{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:02:27Z","timestamp":1790650947838,"version":"4.1.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Medical disease-modifying treatments are lacking in Parkinson\u2019s disease (PD). Physical exercise is potentially an inexpensive and easily accessible disease-modifying therapy, but this remains to be studied using recent promising magnetic resonance imaging (MRI) markers of disease progression. The objective was to determine whether 24\u2009weeks of moderate to high-intensity progressive aerobic exercise affects brain MRI measures in people with PD (pwPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A 24-week randomized controlled multicenter trial (with a 24-week follow-up) was conducted, including an exercise group (supervised aerobic exercise followed by self-guided physical activity) and a control group (habitual lifestyle). Patients older than 40\u2009years with mild to moderate impairments (Hoehn &amp; Yahr score \u22643) were randomized (1:1). The primary outcome was R2* (effective transverse relaxation rate) after 24\u2009weeks, which was analyzed using the intention-to-treat principle. Additional outcomes included free water and neuromelanin levels in the substantia nigra, cardiorespiratory fitness, the Movement Disorder Society-sponsored Revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS), and levodopa equivalent daily dose (LEDD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventy participants were randomized to exercise (n\u2009=\u200936) or control (n\u2009=\u200934). R2* did not change over the intervention period (between-group difference: \u22121.14 [\u22125.14; 2.87], mean [95%CI]). Similarly, no significant effects were seen in cardiorespiratory fitness (+1.64\u2009mL O2\/min\/kg [\u22120.23; 3.51]) and MDS-UPDRS III (\u22120.7 [\u22125.3; 4.0]), whereas LEDD increased less following exercise (\u221278.4 [\u2212154.6; \u22122.1]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings do not support a neuroprotective effect of progressive aerobic exercise on R2* in pwPD, whereas the intervention appears to benefit the efficacy of levodopa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>Clinicaltrials.gov identifier: NCT04379778.<\/jats:p>\n                  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