Exercise as Chronotherapy: Regulating Circadian Rhythms to Alleviate Symptoms in Parkinson's Disease

Parkinson's disease (PD) is a classic neurodegenerative disorder characterized by both motor and nonmotor symptoms, with circadian rhythm disruption being particularly prominent. This disruption leads to issues such as sleep disturbances, cognitive decline, and mood fluctuations in patients. Research has shown a close relationship between circadian rhythm dysregulation and these symptoms, making circadian rhythm regulation an emerging therapeutic strategy. Exercise, as a nonpharmacological treatment, has been demonstrated to modulate circadian rhythms through various mechanisms, thereby improving sleep quality, cognitive function, and emotional state in PD patients. Furthermore, exercise regulates the biological clocks of peripheral tissues such as muscle, liver, and adipose tissue, and affects the central nervous system's rhythms through neuroendocrine pathways, leading to improvements in PD symptoms. This paper introduces the concept of "exercise as chronotherapy," highlighting its role in regulating circadian rhythms and alleviating nonmotor symptoms of PD. It also discusses the future design of personalized exercise prescriptions and technological applications, aiming to provide new perspectives and strategies for the comprehensive treatment of PD.