Effects of exercise modalities on cognitive function and depression in patients with Parkinson's disease: A systematic review and network meta-analysis.

OBJECTIVE

Cognitive impairment and depression are common non-motor symptoms in individuals with Parkinson's disease (PD), often leading to a significant decline in quality of life. Although exercise has been recognized as a promising non-pharmacological intervention, the relative effectiveness of different exercise modalities on cognitive and emotional outcomes remains unclear.

METHODS

A systematic search was conducted in Web of Science, PubMed, EmBase, Cochrane Library, and SPORTDiscus for randomized controlled trials (RCTs) published up to November 10, 2024. Studies evaluating the effects of exercise on cognitive function and depressive symptoms in PD patients were included. Both paired meta-analysis and network meta-analysis (NMA) were performed to compare the efficacy of different exercise modalities.

RESULTS

A total of 34 RCTs were included. Virtual reality training showed the highest efficacy in improving global cognitive function, while dance was the most effective for alleviating depressive symptoms. Resistance training demonstrated the greatest benefits for enhancing quality of life. Subdimension analysis revealed that different modalities exerted specific effects across cognitive and emotional domains.

CONCLUSIONS

This study provides comprehensive evidence that multiple exercise modalities can effectively improve cognitive function, depressive symptoms, and quality of life in individuals with PD. Each modality exhibits domain-specific advantages, underscoring the importance of individualized exercise prescriptions. While preliminary findings also suggest potential benefits of combining exercise with cognitive training for further enhancing quality of life, this requires confirmation in future targeted studies.