AzTrials
AzTrials

Parkinson DiseaseMOVE-ON_WP1NCT06977204

Physical Activity on Neuroinflammation in Parkinson's Disease

An observational study of Parkinson Disease and Physical Inactivity, run by IRCCS National Neurological Institute "C. Mondino" Foundation at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Parkinson's Disease (PD) is a chronic progressive neurodegenerative disorder clinically defined by the association of resting tremor, rigidity, bradykinesia, and postural instability. Read more about this study

Who is it for?
Ages 40 to 80 years
How many people
40 participants
Where
1 siteItaly
Study dates
1 Jan 2023to 1 Jun 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The study population consists of individuals diagnosed with Parkinson's disease, but without other clinically relevant medical conditions. PD-sport group: this population will include a group of PD subjects who regularly performed a high-intensity and regular physical activity (based on IPAQ questionnaire). PD-sedentary group: this population will include a group of PD subjects who did not regularly performed regular physical activity (based on IPAQ questionnaire). The absence of other pathological and voluptuary condition is intended to reduce to possible biases of confounders on the inflammatory status.

Who may be able to join

  • Subjects of both sexes, aged between 40 and 80 years (extremes included)
  • Diagnosis of Parkinson's disease according to the clinical diagnostic criteria of the Movement Disorder Society
  • Hoehn \& Yahr between 1 and 3

Who cannot join

  • Concomitant diagnosis of other neurological diseases
  • Presence of confirmed cognitive decline (MMSE < 24)
  • Presence of depression with (BDI > 40)
  • Patients with deep brain stimulation implant or undergoing DuoDopa therapy
  • Presence of significant diseases affecting the musculoskeletal system
  • Presence of internal medicine conditions, considered clinically significant by the investigator
Show all 11Show fewer
  • Acute or recent infections
  • Body Mass Index (BMI) >= 30
  • Active smoking behavior
  • Ongoing treatment with N-acetylcysteine or anti-oxidants
  • Pregnancy or lactation

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Italy1 site, 1 recruiting
  • IRCCS Mondino Foundation

    Pavia, Pavia, 27100

    Roberto De Icco, +390382380425, roberto.deicco@mondino.it

    Recruiting

Other trials in Italy

About this study

Official title: Role of Physical Activity on Neuroinflammation in Parkinson's Disease

Parkinson's Disease (PD) is a chronic progressive neurodegenerative disorder clinically defined by the association of resting tremor, rigidity, bradykinesia, and postural instability. The histopathology of PD is characterized by the loss of neurons in the substantia nigra pars compacta (SNPc) and the accumulation of α-synuclein aggregates within Lewy bodies. The pathogenic mechanisms underlying the development of the disease, however, are not yet fully understood: genetics, cellular oxidative stress, mitochondrial dysfunction, environmental factors, and neuroinflammation are all potential mechanisms involved in the pathogenesis of PD.

Several studies have now established the involvement of neuroinflammation in the pathogenesis of PD. It is known that α-synuclein aggregates stimulate microglia and astroglia to secrete pro-inflammatory mediators such as IL 1β, IL6, and TNFα. These molecules activate an inflammatory response characterized by altered blood-brain barrier permeability, leukocyte recruitment, and the expression of other pro-inflammatory cytokines. These events contribute to exposing neurons to oxidative stress and cellular damage. Additionally, cellular damage induces neurons to stimulate the release of DAMPs (Damage Associated Molecular Patterns), which in turn activate glial cells. This creates a state of chronic inflammation that could play a role in the progression of the disease. Supporting this hypothesis, elevated levels of IL1β, IL6, and TNFα have been found in the striatum and SNPc of post-mortem PD samples.

Read more

The transcription factor Nrf2 is one of the main regulators of cellular protection in response to stress (inflammation, redox, xenobiotics). Nrf2 promotes the expression of several genes that cooperate in a cytoprotective response, which includes antioxidant defense, resolution of inflammation, increased mitochondrial activity, and protein turnover. Recent clinical studies seem to confirm the hypothesis that Nrf2 plays a role in the pathogenesis of PD, as already suggested by preclinical models. Specifically, altered plasma levels of the Nrf2-activated pathway have been observed in preclinical models.

Studies conducted on animal models of PD have hypothesized how exercise might correlate with protective mechanisms and might promote neuroplasticity and neuro-regeneration, especially when practiced at high intensity. Physical exercise can indeed modulate various systems (including inflammatory pathways and oxidative stress) that regulate neuroinflammation and glial activation. However, the available results are not definitive and often focus on single and separate aspects of the disease.

The aim of the study is to investigate the beneficial effect of physical exercise in patients with Parkinson's Disease (PD). Literature already suggests an improvement in various domains of motor and non-motor aspects, as well as in the overall quality of life, of PD patients even after a period of aerobic activity. Generally, training periods included 3-4 sessions per week of 40-60 minutes each for 4-16 weeks. In general, the literature describes the effects of moderate physical training, while little or nothing is known about how PD is affected by high-intensity sports training.

The primary objective of our study is to compare a group of PD patients undergoing regular and constant intense exercise (PD-sport) with a control group consisting of PD patients leading a sedentary life (PD-sedentary). The primary outcome will be the difference in systemic inflammatory status between the PD-sport group and the PD-sedentary group.

Read the detailed description

Parkinson's disease (PD) is a chronic, progressive neurodegenerative disorder clinically defined by the presence of resting tremor, rigidity, bradykinesia, and postural instability. Pathologically, PD is characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and the accumulation of α-synuclein aggregates within Lewy bodies. While the precise pathogenic mechanisms underlying PD remain incompletely understood, evidence suggests a multifactorial etiology involving genetic predisposition, oxidative stress, mitochondrial dysfunction, environmental factors, and neuroinflammation.

Emerging research highlights the pivotal role of neuroinflammation in PD pathogenesis. α-Synuclein aggregates are known to activate microglia and astroglia, triggering the release of pro-inflammatory mediators such as IL-1β, IL-6, and TNF-α. This inflammatory response disrupts blood-brain barrier integrity, recruits leukocytes, and amplifies the production of other pro-inflammatory cytokines, exposing neurons to oxidative stress and cellular damage. In turn, neuronal damage promotes the release of damage-associated molecular patterns (DAMPs), perpetuating chronic inflammation. Elevated levels of IL-1β, IL-6, and TNF-α have been detected in the striatum and SNpc of post-mortem PD samples, underscoring the role of inflammation in disease progression.

The transcription factor Nrf2 is a master regulator of cellular defense mechanisms against oxidative and inflammatory stress. Nrf2 orchestrates the expression of genes involved in antioxidant defense, inflammation resolution, mitochondrial activity, and protein turnover. Clinical and preclinical studies suggest that dysregulation of the Nrf2 pathway may contribute to PD pathogenesis, as evidenced by altered plasma levels of Nrf2-regulated pathways in preclinical PD models.

Animal studies have proposed that physical exercise may confer neuroprotective effects by promoting neuroplasticity and neuro-regeneration, particularly through high-intensity training. Exercise has been shown to modulate inflammatory pathways, reduce oxidative stress, and influence glial activation. Despite promising results, most studies have focused on isolated aspects, leaving gaps in our understanding of the comprehensive effects of exercise on PD.

This study aims to investigate the beneficial effects of adapted physical exercise in patients with PD, focusing on its impact on systemic inflammation and secondary outcomes such as gait parameters, functional markers of exercise tolerance, and quality of life.

Study Design

  • Observational, case-control, study comparing regular and intense exercise (PD-sport) to a sedentary lifestyle (PD-sedentary).

Primary objective: Evaluate differences in systemic inflammatory status between PD-sport and PD-sedentary groups.

Secondary and Exploratory objective

  • Pro- and anti-inflammatory cytokines (IL-6, IL-10, IL-1β, IL-4, IL-17a, TNF-α).
  • Plasma extracellular vesicle (EV) profiles (number, size).
  • Gait parameters using inertial gait analysis.
  • Clinical tests (e.g., MET, 6MWT, UPDRS) and exercise tolerance biomarkers (e.g., VO2peak, gas exchange threshold).
  • Psychological outcomes (depression, quality of life, and pain scales).
  • Non-motor symptoms (NMS) and cognitive domain assessments.

Recruitment

Participants will be recruited at the IRCCS Mondino Foundation of Pavia, and patient associations. The study will enroll two groups:

  1. PD-sport group: Individuals engaging in moderate-to-high-intensity physical activity.
  2. PD-sedentary group: Individuals with a sedentary lifestyle. Physical activity levels will be assessed using the short version of the International Physical Activity Questionnaire (IPAQ).

Evaluation

Assessments will include:

Comprehensive clinical evaluation by a movement disorder specialist. Biochemical analysis of inflammatory markers from fasting blood samples (35 mL).

Gait analysis using the G-Walk system. Cognitive and psychological evaluations. Exercise tolerance indices measured via cardiopulmonary exercise testing.

Keywords
Physical activity, Neurological disorder, Neuroinflammation
Medical subject headings
Parkinson Disease, Sedentary Behavior, Motor Activity, Nervous System Diseases, Neuroinflammatory Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT06977204
Study groupRoleWhat they receive
PD-SPORTIn PD-SPORT group the investigators aim to enroll subjects affected by Parkinson's Disease who regularly performed intensive physical activity. For the purpose of this study, the intensive physical activity is defined by the International Physical Activity questionnaire (IPAQ).
PD-SEDENTARYIn PD-SEDENTARY group the investigators aim to enroll subjects affected by Parkinson's Disease who did not regularly performed intensive physical activity. For the purpose of this study, the intensive of physical activity is defined by the International Physical Activity questionnaire (IPAQ).

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Set of serum pro-inflammatory and anti-inflammatory cytokines

    the investigators will dose a set of of pro-inflammatory and anti-inflammatory cytokines in the serum, namely interleukin 1β (IL-1β), interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 6 (IL-6), interleukin 10 (IL-10), interleukin 12 (IL-12), tumor necrosis factor alpha (TNF-alpha), and interferon (IFN).

    Measured: Single evaluation at baseline

Secondary outcomes (14)
  1. Time Up and Go test

    Time Up and Go test (continuous variable with units of measurement: second)

    Measured: Single evaluation at baseline

  2. Inertial Gait Analysis

    Gait analysis performed Inertial Measeurement Units to assess spatio-temporal variables ( continuous variables: m/s)

    Measured: Single evaluation at baseline

  3. Inertial Gait Analysis

    Gait analysis performed Inertial Measeurement Units to assess trunk acceleration-derived gait indexes ( continuous variables without measure unit)

    Measured: Single evaluation at baseline

  4. 5 Sit to Stand Test

    Sit to Stand Test (continuous variable with units of measurement: second)

    Measured: Single evaluation at baseline

  5. Hand Grip Test

    Hand Grip Test (continuous variable with units of measurement: N)

    Measured: Single evaluation at baseline

  6. Incremental Maximal Test

    Peak oxygen consumption (continuous variable with units of measurement: ml/kg/min)

    Measured: Single evaluation at baseline

  7. Geriatric depression scale-30

    Geriatric depression scale-30 (continuous variable, score ranging from 0 to 30 with higher scores indicating more severe depression)

    Measured: Single evaluation at baseline

  8. The Parkinson's Disease Questionnaire PDQ-39

    Parkinson's Disease Questionnaire (continuous variable, score ranging from 0 to 156 with higher scores indicating more severe disability)

    Measured: Single evaluation at baseline

  9. Brief Pain Inventory (BPI)

    Brief Pain Inventory (BPI) (continuous variable, score ranging from 0 to 10 with higher scores indicating more severe disability)

    Measured: Single evaluation at baseline

  10. King's PD pain scale (KPPS)

    King's PD pain scale (KPPS) (continuous variable, score ranging from 0 to 168 with higher scores indicating more severe pain)

    Measured: Single evaluation at baseline

  11. Pain Detect

    Pain Detect (continuous variable, score ranging from -1 to 38 with higher scores indicating a more probable neurotic pain)

    Measured: Single evaluation at baseline

  12. Peak work rate

    Peak work rate (continuous variable with units of measuremente: w)

    Measured: Single evaluation at baseline

  13. Peak heart rate

    Peak heart rate (continuous variable with units of measuremente: b/min)

    Measured: Single evaluation at baseline

  14. Gas exchange threshold

    Gas exchange threshold (continuous variable with units of measuremente: l/min)

    Measured: Single evaluation at baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 May 2025
  2. Study start1 Jan 2023
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion1 Jun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06977204
Sponsor's protocol ID
MOVE-ON
Acronym
MOVE-ON_WP1
Status last verified
May 2025
First submitted
28 Apr 2025
Last updated
18 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Szymura J, Kubica J, Wiecek M, Pera J. The Immunomodulary Effects of Systematic Exercise in Older Adults and People with Parkinson's Disease. J Clin Med. 2020 Jan 9;9(1):184. doi: 10.3390/jcm9010184.

    PubMed 31936624
  • Xu J, He X, Xu Y, Chen X, Li M, Zhang L, Fu X, Pan M, Wang Q, Hu X. Characteristics of systemic inflammation and brain iron deposition in Parkinson's disease patients. Ann Clin Transl Neurol. 2022 Mar;9(3):276-285. doi: 10.1002/acn3.51512. Epub 2022 Jan 25.

    PubMed 35078271
  • Pajares M, I Rojo A, Manda G, Bosca L, Cuadrado A. Inflammation in Parkinson's Disease: Mechanisms and Therapeutic Implications. Cells. 2020 Jul 14;9(7):1687. doi: 10.3390/cells9071687.

    PubMed 32674367

Questions about this trial

What is this clinical trial studying?

An observational study of Parkinson Disease and Physical Inactivity, run by IRCCS National Neurological Institute "C. Mondino" Foundation at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 18 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Roberto De Icco (+390382380425, roberto.deicco@mondino.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Set of serum pro-inflammatory and anti-inflammatory cytokines (time frame: Single evaluation at baseline). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06977204, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in