# The impact of exercise on subthalamic nucleus neural activity in Parkinson's disease

> **NIH NIH R21** · CLEVELAND CLINIC LERNER COM-CWRU · 2022 · $201,250

## Abstract

PROJECT SUMMARY/ABSTRACT
Parkinson’s disease (PD) is the fastest growing neurological disease, outpacing even Alzheimer’s disease.
Aerobic exercise is universally accepted as an integral part of PD treatment, and stationary cycling in particular
has been suggested to be an ideal exercise modality for people with PD. Our seminal tandem cycling study
was the first to utilize forced exercise (FE) in human PD patients and demonstrate a 30% improvement in
clinical ratings compared to voluntary exercise (VE) at a self-selected rate. FE is a mode of high intensity
aerobic exercise originating in animal models of PD in which the voluntary pedaling rate (cadence) of exercise
is augmented, but not replaced. Aerobic exercise, including FE, has demonstrated potential as a disease-
modifying intervention; however, in order to truly examine disease-modification, the mechanism of action must
be evaluated. Hypersynchrony of motor circuits within the basal ganglia is associated with cardinal motor signs
such as bradykinesia, tremor, and rigidity in individuals with PD. Recent animal studies using FE evaluated
local field potentials (LFP) from the primary motor cortex (M1) and reported an attenuation of neural
hypersynchrony in the beta (13-35Hz) frequency band associated with improved motor function. Until now,
neural activity from the basal ganglia has been isolated to animal models or highly invasive human studies
where the deep brain stimulator (DBS) wires have been externalized. Recently, advances in DBS technology in
humans allows, for the first time, direct neural activity recording from the subthalamic nucleus (STN) of the
basal ganglia in individuals implanted with the Medtronic Percept DBS system. This project aims to record
neural activity from the STN during two modes, FE and VE, in individuals with PD. Our underlying
hypothesis is that high intensity exercise reduces STN hypersynchrony which facilitates cortico-basal
ganglia thalamocortical circuit functionality thereby improving motor function following exercise.
Fifteen PwPD who have previously undergone DBS surgery utilizing the Percept system will complete a single
FE and VE exercise session on a stationary cycle while off antiparkinsonian medication. Bilateral neural activity
of the STN will be continuously recorded for approximately 130 minutes total (pre-exercise, during FE or VE
and post-exercise) on two separate days. The MDS-UPDRS III Motor Exam and an upper extremity grip force
tracking paradigm will be used to determine motor response to exercise. While we expect improvements in
performance and attenuation in beta band activity following a single bout of FE and VE, it is hypothesized that
FE will experience superior results due to the higher cycling cadence resulting in greater beta attenuation.

## Key facts

- **NIH application ID:** 10538708
- **Project number:** 1R21NS129147-01
- **Recipient organization:** CLEVELAND CLINIC LERNER COM-CWRU
- **Principal Investigator:** JAY L. ALBERTS
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $201,250
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10538708

## Citation

> US National Institutes of Health, RePORTER application 10538708, The impact of exercise on subthalamic nucleus neural activity in Parkinson's disease (1R21NS129147-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10538708. Licensed CC0.

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