Physical activity and neurotrophic factors as potential drivers of neuroplasticity in Parkinson’s Disease: A systematic review and meta-analysis

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

“…In 2020, Johansson et al [ 44 ] included three studies without control groups in their meta-analysis of exercise effects on BDNF levels, showing no significant summary effect size. In 2023, Li et al [ 45 ] and Rotondo and colleagues [ 46 ] pooled data on exercise studies, showing positive effects on BDNF levels compared to controls. Due to the conflicting meta-analytic results and the lack of human PD trials detailing mechanisms of exercise on BDNF levels, the purpose of the present systematic review and meta-analysis is to give an updated overview of the mechanisms and effects of exercise therapy on BDNF levels in PD, in order to bring these insights into the clinical context of physical medicine and rehabilitation for people living with PD.…”

Changes of brain-derived neurotrophic factor (BDNF) levels after different exercise protocols: a systematic review of clinical studies in Parkinson’s disease

“…A synthesis of exercise guidelines suggests that patients with mild to moderate PD should engage in three to five sessions of AT at moderate intensity (40%–60% maximum heart rate) per week and two to three sessions of RT, but the evidence base is less consistent compared to other neurological conditions ( Kim et al, 2019 ). A high intensity (>75% maximum heart rate for AT and >70% 1-repetition maximum for RT) is needed according to some scholars but not others ( Machado et al, 2022 ; Rotondo et al, 2023 ). Recently, a feasible, safe and accessible home-based high-intensity program was proposed ( Harpham et al, 2023 ).…”

“…Previous research, including recent systematic reviews on the effect of exercise on BDNF levels, limited the analysis to controlled trials only ( Hirsch et al, 2018 ; Li et al, 2023 ; Rotondo et al, 2023 ). Randomised trials provide evidence of efficacy of interventions in “ideal” settings, whereas non-randomised studies more accurately reflect usual clinical practice ( Sørensen et al, 2006 ).…”

“…Randomised trials provide evidence of efficacy of interventions in “ideal” settings, whereas non-randomised studies more accurately reflect usual clinical practice ( Sørensen et al, 2006 ). Furthermore, exercise interventions in PD are so heterogeneous that they were classified into 18 different combinations of duration, intensity and type ( Zhou et al, 2022 ; Rotondo et al, 2023 ). This heterogeneity, coupled with a very limited number of trials, makes the evaluation of the effectiveness of exercise intervention extremely hard.…”

“…This heterogeneity, coupled with a very limited number of trials, makes the evaluation of the effectiveness of exercise intervention extremely hard. Recent meta-analyses aimed at assessing whether exercise determined an improvement of BDNF levels ( Hirsch et al, 2018 ; Li et al, 2023 ; Rotondo et al, 2023 ), but a quantitative estimate of the effect of exercise intensity and volume is still lacking. Since it is not known which characteristics of exercise determine the largest benefits for patients with PD, this study aimed at assessing to what extent intensity, volume and type of exercise are associated with changes in BDNF levels in patients with PD.…”