Exercise Intervention for REM Sleep Behavior Disorder in Parkinson's Disease: Mechanisms and Implications for Neurorehabilitation

Jun 15, 2026CNS neuroscience & therapeutics

Exercise for REM Sleep Behavior Disorder in Parkinson's Disease: How It Works and What It Means for Brain Recovery

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

Exercise may enhance α-syn clearance and provide neuroprotective effects for individuals with REM sleep behavior disorder (RBD).

RBD affects approximately 30%-60% of patients with Parkinson's disease.
Multiple mechanisms through which exercise may exert neuroprotective effects for RBD include enhancing α-syn clearance.
Exercise may also regulate neurocircuits and circadian rhythms.
Modulation of oxidative stress and mitochondrial function could be another pathway through which exercise benefits RBD.
Reduction of neuroinflammation is associated with exercise interventions for RBD symptoms.

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BACKGROUNDS: REM sleep behavior disorder (RBD) is a prodromal non-motor symptom of Parkinson's disease (PD) and other α-synucleinopathies, affecting approximately 30%-60% of PD patients. It is closely associated with α-synuclein (α-syn) aggregation, with its primary pathophysiology involving the impairment of brainstem circuits, resulting in movement disorders and circadian rhythm dysfunction. Although exercise is recognized for improving motor symptoms and delaying neurodegenerative disease progression, a comprehensive framework of its underlying mechanisms for RBD symptoms has not yet been thoroughly analyzed.

METHODS: This review examines current literature and evidence regarding the various mechanisms and neuroprotective effects of exercise interventions specifically targeting RBD and its associated symptoms.

RESULTS: Exercise exerts neuroprotective effects for RBD through multiple underlying mechanisms. The analysis highlights key pathways, including the enhancement of α-syn clearance, the regulation of neurocircuits and circadian rhythms, the modulation of oxidative stress and mitochondrial function, and the reduction of neuroinflammation.

CONCLUSION: Exercise demonstrates significant potential as a multi-targeted intervention. By addressing these underlying pathophysiological mechanisms, exercise provides supportive benefits that may positively influence the disease trajectory for patients with RBD and PD.

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Exercise Intervention for REM Sleep Behavior Disorder in Parkinson's Disease: Mechanisms and Implications for Neurorehabilitation

Abstract

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