Integrative Functional Network Interactions Underlie the Association between Physical Activity and Cognition in Neurodegenerative Diseases

Abstract

Physical activity (PA) has preventive and possibly restorative effects in aging-related cognitive decline, which relate to intrinsic functional interactions (functional connectivity, FC) in large-scale brain networks. Preventive and ameliorative effects of PA on cognitive decline have also been documented in neurodegenerative diseases, such as Parkinson's disease (PD). However, the neural substrates that mediate the association between PA and cognitive performance under such neurological conditions remain unknown. Here we set out to examine if the association between PA and cognitive performance in PD is mediated by FC in large-scale sensorimotor and association brain networks. Data from 51 PD patients were analyzed. Connectome-level analysis based on a whole-brain parcellation showed that self-reported levels of PA were associated with increased FC between, but not within the default mode (DMN) and salience networks (SAL) (p < .05, false discovery rate corrected). Additionally, multiple parallel mediation analysis further demonstrated that FC between left lateral parietal nodes in the DMN and rostral prefrontal nodes in the SAL mediated the association between PA and executive function performance. These findings are in line with previous studies linking FC in large-scale association networks with the effects of PA on cognition in healthy aging. Our results extend these previous results by demonstrating that the association between PA and cognitive performance in neurodegenerative diseases such as PD is mediated by integrative functional interactions in large-scale association networks.