Objective: To measure both resting energy expenditure rate (REER) and energy expenditure during mild to moderate exercise in patients with early Parkinson’s disease (PD) that are not using levodopa.

Background: Contradictory observations exist regarding the effect of PD on the REER. While some studies showed increased REER among patients with PD, other studies did not find such a difference. Moreover, energy expenditure during exercise in PD was hardly studied. Understanding of these processes is of great importance in order to explain weight loss in early PD.

Methods: We recruited 7 male patients with mild PD who did not receive levodopa and 4 healthy, age and BMI matched controls. Subjects using medications that affect metabolic rate (such as beta-blockers) were excluded. Energy expenditure was calculated based on determining oxygen consumption using a metabolic cart at three different states – resting, unloaded cycling and cycling against a constant load of 40 watt.

Results: In contrast with previous studies, in our cohort there was no difference in the REER between patients with PD and controls (t-test, p=0.98). On the other hand, during both unloaded and constant load cycling in patients with PD, there was a trend for higher energy expenditure, compared with control subjects (t-test, p=0.07 for both conditions). For both groups respiratory exchange ratio (RER) did not exceed 1.0 during constant load effort thus confirming that steady state conditions below anaerobic threshold were maintained.

Conclusions: Unlike what was previously thought, weight loss in the early stages of PD does not seem to result from increased REER. Our work suggests that increased energy expenditure during physical activity among patients with PD may contribute to the weight loss seen in early stages of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/increased-energy-expenditure-in-early-parkinsons-disease-during-exercise/