This randomized controlled trial will investigate the effects of a 12-week supervised aerobic training program on cerebrovascular function, peripheral vascular health, cardiovascular autonomic modulation, cognition, non-motor symptoms, sleep, mood, gait biomechanics, quality of life, and body composition in patients with Parkinson's disease (Hoehn \& Yahr stages 1-3). Participants will be randomly allocated to aerobic training or usual care.
Clinical diagnosis of Parkinson's disease
Hoehn & Yahr stages 1-3
Stable antiparkinsonian medication for at least 4 weeks
Montreal Cognitive Assessment (MoCA) score ≥ 18
Change in medication
Contraindication to exercise
Parallel
Aerobic training
BehavioralAerobic Exercise Training
Usual Care
BehavioralUsual Care
Change in Cerebrovascular Reactivity
Breath-holding index (dimensionless) assessed by transcranial Doppler
Change in Neurovascular Coupling at 12 Weeks.
Measured by relative (%) changes in middle cerebral artery blood flow velocity during standardized cognitive tasks (Stroop Color-Word Test, Trail Making Test A and B, and silent reading protocol) using transcranial Doppler ultrasound.
Change in Dynamic Cerebral Autoregulation
Transfer function gain and phase (0.02-0.4 Hz frequency bands).
Change in Acute Cerebral Blood Flow Response to Exercise
Change in middle cerebral artery velocity during 6-minute aerobic bout.
Change in Brachial Artery Endothelial Function
Flow-mediated dilation (FMD, %) of the brachial artery assessed by high-resolution vascular ultrasound according to current guidelines.
Change in Brachial Artery Baseline Diameter
Resting brachial artery diameter (mm) measured by vascular ultrasound
Change in Carotid Intima-Media Thickness
Common carotid artery intima-media thickness (mm) assessed by B-mode ultrasound.
Change in Resting Blood Pressure
Systolic and diastolic blood pressure (mmHg).
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Raphael Mendes Ritti Dias
Lead sponsor
University of Nove de Julho
Sponsor institution
