent State University PhD candidate Lara Shigo, a co-author of the study, notes that 80 rpm is faster than a person would normally pedal, but she says the rate doesn't cause fatigue because the motor helps maintain that speed.
Impressive results
Brain signal recordings were taken from implanted DBS electrodes before and after each session.
"Our goal was to understand the immediate and long-term effects of exercise in the area of the brain where the electrodes were implanted, which is where Parkinson's pathology occurs," said Dr. Shaikh.
The researchers found no immediate changes in brain signals, but after 12 sessions they noted measurable changes in signals responsible for motor control and movement.
Joshi and team noted: “While current DBS systems provide new insights into brain activity, they are limited to recording signals only from the areas where electrodes are placed. Other brain regions that may also contribute remain uncovered.”
The key insight, explains Joshi: “There may be a broader circuit involved. Multiple ascending and descending pathways may be affected by exercise, and it’s possible that we’re causing a change at the network level that mediates improvement in motor symptoms.”
Joshi adds that additional research could provide more answers: “The good news is that our next studies could bring us closer to revolutionary and personalized treatments for Parkinson’s disease.”