Neural Mechanisms of Aerobic Exercise Benefits in PD With DBS

This study is focused on people with Parkinson's disease who already have deep brain stimulation devices. The goal is to understand how aerobic exercise, specifically forced vs voluntary cycling, affects movement, thinking, and brain activity in these individuals. Parkinson's disease is a progressive condition that impacts both movement and cognitive function. Previous research suggests aerobic exercise can improve PD symptoms, but the mechanisms underlying the improvement are not fully understood. This study aims to evaluate the neural (brain) mechanisms underlying exercise.

Inclusion Criteria: * Clinical diagnosis of Parkinson's disease * Previous placement of bilateral Medtronic Percept DBS as standard of care treatment for PD * Clinically optimized DBS parameters for one month prior to enrollment * Ability to ambulate with or without an assistive device for 5 continuous minutes * Willingness to withhold antiparkinsonian medication and DBS stimulation for outcomes assessments Exclusion Criteria: * Neurocognitive impairment that compromises the ability to provide informed consent * Neurological disease other than Parkinson's disease (i.e. multiple sclerosis, stroke) * Recommendation for medical clearance using the American College of Sports Medicine (ACSM) Preparticipation Health Screen: 1. If the ACSM screen recommends medical clearance, the subject must obtain medical clearance by their health care provided prior to participation. 2. Those who choose not to obtain physician clearance will not be eligible for participation. Those who do not receive physician clearance for high intensity exercise will not be eligible. * A musculoskeletal issue (arthritis, osteoporosis, back problem) that would limit one's ability to engage in exercise * Current cardiac arrhythmia