Review Associates Exercise With Improved Quality of Life, Immune Response in Parkinson Disease

In managing nonmotor and motor dysfunction in Parkinson disease (PD), exercise has exhibited extensive benefits in improving quality of life (QOL) and even slowing disease progression.

Authors of a review published in Brain Sciences highlight that the efficacy of exercise may also have vital implications during the coronavirus disease 2019 (COVID-19) pandemic, as patients with PD (PwP) are typically older and may have preexisting conditions, which are known causes of higher susceptibility and adverse outcomes in COVID-19 infection.

Researchers sought to delineate what benefit moderate-intensity exercise could have among the PD population, particularly whether this intervention may assist in protecting against SARS-CoV-2, the virus that causes COVID-19, through strengthening the immune system. Moreover, they wanted to assess its impact on modifying the immune system and improving health outcomes in PwP.

In first examining how exercise may modify the immune system, researchers note that both cross-sectional and longitudinal data have associated moderate-intensity exercise with fewer upper respiratory tract infections.

“A common theme across groups, though, is that an increased level of fitness due to exercise training is associated with lower circulating concentrations of pro-inflammatory cytokines and higher circulating concentration of anti-inflammatory cytokines,” expanded the researchers.

They highlighted that through exercise, an optimal balance may be achieved between pro- and anti-inflammatory benefits, caused by “an initial increase in immunosurveillance and an overall reduction in excessive local pro-inflammatory markers.”

Next, researchers examined the role of exercise on health outcomes among PwP. In prior animal models, evidence has shown that exercise’s anti-inflammatory properties can potentially be harnessed in a neuroprotective role, which would then mitigate the neuroinflammation known to occur in the immune systems of those with PwP.

“Importantly, mouse models provide mechanistic insight into how exercise promotes change at the molecular, cellular, and neural network levels,” they wrote.

In human models, the majority of studies of PwP show that sustained moderate exercise can improve QOL among PwP and is likely to assist in down-regulating neuroinflammation. However, the researchers noted that understanding how exercise promotes neuroplasticity in humans has been difficult, with 2 studies currently underway examining this topic.

Lastly, researchers addressed whether exercise could provide protection against COVID-19. They suggested 4 responses to the immune system that exercise could provide, including balancing pro- and anti-inflammatory benefits in preventing acute inflammatory tissue damage, restoring damaged lung tissue, preventing and reducing reactive oxygen species, and providing a targeted decrease in the main health risk factors of COVID-19.

In managing risk and potential presence of comorbidities associated with adverse COVID-19 outcomes, such as hypertension, diabetes, and heart issues, each of these conditions can be lessened or improved through exercise, the researchers wrote.

“Older adults, with or without PD, are more susceptible to SARS-CoV-2 viral infection, and moderate exercise may help to improve the immune response to COVID-19 infection,” the authors concluded. “Moderate-intensity exercise may also help boost the immune system response to the COVID-19 vaccination when it becomes available.”

Reference

Hall MFE, Church FC. Exercise for older adults improves the quality of life in Parkinson disease and potentially enhances the immune response to COVID-19. Brain Sci. Published online September 6, 2020. doi:10.3390/brainsci10090612