# Exploring the molecular mechanisms by which exercise improves cognitive impairment in Parkinson’s disease based on the brain-gut microbiota axis: bibliometrics and visualization analysis

## TL;DR

This study uses bibliometric analysis to explore how exercise improves cognitive impairment in Parkinson’s disease by affecting the brain-gut microbiota axis.

## Contribution

The novel contribution is a systematic bibliometric analysis of how exercise influences cognitive dysfunction in PD through the brain-gut microbiota axis.

## Key findings

- Exercise can regulate intestinal flora and its metabolites, potentially improving cognitive function in PD.
- The USA led in research output, with a peak in publications in 2022.
- Research hotspots include mild cognitive impairment and aerobic exercise.

## Abstract

Parkinson’ s disease (PD) is a common neurodegenerative disease, and its cognitive impairment, as an important non-motor symptom, seriously affects the quality of life of patients. In recent years, the brain-gut flora axis, as a key pathway connecting the central nervous system(CNS) and intestinal microecology, has gradually become the forefront of research on cognitive dysfunction in PD. A large number of studies have shown that the imbalance of intestinal flora is closely related to the occurrence of cognitive impairment in PD, revealing molecular mechanisms such as inflammatory response, neurotransmitter metabolism, and immune regulation. As a safe and effective non-drug intervention, exercise can regulate the structure of intestinal flora and its metabolites, activate relevant signaling pathways, exert a neuroprotective effects, and improve cognitive function. In view of the large increase in related research in recent years, this study aims to use bibliometric methods to systematically review the global research status and trends of exercise treatment for cognitive dysfunction in PD patients, focusing on analyzing the relevant mechanisms of how exercise intervention interferes with Parkinson’ s cognitive ability by affecting the intestinal microecology. To explore the synergistic effect of exercise and intestinal flora regulation and its potential therapeutic value. This review aims to provide a new perspective on the pathological mechanism of cognitive impairment in PD and provide scientific basis for the optimization of exercise intervention strategies.

Literature related to exercise and cognitive dysfunction in PD published between 1999 and 2024 was searched in the Science Citation Index Expanded (SCIE) and Social Science Citation Index (SSCI) databases based on the Web of Science Core Collection (WoSCC). Bibliometric analysis was performed using VOSviewer and CiteSpace software to analyze data on countries, institutions, authors, journals, keywords, citations, and to generate visual maps.

Among 332 publications, annual output peaked in 2022. The USA led in publications (n = 117). Key institutions included Eberhard Karls University of Tübingen. Research hotspots centered on mild cognitive impairment, dementia, and aerobic exercise. Emerging trends include home-based interventions and basal ganglia mechanisms.

This study aims to use bibliometric methods to systematically review the global research status and trends of exercise treatment for cognitive dysfunction in PD patients, focusing on analyzing how exercise intervention affects the intestinal microecology and its interaction with the central CNS, exploring the synergistic effect of exercise and intestinal flora regulation and its potential therapeutic value, and providing a new perspective and path for understanding the intervention of cognitive impairment in PD.