12-Week Aerobic Interval Training Boosts Neuroplasticity and Motor Function in Parkinson’s Disease: Insights From BDNF, [ 18 F]Fluorodopa PET/CT, and EEG

Background Animal models suggest that intensive physical training may promote neuroplasticity in Parkinson’s disease (PD), but its effects in humans remain underexplored. Objectives To investigate the effects of aerobic interval training (AIT) on brain-derived neurotrophic factor (BDNF) levels, striatal [ 18 F]fluorodopa positron emission tomography/computed tomography (PET/CT) uptake ([ 18 F]DOPA PET/CT ), electroencephalography (EEG), and motor function, and to explore their interrelations. Methods Thirty PD patients were randomly assigned to a 12-week moderate-intensity AIT group (PD Training Group [PD-TR], n = 15) or a non-training group (PD Non-Training Group, n = 15). Pre- and post-intervention assessments included BDNF levels, striatal [ 18 F]DOPA PET/CT , EEG during motor task-evoked desynchronization (ERD MT ) and rest-evoked synchronization (ERS REST ) in primary motor cortex (M1) and supplementary motor area (SMA) , and motor function assessed using the Unified PD Rating Scale (UPDRS) Part III and the Manual Bradykinesia Score for the Affected Upper Extremity (MBS-AUE) calculated as the sum of UPDRS items 3.4 to 3.6. Results The PD-TR group showed increased BDNF levels ( P < .001) and improved motor scores (UPDRS III and MBS-AUE; P < .05). Both groups exhibited increased EEG-ERS REST M1 ( P < .05) over time, with no changes in striatal [ 18 F]DOPA PET/CT uptake. Significant group differences were observed in correlations between changes (Δ = POST minus PRE) in: ΔBDNF with Δ[ 18 F] DOPA PET/CT uptake in the putamen and ΔEEG-ERD MT M1 ( P < .001); Δ[ 18 F]DOPA PET/CT uptake in the putamen with Δ[ 18 F]DOPA PET/CT uptake in the caudate and ΔEEG-ERS REST SMA ( P < .05); ΔMBS-AUE scores with ΔEEG-ERS REST SMA ( P < .001). Conclusions Twelve-week AIT enhanced BDNF levels and motor function in PD-TR, with central nervous system neuroplasticity supporting motor recovery.