Skip to main content

Table 1 Exercise-induced BDNF response in human PD and clinical outcome

From: Exercise-induced increase in brain-derived neurotrophic factor in human Parkinson's disease: a systematic review and meta-analysis

Author Country Year [PMID]

N Age PD characteristics setting

Outcome measures

Protocol

Results

Pre to post exercise BDNF level mean±SD and BDNF Effect Size

Clinical measures score and UPDRS Effect Size

Sajatovic

USA

2017 [28579759]

28

Exp=69.8±9.3 yrs

Con=70.3±6.5

H&Y ≤3

6.8±5.3 yrs since diagnosis OR

pBDNF

MADRS

MoCA

UPDRS III SCOPA

Interval high-cadence cycling 3 sessions per week for 45-60 minutes each session for 12 weeks. High cadence interval stationary cycling (20 min) at 60-80% Hear Rate maximum.

Resistance training 2-4 sets of 8-12 repetitions for each set.

Self-management exercise 3 times per week (SGE) and psychoeducation (12 60 minute group sessions).

T0 (baseline) 26.8±15.6 pg/mL

T1 (12 weeks, post test) 90±166.4 pg/mL

T2 (24 weeks) 38.5±46.2 pg/mL

335.8% ↑ pBDNF level at T1 (12 weeks, post-test, p<0.001)

MADRS at T0 21.2±6.3

MADRS at T1 15.2±8.0

Δ28.3% ↓ MADRS

MADRS at T2 14.2±8.5

Δ33.0% ↓ MADRS

MoCA at T0 23.3±4.1

MoCA at T1 25.2±3.7

Δ7.5% ↑ MoCA

MoCA at T2 25.2±5.1

Δ0% ↑ MoCA

SCOPA-Sleep (night sleep) at T2 12.1±4.1

Δ14.0% ↑ SCOPA-Sleep (night sleep)

MADRS, MoCA, an SCOPA-Sleep (night sleep) (all p<0.01).

Frazzitta Italy 2014 [24213955]

24 Exp=67±5 yrs pf age Con=65.4±4 yrs of age H&Y 1-1.5 8±3.5 yrs since diagnosis

IR

sBDNF

UPDRS III

BBS 6MWT

Physical therapy 15 X 60 minute sessions per week/ 3 sessions per day

Exercise on treadmill, 30 minutes per session, 5 days/week at ≤60% HRR and a maximum speed of 3.5 km/h for 4 weeks

T0 (admission) 21.64±3.4 ng/mL

T1 (10 days) 25.04±7.3 ng/mL

T2 (20 days) 25.79±7.9 ng/mL

T3 (discharge) 24.77±6.4 ng/mL

ES of ΔsBDNF=1.1 (p<0.0001)

12.6% ↑ sBDNF level at T3.

UPDRS III at T0 16.4±3.5

UPDRS III at T3 8.8±3.2

ES of ΔUPDRS III = -3.3

Δ46.3% ↓UPDRS III

UPDRS II at T0 8.14±3.3

UPDRS II at T3 5.50±3.0

Δ32.4% ↓UPDRS II

BBS at T0 48.64±6.1

BBS at T3 54.00±2.4

Δ9.9% ↑BBS

6MWT (m) at T0 383±94

6MWT at T3 477±79

Δ19.7% ↑6MWT distance

ΔUPDRS II, BBS, and 6MWT (all p<0.01).

No statistical association between BDNF levels and clinical measures.

Marusiak Poland 2015 [25510618]

11

71±10 yrs of age

H & Y 1-3 8±4 yrs since diagnosis

OR

sBDNF

UPDRS III Myometry

Exercise using stationary bicycle, 3 x per wk, 60 minutes per session for 8 weeks

34% ↑ sBDNF level at post-test (p<0.05).

No sBDNF level change in healthy controls (p=0.809).

Within Group Effect Size BDNF Serum Level: PD: BDNF T0-T1: 0,95 (CI -2,38-1,58)

CONTROL: BDNF T0-T1: 0,10 (CI -1,22-2,33)

↑ sBDNF level correlated with improvements in PD rigidity (p<0.05).

Between Groups Effect Size: Not applicable because controls are healthy.

Angelucci Italy 2016 [26863448]

9

62.7±6.8 yrs of age

11.78±7.3 yrs since diagnosis

IR

sBDNF

UPDRS II UPDRS III

6MWT

PDQ-39

Physical therapy 3 session/day/5 days per week for 30 days

Exercise on treadmill, 20 minutes per session, 5 days per week at 3.5-4 km/h at ≤60% HRR

Exercise using stationary bicycle at 25-30 km/h

Exercise using Wii system Fit Balance board

T0 (admission) 2171.03±1699.69 pg/mL

T7 (7 days) 3396.78±1359.56 pg/mL

T14 (14 days) 2670.01±1439.64 pg/mL

T21 (21 days) 2387.38±1088.84 pg/mL

T30 (30 days) 2339.31±1666.01 pg/mL

36.09% ↑ sBDNF level T7 (p<0.01).

No statistically significant changes in sBDNF at 14d, 21d, 30d, 90d

Within Group Effect Size BDNF Serum Level: BDNF T0-T7 = 0,84 (CI 0,04-1,96)

BDNF T0-T14 = 0,34 (CI 0,60-1,45)

BDNF T0-T21 = 0,16 (CI 0,55-1,27)

BDNF T0-T30 = 0,11 (CI 0,98-1,28)

BDNF T90 days data is missing.

UPDRS II T0 21.77±3.38

UPDRS II T30 7.55±3.12

Δ65.3% ↓UPDRS II

UPDRS III T0 31.62±10.68

UPDRS III T30 14.44±8.07

Δ24.4% ↓UPDRS III

UPDRS III G&B score T0 6.74±5.21

UPDRS III G&B score T30 2.33±1.32

Δ65.4% ↓UPDRS III G&B score

6MWT (m) T0 252.33±111.81

6MWT T30 374.22±124.62

Δ32.5% ↑6MWT distance

PDQ-39 T0 61.0±23.5

PDQ-39 T30 45.44±21.01

Δ25.5% ↓PDQ-39

(all p<0.01 at T30).

Within Group Effect Size UPDRS-IIl: UPDRS-III T0-T30 = -1,93 (CI -7,20 to -5,05)

Fontanesi Italy & USA 2016 [26253177]

16

71.5±6.8 yrs of age

8.43±4.08 yrs since diagnosis IR

BDNF-TrkB

UPDRS 6MWT

BBS

TUG

PDDS

FOGQ

physical and occupational therapy, 3 session a day, 5 days per week, for 4 weeks

Multimodal exercise (i.e., treadmill with visual and auditory cueing, stationary bicycle, eliptical machine, stabilometric platform).

T1 (30 days) 52.6% ±10.8% ↑ in sBDNF-tyrosine receptor kinase signaling (p<0.001).

No data on BDNF concentration.

UPDRS total score at T0 (baseline) 43.31±11.99

UPDRS total score at T1 29.56±9.46

Δ31.7% ↓UPDRS total score

UPDRS III at T0 19.31±4.71

UPDRS III at T1 13.06±3.28

Δ32.3% ↓UPDRS III

6MWT at T0 292.38±103.46

6MWT at T1 363.63±114.64

Δ20% ↑in 6MWT distance

BBS at T0 44.74±7.21

BBS at T1 52.50±4.18

Δ14.7% ↑BBS score

PDDS at T0 71.13±14.53

PDDS at T1 54.25±12.12

Δ23.7% ↓PDDS score

FOGQ at T0 14.27±5.22

FOGQ at T1 9.73±4.03

Δ31.8% ↓FOGQ score

(all p<0.01)

Within Group Effect Size UPDRS-IIl: UPDRS-III T0-T30 =

-0,63 (CI -5,72 to -2,29)

Zoladz Poland

2014 [24930517]

12 70 ± 3 yrs of age

H&Y 1-3

8.5± 1.3 yrs since diagnosis OR

sBDNF UPDRS

Interval exercise on a stationary bicycle, 3 x 60 minute sessions per week, for 8 weeks.

8 sets of 5 minute intervals including 3-minutes at 80-90 rpm and 2-minutes at less than 60 rpm. Target heart rate to achieve during cycling exercise was calculated as 60-75% of the Maximum Heart Rate.

T0 (baseline) 10977±756 pg/mL

T1 (60 days) 14206±1256 pg/mL

Δ 22.7% ↑ in sBDNF levels in PD (p<0.05).

Within Group Effect Size BDNF Serum Level: BDNF T0-T1 = 3,25 (CI 2,54-3,68)

UPDRS total score at T0 48.9±4.3

UPDRS total score at T1 38.1±3.9

Δ 22% ↓ UPDRS total score (p<0.05).

Within Groups Effect Size UPDRS-III: no data.

  1. Table Note: sBDNF serum brain derived neurotrophic factor, pBDNF plasma brain derived neurotrophic factor, UPDRS Unified Parkinson’s disease Rating Scale, UPDRS part III (motor examination), UPDRS part II (Activities of daily living), UPDRS G&B UPDRS gait and balance score, MADRS Montgomery–Asberg Depression Rating Scale, MoCA Montreal Cognitive Assessment, SCOPA Scales for Outcomes in PD – Sleep, BBS Berg Balance Scale, 6MWT six minute walk test, PDQ-39 Parkinson’s disease Quality of Life test 39 questions, d days, wks weeks, yrs years, Exp experimental group, Con control group, H & Y Hoehn and Yahr stage of Parkinson’s disease, IR inpatient rehabilitation, OR outpatient rehabilitation, N sample size, PMID pub med identification number, HRR hear rate reserve, rpm revolutions per minute, km/h kilometers per hour, d days; Moyometry myometric quantification using MyotonPRO myometry (Myoton AS, Tallinn, Estonia), TUG timed-up-and-go test, PDDS Parkinson’s disease disability scale, FOGQ Freezing of Gait Questionnaire, TrkB tyrosine receptor kinase, sVCAM-1 Basal serum soluble vascular cell adhesion molecule-1, TNF-α basal serum tumor necrosis factor, ES effect size, SD standard deviation, con control group, exp experimental group
  2. ‘Exercise’ defined as “a subcategory of physical activity that is planned, structured, repetitive, and purposive in the sense that the improvement or maintenance of one or more components of physical fitness is the objective” [87] (pg. 250). The effect sizes for studies without a control group should be interpreted with caution for the following reasons: a) we do not control for dependency between outcomes in an uncontrolled pre-post design with our classical Cohen’s d, b) we have no control group data on the correlation between pre and post measurements, and c) from studies using a pre-experimental design we cannot rule out bias/placebo effects [88]