Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Function Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
Neural Plast. 2020 Mar 5;2020:8961493. doi: 10.1155/2020/8961493. eCollection 2020.
Parkinson's disease (PD) is a neurodegenerative disorder for which there is currently only symptomatic treatment. During the last decade, there has been an increased interest in investigating physical exercise as a neuroprotective mechanism in PD. Animal studies have suggested that exercise may in fact induce neuroplastic changes, but evidence in humans is still scarce. A handful of reviews have previously reported on exercise-induced neuroplasticity in humans with PD, but few have been systematic, or have mixed studies on both animals and humans, or focused on one neuroplastic outcome only. Here, we provide a systematic review and metasynthesis of the published studies on humans in this research field where we have also included different methods of evaluating neuroplasticity. Our results indicate that various forms of physical exercise may lead to changes in various markers of neuroplasticity. A narrative synthesis suggests that brain function and structure can be altered in a positive direction after an exercise period, whereas a meta-analysis on neurochemical adaptations after exercise points in disparate directions. Finally, a GRADE analysis showed that the current overall level of evidence for exercise-induced neuroplasticity in people with PD is very low. Our results demonstrate that even though the results in this area point in a positive direction, researchers need to provide studies of higher quality using more rigorous methodology.
帕金森病（PD）是一种神经退行性疾病，目前仅对症治疗。在过去的十年中，人们越来越关注将体育锻炼作为 PD 的神经保护机制进行研究。动物研究表明，锻炼实际上可能诱导神经可塑性变化，但人类的证据仍然很少。以前有一些综述报告了 PD 患者的锻炼诱导的神经可塑性，但很少有系统的综述，或者混合了动物和人类的研究，或者只关注一种神经可塑性结果。在这里，我们对该研究领域中人类的已发表研究进行了系统回顾和荟萃分析，我们还纳入了不同的神经可塑性评估方法。我们的结果表明，各种形式的体育锻炼可能会导致神经可塑性的各种标志物发生变化。叙述性综合表明，在锻炼期后，大脑功能和结构可以朝着积极的方向改变，而关于锻炼后神经化学适应性的荟萃分析则指向不同的方向。最后，GRADE 分析表明，目前 PD 患者锻炼诱导的神经可塑性的总体证据水平非常低。我们的研究结果表明，尽管该领域的结果指向积极的方向，但研究人员需要使用更严格的方法提供更高质量的研究。
