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The Interplay between Genetics and Aerobic Exercise to Slow Parkinson's disease (GEARS) Trial

Award Number: R01NS132437
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/18/2024
PERIOD OF PERFORMANCE END DATE: 12/31/2028

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The Interplay between Genetics and Aerobic Exercise to Slow Parkinson's disease (GEARS) Trial - PROJECT SUMMARY/ABSTRACT Despite advances in pharmaceutical and surgical approaches to the treatment of Parkinson’s disease (PD), an effective disease modifying treatment remains elusive. A growing body of evidence supports the notion that high intensity aerobic exercise, when delivered in a highly supervised, well-controlled laboratory setting, improves PD symptomology. Despite community exercise being recommended by the American Physical Therapy Association, high intensity aerobic exercise performed in a community-setting is not supported by third party payors and therefore not delivered by physical therapists. The aim of this project is to address two fundamental gaps related to the widespread utilization of exercise to modify PD: 1) are community-based exercise programs effective in altering disease progression? and 2) what is the role of genetics in modulating the disease altering effects of high intensity aerobic exercise? Our underlying hypothesis is that high-intensity community-based exercise is effective in slowing disease progression in PD and those positive effects are more likely to occur in individuals with a lower genetic biological burden. The proposed multi-site, Genetics and Aerobic Exercise to Slow (GEARS) PD trial will determine the interplay between genetics and exercise in altering PD progression. A total of 250 individuals with PD will be enrolled in Pedaling for Parkinson’s (PFP) programs across six locations in NE Ohio and Salt Lake City. The PFP exercise protocol is rooted in our established and effective laboratory-based exercise protocol for PD (e.g. exercise at 60-80% of heart rate reserve and strive to pedal at 75 RPMs). The PFP community group will exercise 3 times per week for 12 months. A novel and efficient aspect of the GEARS Trial is the leveraging of PD control data (n=125) from Dr. Alberts’ CYCLE-II RCT (2R01NS073717; enrollment completed March 2022). Identical clinical and biomechanical data characterizing motor and non-motor function will be gathered from the PFP group to match historical control outcomes. Genetic burden for PD will be determined for all 375 PD patients by determining the PD polygenic risk score. Aims 1-3 will determine the disease altering potential of community-based exercise using clinical and biomechanical outcomes reflective of motor and non-motor performance. A prognostic model will be developed in Aim 4 to predict what factors are important in modulating the beneficial effects of exercise on slowing disease progression. The model will facilitate understanding of the interplay of genetics, aerobic exercise, and disease progression and serve as a non-incremental step in the development of patient-specific exercise recommendations in which potential outcomes can be estimated. Demonstrating the effectiveness of a community-based exercise program, that can be scaled for minimal cost, will bring an effective intervention to PD patients that is not impacted by the healthcare reimbursement policy and politics.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $613,860 )
2026	2026	CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY	9500 EUCLID AVE.	CLEVELAND	OH	44195	CUYAHOGA	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	3	2/28/2026	NON-COMPETING CONTINUATION	$61,387
2026	2026	CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY	9500 EUCLID AVE.	CLEVELAND	OH	44195	CUYAHOGA	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	1/31/2026	NON-COMPETING CONTINUATION	$552,473
														Subtotal = $613,860

Issue Date FY: 2025 ( Subtotal = $552,473 )
2025	2025	CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY	9500 EUCLID AVE.	CLEVELAND	OH	44195	CUYAHOGA	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	1/10/2025	NON-COMPETING CONTINUATION	$552,473
														Subtotal = $552,473

Issue Date FY: 2024 ( Subtotal = $657,657 )
2024	2024	CLEVELAND CLINIC LERNER COLLEGE OF MEDICINE OF CASE WESTERN RESERVE UNIVERSITY	9500 EUCLID AVE.	CLEVELAND	OH	44195	CUYAHOGA	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	1/17/2024	NEW	$657,657
														Subtotal = $657,657

Grand Total All Awards = $1,823,990

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The Interplay between Genetics and Aerobic Exercise to Slow Parkinson's disease (GEARS) Trial

Award Number: R01NS132437

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/18/2024

PERIOD OF PERFORMANCE END DATE: 12/31/2028

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