We previously reported that exercise can be a proxy for identifying PD-DBS candidates who are at risk for apathy and depression following surgery. Predictors of outcome can facilitate an understanding of compliance and care coordination needs. While mood in PD varies by sex, with men at higher risk for apathy and women at higher risk for depression, less is known about apathy and depression evolution following DBS. 

This single-center retrospective study included three groups stratified by pre-surgical exercise frequency: high (>3 times/week), moderate (2-3 times/week), low (0-1 times/week). Outcomes were assessed with postsurgical Beck Depression Inventory-II and Starkstein Apathy Scale scores, and analyzed with linear regressions. 

Patients with moderate pre-surgical exercise had less post-surgical apathy compared to those with low exercise (B= -1.02, p= .031). There was a trend toward lower apathy in those with high compared to low exercise (B= -0.75, p= .073). There was no effect of sex on apathy (B= -0.34, p= .65), and no interaction between exercise and sex on apathy (p> .5). 

There were no significant associations between presurgical exercise and postsurgical depression. Both the moderate and high exercise groups showed trends toward lower depression compared to the low exercise group (B= -0.51, p= .28; B= -0.43, p= .30, respectively). There was no effect of sex on depression (B= .84, p=0.26), and no interaction between exercise and sex on depression (p> .3). 

Lower presurgical exercise engagement is associated with greater post-DBS apathy in PD. Higher presurgical exercise trended toward lower depression. These relationships were not influenced by sex.