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

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

JOURNAL=Frontiers in Neurology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00698

DOI=10.3389/fneur.2017.00698

ISSN=1664-2295

ABSTRACT=<p>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 (<italic>n</italic> = 11/11). The effects of exercise on resting energy expenditure (REE), glucose metabolism, adiposity, and muscle energy metabolism (<sup>31</sup>P-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 (<sup>31</sup>P-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 <italic>Sirt1</italic> and <italic>Cox7a1</italic>, and the parameters of fitness/strength were positively associated with the expression of <italic>MyHC2, MyHC7</italic>, and <italic>MGF</italic>. Moreover, reduced bradykinesia was associated with better muscle metabolism (maximal oxidative capacity and postexercise PCr recovery; <sup>31</sup>P-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.</p><sec id="ST1"><title>Clinical Trial Registration</title><p><uri xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</uri>, identifier NCT02253732.</p></sec>