OBJECTIVE: To determine whether physical activity may affect cognitive performance in patients with Parkinson's disease by measuring reaction times in patients participating in the Berlin BIG study. DESIGN: Randomized controlled trial, rater-blinded. SETTING: Ambulatory care. PARTICIPANTS: Patients with mild to moderate Parkinson's disease (n = 60) were randomly allocated to 3 treatment arms. Outcome was measured at the termination of training and at follow-up 16 weeks after baseline in 58 patients (completers). INTERVENTIONS: Patients received 16 hours of individual Lee Silverman Voice Treatment-BIG training (BIG; duration of treatment, 4 wk), 16 hours of group training with Nordic Walking (WALK; duration of treatment, 8 wk), or nonsupervised domestic exercise (HOME; duration of instruction, 1 hr). MAIN OUTCOME MEASURES: Cued reaction time (cRT) and noncued reaction time (nRT). RESULTS: Differences between treatment groups in improvement in reaction times from baseline to intermediate and baseline to follow-up assessments were observed for cRT but not for nRT. Pairwise t test comparisons revealed differences in change in cRT at both measurements between BIG and HOME groups (intermediate -52 ms; 95% confidence interval (CI) -84 to -20; p = 0.002; follow-up 55 ms; CI -105 to -6; p = 0.030) and between WALK and HOME groups (intermediate -61 ms; CI -120 to -2; p = 0.042; follow-up -78 ms; CI -136 to -20; p = 0.010). There was no difference between BIG and WALK groups (intermediate 9 ms; CI -49 to 67; p = 0.742; follow-up 23 ms; CI -27 to 72; p = 0.361). CONCLUSION: Supervised physical exercise with Lee Silverman Voice Treatment-BIG or Nordic Walking is associated with improvement in cognitive aspects of movement preparation.

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