Physical activity and network attack tolerance preserve motor function in Parkinson’s disease: A pilot study

We tested whether network resilience, quantified by network attack tolerance (NAT), is associated with dopamine terminal (DaT) integrity, motor function and lifestyle factors in Parkinson's disease (PD). Data from 22 individuals with PD and 39 healthy controls included information on lifetime physical activity (PA), cognitive/motor performance, putaminal DaT integrity, and resting-state fMRI. NAT was assessed at global and subnetwork level by calculating global efficiency upon iterative node removal. Linear-mixed-effects models were used to test the effects of PA, education, and dopamine integrity on NAT. Next, the moderating effect of lifestyle factors on the association between NAT and motor function were assessed, controlling for DaT integrity. Greater putaminal DaT integrity was linked to higher somatomotor NAT. Higher global and somatomotor NAT supported motor function, especially in patients with moderate lifetime PA. These preliminary results indicate that lifestyle factors serve network-specific attack tolerance, thereby aiding maintenance of motor function in early-stage PD.