title: Cortical and motor responses to acute forced exercise in Parkinson's disease.
abstract: BACKGROUND
  Studies in animal models of Parkinson's disease (PD) have suggested that the rate of exercise performance is important in treatment efficacy and neuroprotection. In humans with PD, lower-extremity forced-exercise (FE) produced global improvements in motor symptoms based on clinical ratings and biomechanical measures of upper extremity function.
  
  
  METHODS
  fMRI was used to compare the underlying changes in brain activity in PD patients following the administration of anti-parkinsonian medication and following a session of FE.
  
  
  RESULTS
  Nine individuals with PD completed fMRI scans under each condition: off anti-PD medication, on anti-PD medication, and off medication + FE. Unified Parkinson's Disease Rating Motor Scale scores improved by 50% in the FE condition compared to the off-medication condition. The pattern of fMRI activation after FE was similar to that seen with anti-PD medication. Direct comparison of the fMRI activation patterns showed high correlation between FE and anti-PD medication.
  
  
  CONCLUSIONS
  These findings suggest that medication and FE likely utilize the same pathways to produce symptomatic relief in individuals with PD.
authors: Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA; Cleveland FES Center, L. Stokes Cleveland VA Medical Center, Cleveland, OH, USA. Electronic address: albertj@ccf.org.
authors: Jay L
authors: JL
authors: Alberts
authors: Department of Radiology, Cleveland Clinic, Cleveland, OH, USA.
authors: Michael
authors: M
authors: Phillips
authors: Department of Radiology, Cleveland Clinic, Cleveland, OH, USA.
authors: Mark J
authors: MJ
authors: Lowe
authors: Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.
authors: Anneke
authors: A
authors: Frankemolle
authors: Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.
authors: Anil
authors: A
authors: Thota
authors: Department of Radiology, Cleveland Clinic, Cleveland, OH, USA.
authors: Erik B
authors: EB
authors: Beall
authors: Geisel School of Medicine Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, NH 03756, Lebanon. Electronic address: Mary.S.Feldman@hitchcock.org.
authors: Mary
authors: M
authors: Feldman
authors: Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA; Cleveland FES Center, L. Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
authors: Anwar
authors: A
authors: Ahmed
authors: Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA.
authors: Angela L
authors: AL
authors: Ridgel
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000534:rehabilitation* / Q000628:therapy; D013223:Statistics as Topic
chemical_list: D000978:Antiparkinson Agents; D010100:Oxygen
keywords: Aerobic exercise; Forced exercise; Parkinson's disease; fMRI