A new study has revealed that people with Parkinson's disease benefit from exercise programs on stationary bicycles, with the greatest effect for those who pedal faster.

Functional connectivity magnetic resonance imaging (fcMRI) data showed that faster pedaling led to greater connectivity in brain areas associated with motor ability.

Exercise is thought to have beneficial effects on Parkinson's disease. Jay L. Alberts, Ph.D., neuroscientist at the Cleveland
Clinic Lerner Research Institute in Cleveland, saw this firsthand in 2003 when he rode a tandem bicycle across Iowa with a Parkinson's disease patient to raise awareness of the disease. The patient experienced improvements in her symptoms after the ride.

As part of this inquiry, Dr. Alberts, researcher Chintan Shah, B.S., and their Cleveland Clinic colleagues, recently used fcMRI to study the effect of exercise on 26 Parkinson's disease patients.

"By measuring changes in blood oxygenation levels in the brain, fcMRI allows us to look at the functional connectivity between
different brain regions," Shah said.

The patients underwent bicycle exercise sessions three times a week for eight weeks. Some patients exercised at a voluntary
level and others underwent forced-rate exercise, pedaling at a speed above their voluntary rate. The researchers used a modified exercise bike to induce forced-rate activity.

fcMRI was conducted before and after the eight weeks of exercise therapy and again as follow-up four weeks later. The research team calculated brain activation and connectivity levels from the fcMRI results and correlated the data with average pedaling rate.

Results showed increases in task-related connectivity between the primary motor cortex and the posterior region of the brain's thalamus. Faster pedaling rate was the key factor related to these improvements, which were still evident at follow-up.

"The results show that forced-rate bicycle exercise is an effective, low-cost therapy for Parkinson's disease," Shah said.

Dr. Alberts noted that that while faster pedaling led to more significant results, not all Parkinson's patients need to do forced-rate exercise to see improvement.
"We're now looking at this phenomenon in patients with exercise bikes in their home," he said, "and other exercises like
swimming and rowing on tandem machines may provide similar benefits."

The finding was presented at the annual meeting of the Radiological Society of North America (RSNA).