Does Exercise Actually Increase Dopam... - Parkinson's Movement

Parkinson's Movement

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Does Exercise Actually Increase Dopamine?


"Some evidence suggests that, like levodopa, exercise may exert some of its effects by increasing dopamine. A recent study of 17 Parkinson’s patients used positron emission tomography (PET) scans of the brain before and after stationary cycling. Results showed that habitual exercisers in this group — eight patients who exercised more than three hours a week — had higher dopamine levels in the dorsal striatum (the brain area that receives dopamine input from the substantia nigra to help control movement) after stationary cycling than the nine others who were sedentary."

20 Replies

Hi Jim, I totally agree with this study result. Stationary cycling amazingly has positive effects on the PD.

This human body has been built over the past 100,000 years in a totally different environmental context. A dangerous environment, where the man risked his skin at least once a day ( adrenalin) just to get food. So what forgotten potential ability does it have? Rediscovering any of them could be useful.

Just to be short.

Xenos in reply to GioCas

Well said Gio. We obviously need to take into account what we still are : gatherer/hunters.

I doubt that are no-so-far ancestors had a breakfast when waking up, a lunch at noon. They had to get up and happily go hunting with an empty stomach. Our biology probably is fine tuned to use this kind of life.

Lucal in reply to GioCas

I believe the greatness of mankind is to change the environment to its advantage, and to know how to adapt with minimum effort. 100,000 years ago we had a life expectancy of 20 years .... not really great potential :-) 100,000,000 years ago a T-Rex could live 30 years. They did not adapt or build houses or hospitals. We won.

GioCas in reply to Lucal

Hi Luca,

I agree with you,

it's just that my dopamergic cells were not.

We would need a compromise.


Does exercise actually increase dopamine? Well, it seems so.

We seem to have missed the original PNT article describing this research.

In the article that Jim linked to (in the section which discusses Jay Alberts' "forced exercise" hypothesis) it says the following:

"Alberts conducted a small study in 2009 at the Cleveland Clinic, ... comparing the effects of forced exercise and voluntary exercise (in which patients choose the intensity at which they exercise) ..."

This is a common misunderstanding. The patients in the VE (voluntary exercise) group chose their own cadence, not their own aerobic intensity. It says clearly in the abstract of the research paper [1] that "Aerobic intensity for both groups was identical, 60% to 80% of their individualized training heart rate."

There is of course a separate argument that someone exercising at 60% of HRmax and someone exercising at 80% of HRmax are NOT exercising at identical aerobic intensities. This was recently demonstrated in the SPARX trial [2] (also mentioned in the article that Jim linked to) where participants were assigned to one of three groups: control, moderate-intensity treadmill exercise (60 to 65 percent maximum heart rate) or high-intensity treadmill exercise (80 to 85 percent maximum heart rate). After six months researchers found that the motor symptoms of only the high-intensity group had not progressed.

[1] Forced, Not Voluntary, Exercise Improves Motor Function in Parkinson's Disease Patients, Angela Ridgel et al., Neurorehabilitation and Neural Repair: 23(6) 2009.

[2] Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial, Margaret Schenkman et al., JAMA Neurology: 75(2) 2018.

ddmagee1 in reply to jeffreyn

Very good statistics.

It always struck that whilst I keep within the 80/90 rpm rule, that this must be questionable depending on ones level of fitness? I mean 80 might be forced when you begin the process but surely after ones become very fit one might need 100 rpm to be ‘forced’? I’ve been banging on about this for years now but have never reached a satisfactory outcome so stick between 80 and 90 still.

jeffreyn in reply to jeeves19

jeeves19, forget about the term "forced exercise", it is a misnomer.

The essence of the "forced exercise" hypothesis seems to be that you can essentially get something for nothing i.e. the PwP can somehow benefit from the power supplied by a tandem partner or an electric motor. Perhaps by invoking the "fight or flight" response, as JP has proposed (in a different context)?

After the success of the small (n=10) proof-of-concept trial [1] they conducted a much larger (n=100) trial [2]. Unfortunately, they were unable to reproduce the results of the proof-of-concept trial.

[1] Forced, Not Voluntary, Exercise Improves Motor Function in Parkinson's Disease Patients, Angela Ridgel et al., Neurorehabilitation and Neural Repair: 23(6) 2009.

[2] Results from the Randomized Controlled Trial Cyclical Lower Extremity Exercise (CYCLE) Trial for Parkinson’s disease, Jay Alberts et al., Medicine & Science in Sports & Exercise: May 2018.

the life expectancy of our ancestors varies from 20 years in the Palaeolithic to the 50 of the imperial rome, then collapses in the Middle Ages and rises up to our days. I would not take their habits as examples :-)

I’m a firm believer in exercise, having spent a number of years in personal training, and learning the benefits of exercise. I have found that exercise, especially range of motion, stretch, Dalcroze Eurythmics, and using the TB12 method of resistance exercise, is very helpful, in my being able to deal with the stiffness and slowness, and balance problems, that I have, “battling” being diagnosed, and living with PD and Ataxia. If, for some reason, I miss a day or two of exercise and stretching, my body goes back to being more stiff, and my gait is slower etc.

Jim, I wonder what the best, most effective exercise is for PD? Stationary cycling? Fast walking ect? Are there any studies on this? I have been told that you should always do a exercise that forces you to balance yourself

jeffreyn in reply to NewHope1961

Jim is probably sleeping at this time, so I'll throw in my two cents worth in the interim.

My current belief is that the best way to halt/slow disease progression is to perform at least 30 minutes of aerobic exercise at least 3 times per week. Aerobic exercise being anything that raises your heart rate to 80% of HRmax, where HRmax is calculated as 220 minus your age. This corresponds with the recent results of the SPARX trial.

jimcaster in reply to jeffreyn

I completely agree.

I agree with Jeffreyn that getting your heart rate to 80% of capacity is key. Whether you run on a treadmill or pedal or box depends on your condition and preference. The key, in my opinion, is finding something you'll do at least 3 days per week. I usually jog, but also pedal on stationary bike occasionally.

Interesting thread. My father had Parkinson's and I watched him deteriorate, his muscles atrophying over the years (he was 80 at diagnosis, 93 when he died, and had a stroke at 85). He'd been physically fit his whole life. When I was diagnosed, I originally viewed exercise as a way to keep my muscles strong. But then my son suggested books on neuroplasticity (written about the general population).

I primarily walk on the treadmill, outside when the weather is decent. More and more I find myself on the treadmill. I don't think about HRmax or anything else, I just walk as briskly as I can that day. If my meds are working well, like yesterday, I can do a mile in 14 minutes. If they haven't kicked in fully, I might need 17 minutes to walk that same mile but it takes just as much effort. I walk 22 minutes (avg 1.5 miles) on a day I take a yoga class and 32-40 minutes on other days (avg 2.2 to 3 miles). I try to focus on a long, even stride and I do work up a sweat. More times than not, I crash afterwards, that is am way off, which I attribute to the adrenaline rush. Overall I feel better on days I walk than days I don't, although I do take 1 or 2 days off a week.

I don't have the scientific knowledge to expand on neuroplasticity, but my belief is in addition to slowing down the demise of dopamine neurons, the exercise is helping generate new brain cells and perhaps new neural connections to compensate (like in stroke recovery).

jimcaster in reply to PDGal4

Congratulations! Exercise seems to be the only universally accepted way to slow progression.

An attempt of logic in giving a foundation that is of orientation I had done in old post that then I removed in which I said to divide the problem in Function and Structure where the Function determines the Structure.I know that the thing will seem lunar, but anyway the principle is present: every organ of the human body has a function that it carries out through a particular structure. For example, the kidneys purify the blood with a structure that can filter it. This subdivision brings us an unexplored territory and places this science fiction principle: if the damaged brain structure influences the movement, will the reverse line also work? In other words, will the forced movement of physical exercise (function) influence the brain structure over time, repairing it? This is science fiction, or something that in ancient Greece would be called meta-biology. I apologize, I only dreamed that it was possible. :-)

I retired one week ago. People who retire should have plans in place so you have something to do. I was in denial about retirement. So now all I do is plan my day around exercise. I'm 63. The standard for maximum heart rate is 220 minus one's age. That's 157 for me. Exercising at 90% of MHR is 141. At 85% it's 133. At 80% it's 125. I wear a heart rate monitor while exercising. I know how hard to run on a treadmill to reach 90%, I'm learning how much to do to reach 80% while lifting weights. Short answer; do squats not pushups. Do a lot of core work to keep your back strong enough to tolerate heavy squats.

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