Aerobic exercise modulates plasma oxidized lipid metabolites and neurotransmitters in Parkinson's disease motor...

To examine the effects of aerobic exercise on clinical symptoms in Parkinson's disease (PD) patients with distinct motor subtypes, further explore exercise-induced alterations in oxidative lipid and neurotransmitter.

Fifty-one PD patients were randomized into the aerobic exercise group (n = 26) and the control group (n = 25). The aerobic exercise group was further divided into postural instability gait disorder (PIGD) and tremor-dominant (TD) subgroups. Clinical scales, plasma oxidized lipid, and neurotransmitter contents were assessed before and after the exercise. Paired t-tests were applied to evaluate within-group changes. Linear mixed-effects model was used to evaluate group-time interactions for metabolites. Mediation analysis was used to examine whether changes in metabolites mediated the effects of aerobic exercise on clinical symptoms.

Aerobic exercise reduced UPDRS-III and SCOPA-AUT scores in both subtypes (all P-values < 0.05). And FOG-Q and RBD-HK scores decreased in TD, whereas Berg balance scale, Tinetti balance scale, MoCA scores (all P-values < 0.05) increased in PIGD following aerobic activity. Exercise altered oxidative lipids and neurotransmitters in both groups. And the linear mixed effect model shows that the differences of PGD2, arginine, glutamine, and lysine were still statistically significant among the groups (all P-values < 0.05). Notably, 20-OH-LTB4 mediated exercise-induced Tinetti Balance Scale-A improvements (indirect effect: β = 0.73, 95 % CI:0.009-1.826, P-value = 0.046) in PIGD.

Aerobic exercise ameliorates motor and non-motor symptoms in TD and PIGD subtypes of PD, potentially mediated by oxidative lipid. This provides further reference for the potential mechanism and clinical treatment of aerobic exercise for PD patients with different motor subtypes.